Classical Paracoccidioidomycosis with skin component of lacaziosis or Jorge Lobo disease

61 year old male patient living in a rural area who presents a parakeloidean lesion of right hemi-face, that progresses with an active ulcerous, crusty, papilomatous border from the around the ear region towards the middle of the facial mass involving the outer part of the nostrils, chin, etc. The skin clinical aspect of this classical paracoccidioidomycosis that is very similar to lacaziosis or keloid paracoccidioidomycosis, or in other words, Jorge Lobo's disease