Dermatologic Manifestations of Yaws

Author: Caroline L Levine, MD; Chief Editor: William D James, MD more...

Updated: Jan 31, 2012

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Background
Pathophysiology
Epidemiology
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Background

Yaws is the most prevalent infectious, nonvenereal, treponemal disease and is caused by Treponema pallidum subsp pertenue. Yaws is transmitted by direct skin contact and usually affects children, with a peak incidence in those aged 6-10 years. Similar to syphilis, yaws can persist for years as a chronic, relapsing disease.

Yaws continues to be endemic along the tropical belt in areas characterized by hot temperatures, high humidity, and heavy rainfall. These conditions coupled with the persistence of poverty, poor sanitation, overcrowding, and lack of public health surveillance allow for yaws perpetuation.^[1]

Pathophysiology

Cutaneous lesions characterize the primary and secondary stages of yaws. The tertiary stage of yaws may include involvement of skin, bones, and joints.

Frequency

International

In the early 1950s, the estimated number of active yaws cases in areas of Africa, Asia, South America, Central America, and the Pacific Islands was 25-150 million. After the World Health Organization (WHO) supported mass yaws treatment campaigns from 1954-1963, researchers observed a dramatic fall in the prevalence. Since then, however, cases of yaws rebounded because of the lack of public health surveillance and inadequate treatment facilities.^{[2, 3]}Currently, researchers estimate that 100 million children are at risk of acquiring yaws.

Mortality/Morbidity

Unless treated, yaws can become a chronic, relapsing disease with skin, bone, and joint involvement. In 10% of yaws 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 in yaws.

Sex

No sexual predilection exists for yaws.

Age

Children serve as the primary reservoir for yaws. Yaws is most common in children younger than 15 years, with the peak incidence occurring between ages 6 and 10 years.

Proceed to Clinical Presentation

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

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