Located in uncovered areas that have been traumatized (mostly feet, legs, and hands)
Most often affects lower extremities (typically a single foot) 
Characteristic triad is tumor, sinus tracts, and macroscopic grains
Progression
Initial lesions are painless, often begin as slowly growing indurated subcutaneous nodules
Extension occurs due to nodule swelling and coalescence, resulting in large tumors that can evolve into necrotic abscesses with sinus tracts
May progress over months to many years
Can extend from skin and subcutaneous tissue to muscle, bone, and lymphatic vessels
Pain is usually associated with secondary bacterial infection
Initial lesions are painless, often begin as slowly growing indurated subcutaneous nodules
Extension occurs due to nodule swelling and coalescence, resulting in large tumors that can evolve into necrotic abscesses with sinus tracts
May progress over months to many years
Can extend from skin and subcutaneous tissue to muscle, bone, and lymphatic vessels
Fibrosis
Ankylosis
Lymphedema
Joint destruction
Eumycetoma
Actinomycosis
Giant cell tumor
Botryomycosis
Ganglion cyst
Nocardiosis
Basal cell carcinoma
Foreign body granuloma