Medical history A 20-year old previously healthy male patient, who was born and resides in a brazilian countryside town working as a bricklayer, presents with a single nodular skin lesion on the dorsal side of his right wrist. It was firstly noticed two months ago and has since evolved to a painless ulcer with raised edges and filled with granulation tissue. No lymph nodes enlargement, fever or any other constitutional symptoms are observed.Figure 1: Photograph of the dorsal side of the patient´s right wrist Question:Based on the clinical data and photograph provided herein, which is the most likely diagnosis? Basal cell carcinoma American Cutaneous Leishmaniasis Verrucous Cutaneous Tuberculosis Sporothricosis Time is Up! Time's up
