 We have observed in a few cases the emergence of new lesions which may occur at the site or adjacent or sometimes distant from the initial lesions. These seem to occur during the second four weeks of antibiotic treatment. These lesions are shiny, sometimes tender and fluctuant. These characteristics suggest that these new lesions are of inflammatory nature. And early suggestions indicate that they may arise as a result of restoration of the immune system to M. ulcerans Possibly when mycolactone concentrations in tissues decline with antibiotic treatment. Our recommendation based on experience is not to restart antibiotic treatment because most of these new lesions resolve on their own. A fine needle aspirate or a pine spiopsy of these new lesions should be obtained and send to the microbiology lab for mycobacterial culture, other bacterial culture, and then zilnel sustaining for detection of acid fast basilar. However, our experience has been that these new lesions tend to be sterile. These highlights or indicates the inflammatory nature of these new lesions. If these lesions ulcerate, it is advisable to continue daily dressings till they heal or resolve on their own.