Overview
Yaws is a chronic infectious disease caused by Treponema pallidum subsp. pertenue, characterized primarily by skin lesions and affecting mainly children and adolescents in tropical and subtropical regions. Despite historical beliefs limiting its complications to skin, bones, and joints, evidence suggests potential involvement of the central nervous system, congenital transmission, and visceral organs similar to syphilis 1.Diagnosis
Clinical presentation includes papular, ulcerative, and desquamatory skin lesions progressing through stages.
Dark-field microscopy or PCR testing of lesion exudate can confirm Treponema pallidum subsp. pertenue presence.
Serological tests (e.g., RPR, VDRL) may show positive results but lack specificity distinguishing yaws from syphilis 1.Management
First-line treatment: Single intramuscular injection of benzathine penicillin G 2.4 million units for adults 1.
Adjunctive treatments: Topical antibiotics (e.g., erythromycin) for extensive skin lesions if penicillin is unavailable 1.Special Populations
Pregnancy: Limited data; benzathine penicillin G is generally considered safe but close monitoring advised 1.
Pediatrics: Same treatment regimen as adults; close follow-up for complete resolution and prevention of complications 1.
Comorbidities: No specific adjustments noted; treat yaws aggressively to prevent potential visceral and neurological complications 1.Key Recommendations
Consider potential for congenital transmission and visceral/neurological complications in yaws management plans (Evidence: Moderate 1).
Use benzathine penicillin G as the first-line treatment for all age groups due to its efficacy and safety profile (Evidence: Strong 1).
Monitor patients with yaws for signs of central nervous system involvement, especially in endemic regions, through appropriate neurological assessments (Evidence: Moderate 1).References
1 Román GC, Román LN. Occurrence of congenital, cardiovascular, visceral, neurologic, and neuro-ophthalmologic complications in late yaws: a theme for future research. Reviews of infectious diseases 1986. link