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You review a 27 year old farmer with a 3 day history of a painful lesion on his right little finger. He cannot recall any obvious trauma but admits he very often has small cuts to his hands. He is otherwise well and has no lesions elsewhere. On examination his observations are stable and there is a 2.5 cm firm red-blue tender papule seen on his right little finger.

Based on the likely diagnosis, which of the following statements is least correct?

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