This case report describes the clinical findings, diagnostic procedures, therapeutic options, and the outcome in a llama suffering from idiopathic, necrolytic, neutrophilic hyperkeratosis (INNH) around the nares. The exact pathogenesis and etiology of this disease remains unknown up to now . To date, only a few reports on this condition are available in the scientific literature. Information regarding prevalence of this disease among South American camelids is lacking.The multimodal therapeutic measures (surgically, medically, physically) and the course of the disease are presented. A lasting clinical improvement was achieved, although complete healing did not occur.