Blastomycosis is an uncommon infection caused by Blastomyces dermatitidis. While management is fairly straightforward, diagnosis can be quite challenging. We describe a case of a healthy 37-year-old man who presented with progressive mucocutaneous lesions, without lung or other systemic involvement. Treatment with itraconazole resulted in complete resolution of signs and symptoms. This case showcases the variety of blastomycosis clinical presentation and the importance of blastomycosis in the differential diagnosis of verrucous and papillomatous mucocutaneous lesions.