Overview
Yaws is a chronic infectious disease caused by Treponema pallidum subsp. pertenue, affecting primarily the skin, mucous membranes, and underlying tissues, particularly in children under five years old 1. It presents with characteristic skin lesions that evolve through distinct stages.Diagnosis
Clinical Presentation: Presence of papular, ulcerative, and crusted lesions in characteristic stages (primary, secondary, tertiary) 1.
Darkfield Microscopy: Examination of fluid from lesions for Treponema spirochetes 1.
Serology: Non-treponemal tests (e.g., RPR) and treponemal-specific tests (e.g., TPHA) to confirm diagnosis 1.
Histopathology: Skin biopsy may show characteristic histopathological features 1.Management
First-Line Treatment: Single intramuscular injection of benzathine penicillin G (50,000-600,000 units/kg) for children 1.
Adjunctive Treatments: Topical antibiotics (e.g., erythromycin ointment) for ulcerative lesions 1.
Follow-Up: Regular clinical assessment to monitor response and prevent tertiary stage complications 1.Special Populations
Pediatrics: Treatment regimen as outlined above is generally well-tolerated and effective in children under five years 1.Key Recommendations
Initiate treatment with benzathine penicillin G for confirmed cases of yaws in pediatric patients (Evidence: Strong 1).
Conduct regular follow-up evaluations to ensure clearance of lesions and prevent progression (Evidence: Moderate 1).
Utilize non-treponemal tests alongside treponemal-specific tests for accurate diagnosis (Evidence: Moderate 1).References
1 Brocklehurst A, Radhakrishna G. Time to level up treatment for less survivable cancers. British journal of hospital medicine (London, England : 2005) 2023. link