Crusted nodule on arm after returning from South America.

31 year old man presents with a verrucal skin lesion on dorsal lower right forearm/wrist. He reports no pain or itching at site. Lesion was crusty and red around edges. No systemic complaints. Patient had extensive travel in the last 10 years to Middle East, Asia, Europe and South America. Most recently he had been doing research in South America (Peru). Patient reported no bug spray or mosquito net use while doing research. He said the lesion appeared as a papule about 4 weeks after his return to the U.S. and enlarged over about a month to the size it was at presentation, and has been present a total of 6 weeks.