ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

The Health Significance And Clinical Manifestations Of Nonveneral Treponematoses (Yaws And Pinta)

Updated on March 25, 2014

The Physical Presentations Of Yaws



Yaws and pinta are non-veneral diseases caused by spirochetes which resemble Treponema pallidum morphologically and epidemiology. Primary infection is usually acquired in childhood. Transplacental transmission of infection does not occur usually. Pathologic lesions are confined to the skin and bones, the other viscera are not affected as in syphilis.


Yaws is widely prevalent in the tropics and subtropics. It is seen sporadically in all parts of India, though the disease is more prevalent in Africa. The causative organism is treponema pertenue. The discharges from the primary and early secondary lesions teem with the organism. Portal of entry is abrasions on the skin. Overcrowding and poor personal hygiene favour transmission. Three stages: primary, secondary and tertiary can be indentified during the course of the disease. With the improvement in living conditions and advent of penicillin therapy, the picture of yaws and its prevalence have changed considerably, though there are some suggestions that the disease is also showing signs of resurgence.

The primary stage: This shows red maculopapular lesions which develop at the site of inoculation of the organism after three to six weeks. These enlarge and become multiple. They are painless but pruritic. Ordinarily, they heal without scarring.

The secondary lesions: develop in crops, weeks to moths after the healing of the primary lesions. Though they resemble the primary lesions, they are more numerous and widely distributed over circumoral, axilary, perineal and perianal regions. In the moist areas, they assume the appearance of condylomas. Over the palms and soles, the lesions become painful and walking may be restricted due to pain (crab yaws). Bones are affected in the secondary stage. Multiple long bones are involved. The shaft shows cortical rarefaction and subperiosteal inflammation and new bone formation. The affected part is thickened and painful. Nasal bones show thickening (gondov) and the tribial lesion may give rise to sabre tibia.

The tertiary stage develops 5 to 10 years later with gummatous and destructive lesions. The skin and bones are affected. Deep ulcers develop which show overhanding edges. Chronic destructive lesions in the bone may lead to discharging sinuses. Extensive destruction of the facial tissues with gross formation of a single open cavity (gangosa).

Diagnosis: Clinical suspicion should be strong to diagnose this condition since it occurs sporadically or in families and the condition is likely to be missed by the unwary physician. Yaws has to be differentiated from other granulomatous lesions involving the skin and bones such as syphilis, tuberculosis, leprosy and mucocutaneous leishmaniasis. The diagnosis is confirmed by demonstrating the treponemes in the discharges from primary and secondary lesions by dark ground illumination. Serological tests resemble those of syphilis.

Treatment: Dramatic improvement occurs with a single dose of 1.2 mega units of benzathine penicillin given intramuscularly. An alternative regimen is to give tetracycline 1- 2g daily for 5 days. Early cases are cured, whereas in the late cases, mutilation may persist.

The Physical Presentation Of Pinta



Pinta, which is also a non-veneral treponemal disease prevalent in South and Central America, is caused by Treponema Carateum. Transmission occurs by close physical contact and the organism enters through skin abrasions. Exudates from the early skin lesions are highly infective.

Clinical features: The incubation period is 7 to 12 days. The primary lesions develop at the site of inoculation as erythematous, pruritic papules, which coalesce to form ulcers, which take a long time to heal. Scarring and depigmentation occur at these sites.

The secondary stage develops three to twelve months after the primary stage. Morphologically, these lesions resemble the primary lesions. They are smaller but more numerous and widely distributed. Lesions at different stages of development occur simultaneously. Constitutional symptoms may occur at this stage. When the skin lesions heal, atrophy, scarring and depigmentation result.

Diagnosis: The discharges from early skin lesions reveal spirochetes on dark groun illumination. In late lesions organisms may not be demonstrable. Serological tests for syphilis are positive in such cases.

Treatment: Single dose of 1.2 mega units of benzathine penicillin given intramuscularly is curative in most of the cases.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)