Phialophora verrucosa is one of several pathogenic dematiaceous fungi associated with chromomycosis and occasionally phaeohyphomycosis. Infection appears to be increasing in frequency in both immunocompromised and presumably healthy patients. Medical therapy is often difficult, and a wide variety of antifungal agents have been tried with varying degrees of success. We report a patient with acquired immunodeficiency syndrome (AIDS) and extensive cutaneous fungal infection due to Phialophora verrucosa. The disease failed to respond to ketoconazole, but regression of the lesions was obtained with itraconazole.