It has been accepted over the years that there are three distinct types of lesions in frambesia tropica (yaws). They tend to occur in a certain sequence. In consequence, it has been customary to refer to the three types of lesions as belonging to the primary, secondary, and tertiary stages. However, there is a great deal of variation in the time relationship of the lesions of the three stages and much overlapping. Because of this, it has been suggested that the old terminology be discarded. Nevertheless, the lesions of the three stages do occur in a definite sequence and develop differently.
Hill, Kodijat, and Sardadi (1951) suggest that the initial lesion should be called initial frambesioma or initial frambesial ulcer. The initial lesion, however, may start as a papule and develop into the typical papilloma or frambesioma; or infection may occur on an excoriation, fissure, or ulcer, the preexisting