A 29-year-old Italian woman presented at the emergency department with a 65-day history of cutaneous lesion on her left forearm, started while she was on a stay in Bolivia. Initially, the lesion was an erythematous and pruriginous papule; the patient reported pricking pain at the site of the lesion several days before its onset. After she was back in Italy, she underwent 3 cycles of three days oral azithromycin for the suspicion of a spider bite, without benefit. At our evaluation, the lesion appeared as a little ulcer one cm wide, with swollen and erythematous edges 2 cm wide, with serous exudate (Fig.
