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Dermatology116 papers

Early yaws skin lesion

Last edited: 4/14/2026

Overview

Yaws is a chronic infectious disease caused by Treponema pallidum subsp. pertenue, characterized by early skin lesions that are typically papular, often found on the extremities and face, and can progress through various stages if left untreated 424.

Diagnosis

  • Clinical Presentation: Early lesions are usually small, firm, and often grouped papules 424.
  • Diagnostic Tests: Dermatoscopic examination and shave biopsy are crucial for definitive diagnosis 4.
  • Biopsy Techniques: Shave biopsy is recommended for superficial lesions to obtain adequate histopathological evidence 14.

    • Management

  • First-Line Treatment: Single-dose oral azithromycin or benzathine penicillin G are effective treatments 24.
  • Adjunctive Measures: Follow-up evaluations are essential to ensure complete resolution and prevent recurrence 12.

    • Special Populations

  • Pediatrics: Early diagnosis and treatment are critical to prevent long-term sequelae; pediatric-specific dosing guidelines should be followed 24.
  • Elderly: Similar treatment protocols apply, but careful monitoring for comorbidities is advised 24.

    • Key Recommendations

  • Perform dermatoscopic examination followed by shave biopsy for definitive diagnosis of early yaws lesions (Evidence: Moderate 4).
  • Initiate treatment with a single dose of oral azithromycin or benzathine penicillin G for effective management (Evidence: Moderate 24).
  • Ensure regular follow-up to monitor treatment efficacy and prevent recurrence (Evidence: Expert opinion 12).

    • References

    1 Woodie BR, Nicholas A, Fleischer AB. Dermatologist Characteristics Associated With Outlier Performance of Destruction for Benign Lesions. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2025. link 2 Ludden-Schlatter A, Bunt S, Hanrahan KD. Development and Validation of a Shave Biopsy Training Checklist. Family medicine 2025. link 3 Clarke EL, Reichenberg JS, Ahmed AM, Keeling B, Custer J, Rathouz PJ et al.. The utility of teledermatology in the evaluation of skin lesions. Journal of telemedicine and telecare 2023. link 4 Grover M, Chavez A, Nelson S, Swanson D. Slow-growing lesion on eyebrow. The Journal of family practice 2021. link 5 Desai S, Creadore A, Duncan LM, Lian CG, Yasuda MR, Mostaghimi A et al.. Comparison of Shave and Punch Biopsy Utilization Among Dermatology Practices. Cutis 2021. link 6 Li X, Yu L, Chen H, Fu CW, Xing L, Heng PA. Transformation-Consistent Self-Ensembling Model for Semisupervised Medical Image Segmentation. IEEE transactions on neural networks and learning systems 2021. link 7 Mannam H, Choi A, Jacob S, Kwa M, Xu S, Robinson JK. Assessment of the Diameter of Pigmented Skin Lesions With and Without a Ruler. JAMA dermatology 2018. link 8 Maymone MBC, Neamah HH, Wirya SA, Patzelt NM, Secemsky EA, Zancanaro PQ et al.. Background and Room Illumination in Color Identification of Skin Lesions: A Cross-sectional Study. JAMA dermatology 2017. link 9 Fernández-Flores A. Morphology of rare exogenous materials in dermatopathology. Journal of cutaneous pathology 2017. link 10 Łudzik J, Witkowski AM, Roterman-Konieczna I. New telemedicine techniques in dermatology - evaluation with reflectance confocal microscopy via cloud-based platform. Folia medica Cracoviensia 2016. link 11 Lenardis MA, Solomon RS, Leung FH. Store-and-forward teledermatology: a case report. BMC research notes 2014. link 12 Bilgili ME, Yildiz H, Cengiz BP, Saydam IM. Effect of preoperative evaluation by a dermatologist on diagnostic accuracy. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2014. link 13 Kim P, Kim HJ. S-plasty--clinical applications for skin surgery. Australian family physician 2011. link 14 Pickett H. Shave and punch biopsy for skin lesions. American family physician 2011. link 15 Aldridge RB, Glodzik D, Ballerini L, Fisher RB, Rees JL. Utility of non-rule-based visual matching as a strategy to allow novices to achieve skin lesion diagnosis. Acta dermato-venereologica 2011. link 16 Salam MA, Matai V, Salhab M, Hilger AW. The facial skin lesions "see and treat" clinic: A prospective study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2006. link 17 Fernandez EM, Helm T, Ioffreda M, Helm KF. The vanishing biopsy: the trend toward smaller specimens. Cutis 2005. link 18 Gassem F, Farcy R, Pruvost L. Real time control of the spatial selectivity during laser treatment of a biological surface. Physics in medicine and biology 2005. link 19 Stone JA, Morrison AL. Piloleiomyoma mistaken for postacne scarring. Cutis 2004. link 20 Goldberg LH, Alam M. Elliptical excisions: variations and the eccentric parallelogram. Archives of dermatology 2004. link 21 Moody BR, McCarthy JE, Sengelmann RD. The apical angle: a mathematical analysis of the ellipse. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2001. link 22 Sneiderman CA, Hood AF. A comparison of video and photographic display of skin lesions for morphology recognition. The Journal of biocommunication 1991. link 23 Alcalay J, Goldberg LH. Intraoperative nasal ala stabilization using the Foley catheter. The Journal of dermatologic surgery and oncology 1991. link 24 Orengo IF, Goldberg LH, Tschen J. The solitary brown macule. American family physician 1987. link 25 Ohshiro T. The CO2 laser as an ideal microsurgical tool. Lasers in surgery and medicine 1986. link 26 Tolleth H. Long-term efficacy of collagen. Aesthetic plastic surgery 1985. link 27 Ebbehøj J. Y to V instead of Z to N. Burns, including thermal injury 1983. link90009-8) 28 Rahbari H. Hidroacanthoma simplex--a review of 15 cases. The British journal of dermatology 1983. link 29 Robinson JK. Variation in operative technique: the "nip 'n tuck" principle in dermatologic surgery. The Journal of dermatologic surgery and oncology 1980. link 30 Spiller WF, Spiller RF. Cryosurgery in dermatologic office practice: special reference to dermatofibroma and mucous cyst of the lip. Southern medical journal 1975. link

