yaws (frambesia)

Epidemiology

• endemic non-venereal spirochete infection with Treponema pallidum subspecies pertenue
• humid equatorial countries where transmission is favored by scanty clothing & skin trauma

Clinical manifestations

• typical primary, secondary & tertiary disease
• initial mucocutaneous lesion followed by diffuse secondary lesions, a latent period, & late destructive disease
• primary: red papule at site of innoculation that enlarges, erodes, & ulcerates
• secondary:
  • diffuse secondary lesions that resemble the primary lesion
  • axillae, skinfolds, & mucosal surfaces
  • heal slowly & may recur
• tertiary:
  • a latent period prior to late destructive disease 5-10 years later
  • periostitis (particularly of the tibia)
  • proliferative exostoses of the nasal portion of the maxillary bone
  • juxta-articular nodules
  • gummatous skin lesions
  • mutilating facial ulcers, particularly around the nose

Laboratory

• see syphilis
• morphologically & serologically indistinguishable from the agent of syphilis Treponema pallidum subspecies pallidum

Management

• penicillin (see syphilis)

More general terms

• syphilis

More specific terms

• gangosa; rhinopharyngitis mutilans
• tertiary yaws