The condition includes three distinct entities, such as endemic syphilis, yaws, and pinta. These conditions are found in several parts of the world associated with poor socioeconomic condition and poor hygiene.
Endemic syphilis is a nonvenereal treponemal infection reported from different parts of the world. The condition, also known as Bejel in the Middle East, njovera in Zimbabwe,dichuchwa in Bechuanaland, Skerjevo in Eastern Europe, and siti in Zambia, is caused by T. pallidum subspp. endemicum. Thecondition has also been documented from India.
The disease is transmitted from person-to-person by the use of contaminated utensils. The disease is commonly seen in young children. The initial lesions, such as primary chancre, are rarely seen. Secondary manifestations of syphilis are usually seen, which include lesions like oral papules and mucosal patches. Late manifestations of the disease include gummatous lesions of skin, bones, and nasopharynx. The laboratory diagnosis and treat-ment of endemic syphilis are similar to those of venereal syphilis.
Yaws is a nonvenereal treponemal disease caused by T. pertenue. The condition also known as Pian, Parangi, etc., is prevalent in the primitive tropical parts of central Africa, South America, and Southeast Asia. The condition is also documented in India from Andhra Pradesh and Madhya Pradesh.
The causative agent T. pertenue is morphologically and anti-genically similar to T. pallidum. The pathogen causes yaws, which is characterized by an extragenital papule, which subsequently enlarges and breaks down to form an ulcerating granuloma. Late manifestations of the disease include destructive lesions of the skin, bone, and lymph nodes. The disease is transmitted by direct contact with infected skin lesions. Laboratory diagno-sis and treatment are similar to that of venereal syphilis.
Pinta is a contagious disease of the skin caused by T. carateum. Pinta, also known as carate, mal del pinto, is endemic in Central and South America and the neighboring islands. An extragenital papule is the primary skin lesion observed in the condition. Small pruritic papules develop on surface of the skin after an incubation period of 1–3 weeks. These lesions do not ulcerate, but enlarge and persist for months to years before resolving. The condition, if remains untreated, progresses to form disseminated recurrent and hypopigmented lesions leading to scarring and disfigurement. Pinta spreads by direct contact with infected lesions. Laboratory diagnosis and treatment are same as for syphilis.