Yaws

Yaws is a chronic infection by a bacterium that affects mainly the skin, bone and cartilage. Most people affected 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.

Cause

Treponema pertenue

Symptoms

Raised skin lesions
Painless skin ulcer
Bone pain

Signs

Papular skin lesions
Painless skin ulcer with scab
Deformities of the nose, bones
Palmar or plantar skin thickening

Investigations

VDRL

TreatmentTreatment Objectives

To eradicate the organism and ensure cure
To prevent spread of the infection
To prevent long term complications

Non-pharmacological treatment

None

Pharmacological treatment

Evidence Rating: [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; 1.5 g

6-9 years; 1 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; 600 000 units stat.

Referral Criteria

Refer intractable cases to the dermatologist.