Tropical ulcer Rapidly growing and painful ulcer of the legs. Malnourished children. Poor socioeconomic conditions. Fusobacterium ulcerans. Papules or bullae that ulcerate. Ulcers may last for years. Squamous cell carcinoma is reported in ulcers persisting 10 years or longer. Healing leads to much scarring. Cleansing and elevation. Debrisment and local application of silver nitrate solution. Penicillin and Flagyl Improved diet