This granulomatous infection in an employee of a tropical fish store was due to Mycobacterium marinum , which is usually acquired from an inoculation injury. It is also referred to as swimming pool granuloma. The lesions are nodular rather than vesicular and run a self-limiting course in several months. While the hand are most often affected, the virus can be carried to other skin sites.
Ticks present a considerable problem for outdoor workers in wooded areas.
Because the initial bite is painless, the first sign may be itching at the site of the bite several days ater.