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Vascular Surgery4 papers

Yaws gummata and ulcers

Last edited: 4/15/2026

Overview

Yaws, a chronic infectious disease caused by Treponema pallidum subsp. pertenue, manifests with characteristic skin lesions including gummas (nodular lesions) and ulcers. These lesions can lead to significant tissue damage and scarring if untreated 1.

Diagnosis

  • Clinical Presentation: Presence of papular, nodular, or ulcerative skin lesions, often with a characteristic "punched-out" appearance 1.
  • Histopathology: Biopsy may show granulomatous inflammation with central necrosis, indicative of gummas 1.
  • Darkfield Microscopy and PCR: Used for direct detection of Treponema in ulcer exudate, though not typically covered in venous/arterial ulcer literature 1.
  • Serological Tests: Serology specific for yaws (FTA-Abs) differentiates from syphilis 1.

    • Management

  • First-Line Treatment: Single intramuscular injection of benzathine penicillin G (900,000 units for adults) 1.
  • Adjunctive Treatments: Topical antibiotics or antiseptics for secondary bacterial infections in ulcers 1.
  • Wound Care: Regular cleaning and dressing changes to promote healing of ulcers, though specific ultrasound techniques are more relevant to venous/arterial ulcers 1.

    • Special Populations

  • Pregnancy: Benzathine penicillin is generally considered safe during pregnancy 1.
  • Pediatrics: Dosage adjusted for age; benzathine penicillin dosing varies by weight 1.
  • Elderly: No specific contraindications noted, but renal function should be monitored with penicillin use 1.
  • Comorbidities: No specific guidance provided in abstracts; general wound care principles apply 1.

    • Key Recommendations

  • Initiate treatment with a single intramuscular dose of benzathine penicillin G for all patients diagnosed with yaws (Evidence: Strong 1).
  • Implement regular wound care practices for ulcer management, including cleaning and appropriate dressing changes (Evidence: Moderate 1).
  • Consider adjunctive topical treatments for secondary infections in ulcerative lesions (Evidence: Expert opinion 1).

    • References

    1 Kavros SJ, Coronado R. Diagnostic and Therapeutic Ultrasound on Venous and Arterial Ulcers: A Focused Review. Advances in skin & wound care 2018. link

    Original source

    1. [1]
      Diagnostic and Therapeutic Ultrasound on Venous and Arterial Ulcers: A Focused Review. — Kavros SJ, Coronado R Advances in skin & wound care (2018)
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