    Original source

    1. [1]
      Dermatologist Characteristics Associated With Outlier Performance of Destruction for Benign Lesions. — Woodie BR, Nicholas A, Fleischer AB Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2025)
    2. [2]
      Development and Validation of a Shave Biopsy Training Checklist. — Ludden-Schlatter A, Bunt S, Hanrahan KD Family medicine (2025)
    3. [3]
      The utility of teledermatology in the evaluation of skin lesions. — Clarke EL, Reichenberg JS, Ahmed AM, Keeling B, Custer J, Rathouz PJ et al. Journal of telemedicine and telecare (2023)
    4. [4]
      Slow-growing lesion on eyebrow. — Grover M, Chavez A, Nelson S, Swanson D The Journal of family practice (2021)
    5. [5]
      Comparison of Shave and Punch Biopsy Utilization Among Dermatology Practices. — Desai S, Creadore A, Duncan LM, Lian CG, Yasuda MR, Mostaghimi A et al. Cutis (2021)
    6. [6]
      Transformation-Consistent Self-Ensembling Model for Semisupervised Medical Image Segmentation. — Li X, Yu L, Chen H, Fu CW, Xing L, Heng PA IEEE transactions on neural networks and learning systems (2021)
    7. [7]
      Assessment of the Diameter of Pigmented Skin Lesions With and Without a Ruler. — Mannam H, Choi A, Jacob S, Kwa M, Xu S, Robinson JK JAMA dermatology (2018)
    8. [8]
      Background and Room Illumination in Color Identification of Skin Lesions: A Cross-sectional Study. — Maymone MBC, Neamah HH, Wirya SA, Patzelt NM, Secemsky EA, Zancanaro PQ et al. JAMA dermatology (2017)
    9. [9]
      Morphology of rare exogenous materials in dermatopathology. — Fernández-Flores A Journal of cutaneous pathology (2017)
    10. [10]
      New telemedicine techniques in dermatology - evaluation with reflectance confocal microscopy via cloud-based platform. — Łudzik J, Witkowski AM, Roterman-Konieczna I Folia medica Cracoviensia (2016)
    11. [11]
      Store-and-forward teledermatology: a case report. — Lenardis MA, Solomon RS, Leung FH BMC research notes (2014)
    12. [12]
      Effect of preoperative evaluation by a dermatologist on diagnostic accuracy. — Bilgili ME, Yildiz H, Cengiz BP, Saydam IM Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2014)
    13. [13]
      S-plasty--clinical applications for skin surgery. — Kim P, Kim HJ Australian family physician (2011)
    14. [14]
      Shave and punch biopsy for skin lesions. — Pickett H American family physician (2011)
    15. [15]
      Utility of non-rule-based visual matching as a strategy to allow novices to achieve skin lesion diagnosis. — Aldridge RB, Glodzik D, Ballerini L, Fisher RB, Rees JL Acta dermato-venereologica (2011)
    16. [16]
      The facial skin lesions "see and treat" clinic: A prospective study. — Salam MA, Matai V, Salhab M, Hilger AW European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2006)
    17. [17]
      The vanishing biopsy: the trend toward smaller specimens. — Fernandez EM, Helm T, Ioffreda M, Helm KF Cutis (2005)
    18. [18]
      Real time control of the spatial selectivity during laser treatment of a biological surface. — Gassem F, Farcy R, Pruvost L Physics in medicine and biology (2005)
    19. [19]
      Piloleiomyoma mistaken for postacne scarring. — Stone JA, Morrison AL Cutis (2004)
    20. [20]
      Elliptical excisions: variations and the eccentric parallelogram. — Goldberg LH, Alam M Archives of dermatology (2004)
    21. [21]
      The apical angle: a mathematical analysis of the ellipse. — Moody BR, McCarthy JE, Sengelmann RD Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2001)
    22. [22]
      A comparison of video and photographic display of skin lesions for morphology recognition. — Sneiderman CA, Hood AF The Journal of biocommunication (1991)
    23. [23]
      Intraoperative nasal ala stabilization using the Foley catheter. — Alcalay J, Goldberg LH The Journal of dermatologic surgery and oncology (1991)
    24. [24]
      The solitary brown macule. — Orengo IF, Goldberg LH, Tschen J American family physician (1987)
    25. [25]
      The CO2 laser as an ideal microsurgical tool. — Ohshiro T Lasers in surgery and medicine (1986)
    26. [26]
      Long-term efficacy of collagen. — Tolleth H Aesthetic plastic surgery (1985)
    27. [27]
      Y to V instead of Z to N. — Ebbehøj J Burns, including thermal injury (1983)
    28. [28]
      Hidroacanthoma simplex--a review of 15 cases. — Rahbari H The British journal of dermatology (1983)
    29. [29]
      Variation in operative technique: the "nip 'n tuck" principle in dermatologic surgery. — Robinson JK The Journal of dermatologic surgery and oncology (1980)
    30. [30]
      Cryosurgery in dermatologic office practice: special reference to dermatofibroma and mucous cyst of the lip. — Spiller WF, Spiller RF Southern medical journal (1975)
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