What is a Buruli ulcer?

Buruli ulcer, caused by Mycobacterium ulcerans, is another of the inoculation mycobacterioses and is the third most common mycobacterial disease in immunocompetent individuals. It occurs in warm tropical climates, most notably Africa, Australia, and Mexico. The organism is inoculated into the skin through minor cuts, most commonly on the extensor surface of the extremities. Over a period of 4 to 6 weeks, a painless subcutaneous swelling develops; it may or may not be pruritic. The swelling then ulcerates and has a necrotic center, undermined borders, and can attain the size of an entire limb. Treatment is primarily surgical.