Dermatologic Manifestations of Yaws Follow-up

  • Author: Caroline L Levine, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 31, 2012
 

Complications

  • Unless treated, yaws can become a chronic, relapsing disease with skin, bone, and joint involvement. In 10% of cases, patients enter a late stage (tertiary stage) characterized by destructive cutaneous lesions and severely deforming bone and joint lesions. Neurologic and ophthalmologic involvement may also occur.
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Prognosis

  • Patients may develop relapses at intervals up to 5 years after infection.
  • In 10% of patients, a late stage (tertiary stage) develops after 5-15 years. This stage is characterized by destructive skin lesions, bone lesions, and possible neurologic and ophthalmologic involvement (see Physical).
  • Agmon-Levin et al suggested that the antitreponemal antibodies that build up in certain populations may also be protective for atherosclerosis while also being pathogenic for yaws.[11]
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Contributor Information and Disclosures
Author

Caroline L Levine, MD  Staff Physician, Department of Dermatology, Emerson Hospital, Mt Aburn Hospital

Caroline L Levine, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Donald Belsito, MD  Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center

Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, New York County Medical Society, New York Dermatological Society, Noah Worcester Dermatological Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD  Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Lupi O, Madkan V, Tyring SK. Tropical dermatology: bacterial tropical diseases. J Am Acad Dermatol. Apr 2006;54(4):559-78; quiz 578-80. [Medline].

  2. Gerstl S, Kiwila G, Dhorda M, et al. Prevalence study of yaws in the Democratic Republic of Congo using the lot quality assurance sampling method. PLoS One. Jul 22 2009;4(7):e6338. [Medline].

  3. Guerrier G, Marcon S, Garnotel L, Deltour R, Schinas S, Mathelin JP, et al. Yaws in Polynesia's Wallis and Futuna Islands: a seroprevalence survey. N Z Med J. Apr 29 2011;124(1333):29-31. [Medline].

  4. Mitjà O, Hays R, Ipai A, Gubaila D, Lelngei F, Kiara M, et al. Outcome predictors in treatment of yaws. Emerg Infect Dis. Jun 2011;17(6):1083-5. [Medline].

  5. Etymologia: yaws. Emerg Infect Dis. Jun 2011;17(6):1082. [Medline].

  6. Rothschild BM, Heathcote GM. Characterization of the skeletal manifestations of the treponemal disease yaws as a population phenomenon. Clin Infect Dis. Aug 1993;17(2):198-203. [Medline].

  7. Farnsworth N, Rosen T. Endemic treponematosis: review and update. Clin Dermatol. May-Jun 2006;24(3):181-90. [Medline].

  8. Mitjà O, Hays R, Ipai A, Penias M, Paru R, Fagaho D, et al. Single-dose azithromycin versus benzathine benzylpenicillin for treatment of yaws in children in Papua New Guinea: an open-label, non-inferiority, randomised trial. Lancet. Jan 28 2012;379(9813):342-7. [Medline].

  9. Backhouse JL, Hudson BJ, Hamilton PA, Nesteroff SI. Failure of penicillin treatment of yaws on Karkar Island, Papua New Guinea. Am J Trop Med Hyg. Sep 1998;59(3):388-92. [Medline].

  10. Manirakiza A, Boas SV, Beyam NE, Zadanga G, Konamna FX, Njuimo SP, et al. Clinical outcome of skin yaws lesions after treatment with benzathinebenzylpenicillin in a pygmy population in Lobaye, Central African Republic. BMC Res Notes. Dec 15 2011;4(1):543. [Medline].

  11. Agmon-Levin N, Bat-sheva PK, Barzilai O, et al. Antitreponemal antibodies leading to autoantibody production and protection from atherosclerosis in Kitavans from Papua New Guinea. Ann N Y Acad Sci. Sep 2009;1173:675-82. [Medline].

  12. Engelkens HJ, ten Kate FJ, Judanarso J, et al. The localisation of treponemes and characterisation of the inflammatory infiltrate in skin biopsies from patients with primary or secondary syphilis, or early infectious yaws. Genitourin Med. Apr 1993;69(2):102-7. [Medline].

  13. Koff AB, Rosen T. Nonvenereal treponematoses: yaws, endemic syphilis, and pinta. J Am Acad Dermatol. Oct 1993;29(4):519-35; quiz 536-8. [Medline].

  14. Sanchez MR. Endemic (Nonvenereal) Treponematoses. In: Freedberg IM, Eisen AZ, Wolff K, Austen F, Goldsmith LA, Katz S, eds. Fitzpatrick's Dermatology in General Medicine. 6th ed. New York, NY: McGraw-Hill; 2003.

  15. Sehgal VN, Jain S, Bhattacharya SN, Thappa DM. Yaws control/eradication. Int J Dermatol. Jan 1994;33(1):16-20. [Medline].

 
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