An 80-year-old woman has had a painful or tender, non-healing, eczematous plaque on the extensor surface of the left forearm for 4 years. A biopsy specimen revealed the characteristic thick-walled morulalike sporangia in the dermis. P. wickerha mili was isolated in the culture and the biochemical studies. Electron microscopic examination showed the thick-walled spores containing dark dense bodies and amyloplasts. Oral itraconazole therapy for 4 weeks resulted-in a marked improvement of the skin lesion.