Granulomata in turn coalesce to form tubercles, nodules or masses that often ulcerate. The lesions often ulcerate and bleed. If the keloid becomes infected, it may ulcerate. At later stages, the mole may itch, ulcerate or bleed. They have propensity to enlarge progressively and ulcerate the overlying skin and extrude. The lesions are often asymptomatic but may become tender and ulcerate when injured. If melanomas become large and ulcerate, they may become infected. It then undergoes central necrosis to ulcerate. The central portion of the lesion may heal, producing a scar, or it may ulcerate. Often, ulcerate causing a mistaken diagnosis of a poorly healing traumatic wound or wart. They are bright red due to being highly vascularised, and bleed and ulcerate easily. Visible signs of DFTD begin with lumps of soft tissue around the mouth, which ulcerate. Rarely, infants can ulcerate the tongue or lower lip with the teeth, termed Riga-Fede disease. These capsules can ulcerate and heal over time. If there is ongoing inflammation, the cap may be thin or ulcerate.