textbook pic of Buruli Ulcer can it be Sq. cell Carcinoma ...i guess, no - becos the patient wouldn't have survived that long. i additionally see that the arm and forearm are sutured together by raising a flap ( possibly as a palliative measure )....i guess amputation and prosthesis wud hav been a better option, becos the villain ( M. ulcerans ) seems to hav made a meal out of the radial and ulnar nerves.
Buruli ulcer complicated by a Sq. cell Carcinoma a ulcer is by definition hollow. there is here a budding sign of carcigenesis
possible and only biopsy can confirm...but this can also be an exuberant granulomatous reaction ( of which Mycobacteria are capable of ) additionally the edge of the lesion is not raised and everted as in a typical SCC
