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Cutaneous disorders of Yaws — Clinical Guidelines

Overview

Yaws is a chronic infectious disease caused by Treponema pallidum subsp. pertenue, characterized by papular, ulcerative, and crusted skin lesions, primarily affecting children in tropical and subtropical regions 4.

Diagnosis

Clinical Presentation: Corymbiform pattern of lesions (central larger lesion with smaller surrounding lesions) 4.

Diagnostic Tests: Dark-field microscopy, serological tests (e.g., serological reactions for treponemal antibodies), and biopsy for histopathology 4.

Differential Diagnosis: Secondary syphilis, other chronic ulcers, and tropical skin conditions 4.

Management

First-Line Treatment: Single intramuscular injection of long-acting penicillin (e.g., benzathine penicillin G 2.4 million units for adults) 4.

Adjunctive Treatments: Topical agents for secondary infections or wound care, though systemic treatment is primary 7.

Follow-Up: Regular clinical evaluations to ensure complete resolution and prevent complications 3.

Special Populations

Pediatrics: Yaws predominantly affects children, requiring careful monitoring and adherence to treatment regimens 4.

Comorbidities: No specific management adjustments noted for comorbidities; focus remains on treating yaws effectively 3.

Key Recommendations

Initiate Treatment with Long-Acting Penicillin: Use benzathine penicillin G for definitive treatment (Evidence: Strong 4).

Monitor for Complete Resolution: Regular follow-up visits are essential to ensure the disease is fully eradicated (Evidence: Moderate 3).

Consider Topical Support for Secondary Infections: Manage secondary infections with appropriate topical agents as needed (Evidence: Expert opinion 7).

References

1 Bapna M, Deng M. Vitamin K in dermatology. Clinics in dermatology 2026. link 2 Wollina U, Hoenig LJ, Walter S, Parish LC. The church spire sign. Clinics in dermatology 2025. link 3 Pariser RJ, Alnaif S. Analysis of Errors in the Management of Cutaneous Disorders. Cutis 2025. link 4 McKinnon AT, Sadeghi NB, Nieman EL, Morrell DS, McShane DB, Kincannon JM et al.. Corymbiform cutaneous disorders in pediatric dermatology: Exploring this pattern of presentation beyond secondary syphilis. Pediatric dermatology 2024. link 5 Ohanenye C, Taliaferro S, Callender VD. Diagnosing Disorders of Facial Erythema. Dermatologic clinics 2023. link 6 González-Urbieta I, Jafferany M, Torales J. Bupropion in dermatology: A brief update. Dermatologic therapy 2021. link 7 Searle T, Ali FR, Al-Niaimi F. Intralesional methotrexate in dermatology: Diverse indications and practical considerations. Dermatologic therapy 2021. link 8 Bienenfeld A, Azarchi S, Lo Sicco K, Marchbein S, Shapiro J, Nagler AR. Androgens in women: Androgen-mediated skin disease and patient evaluation. Journal of the American Academy of Dermatology 2019. link 9 Pasmatzi E, Papadionysiou C, Monastirli A, Badavanis G, Tsambaos D. Galectin 1 in dermatology: current knowledge and perspectives. Acta dermatovenerologica Alpina, Pannonica, et Adriatica 2019. link 10 Azarchi S, Bienenfeld A, Lo Sicco K, Marchbein S, Shapiro J, Nagler AR. Androgens in women: Hormone-modulating therapies for skin disease. Journal of the American Academy of Dermatology 2019. link 11 Lacarrubba F, Ardigò M, Di Stefani A, Verzì AE, Micali G. Dermatoscopy and Reflectance Confocal Microscopy Correlations in Nonmelanocytic Disorders. Dermatologic clinics 2018. link 12 Kong HH, Andersson B, Clavel T, Common JE, Jackson SA, Olson ND et al.. Performing Skin Microbiome Research: A Method to the Madness. The Journal of investigative dermatology 2017. link 13 Wen X, Li Y, Hamblin MR. Photodynamic therapy in dermatology beyond non-melanoma cancer: An update. Photodiagnosis and photodynamic therapy 2017. link 14 Doshi SN, Alster TS. 1,450 nm long-pulsed diode laser for nonablative skin rejuvenation. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2005. link 15 Smith KJ, Skelton H. Arachidonic acid-derived bioactive lipids: their role and the role for their inhibitors in dermatology. Journal of cutaneous medicine and surgery 2002. link 16 Touart DM, Sau P. Cutaneous deposition diseases. Part II. Journal of the American Academy of Dermatology 1998. link70001-5) 17 Rothe MJ, Nowak M, Kerdel FA. The mast cell in health and disease. Journal of the American Academy of Dermatology 1990. link70264-i) 18 Edwards EK. Ozone production by dermatologic phototherapy equipment. Cutis 1981. link

Cutaneous disorders of Yaws