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Mycobacterium marinum is an environmental, nontuberculous mycobacteria found in fresh and salt water, causing disease in humans through traumatized skin. We describe a young, healthy South Pacific Islander with chronic, progressive large verrucous plaques on the left lower extremity, with cultures positive for M. marinum. This morphology, distribution, and disease course is likely representative of an atypical presentation of M. marinum infection in South Pacific Islanders.