Clinical Manifestations

The major clinical distinctions made between venereal syphilis and the nonvenereal treponematoses are the apparent lack of congenital transmission and of CNS involvement in the nonvenereal infections. However, these distinctions may not be entirely accurate.

• Yaws is characterized by the development of one or more primary lesions (“mother yaw”) followed by multiple disseminated skin lesions.
  • - At 3-4 weeks after acquisition of the organism, the pt develops a papule that ultimately enlarges, is associated with regional lymphadenopathy, and heals spontaneously within 6 months.
  • - Late gummatous lesions of the skin and long bones affect 10% of untreated persons and are similar to the destructive lesions of leprosy and leishmaniasis.
• Endemic syphilis is initially localized to mucocutaneous and mucosal surfaces. Pts develop an intraoral papule, which is followed by mucous patches on the oral mucosa and mucocutaneous lesions resembling the condylomata lata of secondary syphilis. Destructive gummas, osteitis, and gangosa (destruction of the nose, maxilla, palate, and pharynx) are more common in endemic syphilis than in yaws.
• Pinta is the most benign of the treponemal infections in that it does not cause destructive lesions or involve tissues other than the skin. The disease has three stages that are characterized by marked changes in skin color.