Red weeping nodule on the hand of a young farmer

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A 20-year-old agricultural worker requested evaluation of a 3-cm reddish weeping nodule with an ulcerative center. The lesion had first appeared on his hand more than two weeks earlier. The patient noted minimal tenderness of the area but had no other symptoms or constitutional complaints. He had applied bacitracin/polymyxin (Polysporin) ointment, with no success. One of his goats had a herpeslike eruption that he thought might be “scabby mouth,” and he had tried to avoid direct contact.

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