A 21-year-old man from Sudan presented with a large facial mass. During the 3 months after his arrival in Canada, it had gradually grown to a roundish raised lesion 3 cm in diameter (Figure 1). Although there was local pain, there was no discharge, fever, or weight loss. No local lymphadenopathy or hepatosplenomegaly was found. A biopsy of the lesion showed many tiny roundish and basophilic structures within macrophages (Figure 2).
The most likely diagnosis is
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Blastomycosis
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Cutaneous leishmaniasis
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Tuberculosis
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Squamous cell carcinoma
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