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An ulcerative nodule on the forearm of a healthy male farmer

A 41-year-old healthy male presented with an erythematous ulcerative nodule on the left forearm that had been rapidly growing for three weeks (Fig. 1a). He had no pertinent past medical history and denied a history of skin cancer. The patient worked as a farmer and had recently noticed a wound present on the ear of one of his lambs near its identification tag (Fig. 1b). One week prior to the onset of the nodule on his forearm, the patient had cleaned the wound on the lamb’s ear. The patient had previously also noticed a similar lesion present near the lamb’s