Nilutamide, on the other hand, has always been a poor third competitor to flutamide and bicalutamide and, in relation to this fact, has not been developed as a generic and is only available as brand name Nilandron, at least in the U.S.Bicalutamide is considerably less costly than GnRH analogues, which, in spite of some having been off-patent many years, have been reported (in 2013) to typically cost US$10,000–$15,000 per year (or about US$1,000 per month) of treatment. Sales and usage
Sales of bicalutamide (as Casodex) worldwide peaked at US$1.3 billion in 2007, and it has been described as a "billion-dollar-a-year" drug prior to losing its patent protection starting in 2007. In 2014, despite the introduction of abiraterone acetate in 2011 and enzalutamide in 2012, bicalutamide was still the most commonly prescribed drug in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Moreover, in spite of being off-patent, bicalutamide was said to still generate a few hundred million dollars in sales per year for AstraZeneca. Total worldwide sales of brand name Casodex were approximately US$13.4 billion as of the end of 2018. Between January 2007 and December 2009 (a period of three years), 1,232,143 prescriptions of bicalutamide were dispensed in the U.S., or about 400,000 prescriptions per year. During that time, bicalutamide accounted for about 87.2% of the NSAA market, while flutamide accounted for 10.5% of it and nilutamide for 2.3% of it. Approximately 96% of bicalutamide prescriptions were written for diagnosis codes that clearly indicated neoplasm.
Diagnosis
Differential diagnosis
The disease is often misdiagnosed as Blastomyces dermatitidis or Paracoccidiodes brasiliensis due to its similar morphology. Treatment
Surgical excision or cryosurgery is the treatment of choice. Treatment with antifungals has been considered ineffective, but the use of clofazimine and dapsone in patients with leprosy and lobomycosis has been found to improve the latter. This treatment regimen, with concomitant itraconazole, has been used to prevent recurrence after surgery. Other animals
Lesions in dolphins occur on the dorsal fin, head, flukes, and peduncle. In January 2006, a potential epidemic of lobomycosis was reported in dolphins of the Indian River Lagoon in Florida. See also
List of cutaneous conditions

References
Further reading
Bermudez, L., M.F. van Bressem, O. Reyes-Jaimes, A.J. Sayegh & A.E. Paniz Mondolfi (2009) Lobomycosis in man and lobomycosis-like disease in bottlenose dolphin, Venezuela. Emerg. Infect. Dis., 15: 1301–1303. Carvalho, K. A. D., Floriano, M. C., Enokihara, M. M. S., & Mascarenhas, M. R. M. (2015). Jorge Lobo’s disease. Anais brasileiros de dermatologia, 90(4), 586–588. Esperon, F., D. Garcia-Parraga, E.N. Belliere & J.M. Sanchez-Vizcaino (2012) Molecular diagnosis of lobomycosis-like disease in a bottlenose dolphin in captivity. Med. Mycol., 50: 106–109. Francesconi, V. A., Klein, A. P., Santos, A. P. B. G., Ramasawmy, R., & Francesconi, F (2014) Lobomycosis: epidemiology, clinical presentation, and management options. Therapeutics and Clinical Risk Management, 10, 851. Rodríguez-Toro G (May 1993). "Lobomycosis". Int. J. Dermatol. (Review). 32 (5): 324–32. doi:10.1111/j.1365-4362.1993.tb01466.x. PMID 8505156. S2CID 221814305. Paniz-Mondolfi, A., C. Talhari, L.S. Hoffmann, D.L. Connor and S. Talhari & al. (2012) Lobomycosis: An emerging disease in humans and delphinidae.