New Medical Challenge

Here is this weeks medical challenge from the New England Journal of Medicine. You be the doctor. This patient is from Tunisia (North Africa on the Mediterranean) and this is what her ear looks like. What is the diagnosis? (These are all infectious diseases) 1. Leprosy (a mycobacterium)2. Leishmaniasis (a protozoa from the bite of a sand fly)3. Syphilis (a sexually transmitted spirochete