Yaws

What is yaws?

Yaws is a chronic infection by a bacterium that affects mainly the skin, bone and cartilage.
Most people affected by this condition are children under 15 years of age but adults are not exempt.
It is transmitted mainly through skin contact with an infected person.
A single skin lesion develops at the point of entry of the bacterium after 24 weeks.
Without treatment, multiple lesions appear all over the body.
The disease is rarely fatal, however it can lead to chronic disfigurement and disability in about 10% of affected individuals if left untreated.
Treatment with antibiotics is curative and relapse is rare.
Overcrowding, poor personal hygiene and poor sanitation facilitate the spread of the disease.

Causes of Yaws

Yaws is caused by Treponema pallidum pertenue, a spirochete bacterium.

Symptoms of Yaws

The following are the symptoms of Yaws:

  1. Raised skin lesions
  2. Painless skin ulcer
  3. Bone pain

Signs of Yaws

  1. Papular skin lesions
  2. Painless skin ulcer with scab
  3. Deformities of the nose, bones
  4. Palmar or plantar skin thickening.

Investigations

  • VDRL

Treatment for Yaws

Treatment objectives

  1. To eradicate the organism and ensure cure
  2. To prevent spread of the infection
  3. To prevent long term complications

Pharmacological treatment

Evidence Rating: [A]
A. Single Dose Treatment for Yaws
Azithromycin, oral,

  • Adults: 30 mg/kg body weight (max. 2 g) as a single dose
  • Children:
    • > 15 years; 2 g
    • 10-15 years; 1g
    • 6-9 years; 1.5 g
    • 6 months – 6 years; 500 mg (syrup preferable)
    • <6 months: not recommended

For Non-response or Non-availability of Azithromycin
Benzathine Penicillin, IM,

  • Adults 1.2 million units stat.
  • Children
    • > 10 years: 1.2 MU stat
    • < 10 years; 1.2 MU stat. 600,000 units stat.

Referral Criteria

  • Refer intractable cases to the dermatologist.