Dermatologic Manifestations of Yaws Treatment & Management

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

Medical Care

Treatment consists of appropriate antibiotic therapy. Penicillin remains the drug of choice for yaws. Tetracycline, erythromycin, or doxycycline should be considered for patients allergic to penicillin.[7]

Because oral azithromycin is effective for syphilis, it was tested in one study as an alternative to treatment with penicillin in children in Papua New Guinea. Children aged 6 months to 15 years diagnosed with yaws were randomly allocated to receive either one 30 mg/kg oral dose of azithromycin or an intramuscular (IM) injection of 50000 units per kg benzathine benzylpenicillin. After 6 months of follow-up, 96% of patients in the azithromycin group were cured, compared with 93% in the benzathine benzylpenicillin group, proving that a single oral dose of azithromycin is non-inferior to benzathine benzylpenicillin. Oral azithromycin is a reasonable alternative for treating yaws in rural, tropical areas as it is a simpler regimen that does not require trained medical personnel for administration.[8]

  • Epidemiological treatment recommendations for yaws are as follows:
    • If greater than 50% of children are seropositive (hyperendemic), treat the entire population.
    • If 10-50% of children are seropositive (mesoendemic), treat active cases, contacts, and all children aged 15 years or younger.
    • If less than 10 of children are seropositive (hypoendemic), treat active cases, household members, and other obvious contacts.
Proceed to Medication
 
 
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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