Five to 10 years later, destructive lesions (tertiary yaws) may develop; they include the following: Periostitis (particularly of the tibia) Proliferative exostoses of the nasal portion of the maxillary bone (goundou) Juxta-articular nodules Gummatous skin lesions Ultimately, mutilating facial ulcers, particularly around the nose (gangosa) Stages of Yaws Yaws—Primary Primary yaws manifests as a large yellow papule or papillomata at the site of inoculation.