[2] Ulcers occur on exposed parts of the body, primarily on anterolateral aspect of the lower limbs and may erode muscles and tendons, and sometimes, the bones.

Once developed, the ulcer may become chronic and stable, but also it can run a destructive course with deep tissue invasion, osteitis, and risk of amputation.

[1] Chronic ulcers involve larger areas and may eventually develop into squamous epithelioma after 10 years or more.

[5] Early lesions may be colonized or infected by, Bacillus fusiformis (Vincent's organism), anaerobes and spirochaetes.

[1] Tropical ulcer has been described as a disease of the 'poor and hungry'; it may be that slowly improving socioeconomic conditions and nutrition account for its decline[citation needed].

[4] The disease is most common in native laborers and in schoolchildren of the tropics and subtropics during the rainy season and is caused in many instances by the bites of insects, poor hygiene, and pyogenic infections.