A previously healthy 47-year-old male presented to a community hospital emergency department (Manitoba, Canada) with nodular cutaneous lesions involving the right side of his scrotum, the right thigh, the left inguinal crease, and his penis. The lesions were mal- odorous and had been progressing over a period of approximately two months. The patient denied having fever, rash, arthralgias, or urinary symptoms. He was sexually active with female partners, and reported he last had unprotected sex one week before presenting to care. He was not forthcoming regarding the number of partners with whom he had sex over the preceding six months. The patient was born in Laos, but had lived in Canada for over thirty years. He denied recent travel and recreational drug use, and was currently working in the home renovation industry.
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