A 14-year-old adolescent girl presented with spreading painful lesions on the legs and left forearm of 2 years’ duration. Her travel history included several countries in South and Central America, traversing the Colombian jungle on foot. Near the end of the jungle trip, she noted a skin lesion on the left forearm around the site of an insect bite. Within 1 month, the lesions spread to the legs. She was treated with topical corticosteroids without improvement. Physical examination revealed verrucous, reddish-brown plaques on the legs and left forearm. Intranasal examination revealed a red rounded lesion inside the left nostril. What's your diagnosis?
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