A healthy 17-year-old boy with a one-year history of asymptomatic, slowly enlarging nodules affecting his right ear was seen. The patient's past medical history was unremarkable, he was not immunosuppressed, he was not taking any drugs, and he was employed as a rubber worker in the Amazon region. Physical examination revealed ill-defined, smooth, shiny, hard nodules on his right ear (Figure 1). The consistency of the skin lesions was hard, and pain was absent.