PianPian, yaws, yaws or yaws, is an infectious disease caused by a bacterium called spiral Treponema pallidum pertenue spp.. Within the genus Treponema , the best known species is Treponema pallidum, which causes the syphilis. Yaws is caused by a subspecies of Treponema pallidum, but it is not sexually transmitted, but it does so by direct contact with infected skin lesions (usually affect the extremities for most of the time).
As a result of infection in the skin of the affected are some ulcerative lesions shaped raspberry affecting the skin, cartilage and bones. Usually do not hurt, but yes they are itching, it makes the affected to try to soothe the itching spreading bacteria to other parts of the body.
This tropical disease appears mainly in environments, humid and warm from the sub-continent Indian, Southeast Asia, Africa and Latin America, where the transmission person to person is favoured by the fact go with bare skin, and the greater risk of cuts and small scratches caused by vegetation or other objects while playing, working, or walking to the open air.
The pian mainly affects children between 2 and 15 years, being predominantly in rural areas (75% of those affected are under 15 years of age). It affects equally men and women. It is not transmitted through the placenta. If time is not presents further complications, but in one in ten cases, five years later, can cause distortions in the area of the nose and bone, thickening plant and mobility problems.
In the years 50-60 occurred global campaigns by treatment penilicina injections which managed to reduce from 50 million to 2.5 million estimated number of affected by infections of Treponemes, which, yaws, though there are no clear records, is estimated that affects some 450,000-500,000 people. To date, India is the only country which in recent years has managed to completely eradicate its transmission.
Symptoms of yawsThe incubation period of this disease - rather than appreciate the first symptoms of the pian- ranges from 9 to 90 days, with being the most common place around three weeks. The initial lesion of yaws, known as protopianoma, consists of one or more skin lesions of small size and ulcerated and rust, they grow rapidly and form a mass papillomatous colored with a raspberry-like appearance. This lesion, which is located in the area that has penetrated the bacteria on the skin, usually not painful, although Yes it causes itching sometimes. In the exudate that emits Treponemes that cause of yaws, this being the diagnostic method of choice can be viewed under a microscope.
It is also frequent the presence of one or more swollen lymph nodes in the body region where is located the protopianoma, although they do not have to be painful. This initial injury heals spontaneously, leaving a scar; You can persist for months and be absent in 10% of cases, which begin with secondary injuries.
The secondary period phase begins within 3-12 months of infection and is characterized by the appearance of an skin rash, often bilateral and symmetric (i.e. affects both sides of the body in a similar way), which predominates in the vicinity of the body orifices. These lesions are known as yaws. They can be of different sizes, and sometimes are covered in scabs and exudates. The condition of the soles of the feet, which is very characteristic, causes much pain. Bone lesions are frequent in children.
The tertiary manifestations affect 10% of the patients. They may appear next to the secondary lesions, or after a symptom-free period. These lesions may affect cartilage and bony structures, producing lesions in the joints and bones.
In some cases, primarily in untreated patients with antibiotic, very aggressive lesions such as mutilation of the central part of the face, may result in what is known in medical terms as the gangosa. The pian not never affects the central nervous system.
Diagnosis of yawsThe clinical history and physical examination are the first two steps that allow suspect if a patient presents yawsor pian . To be sure, it is important to ask the patient if he has traveled to areas where there is greater risk of contracting this infection, if it comes from them, or if you have been exposed to people with similar injuries in the weeks prior to the onset of symptoms.
The physical examination should be detailed, so that the doctor must be fixed carefully on the appearance of lesions that are found on the skin.
The diagnosis of yaws is established by visualization of Treponemes (this disease-causing bacteria) in the exudate of the lesions through microscopic examination with a special team called the dark field microscopy.
The blood analysis also helps to support the diagnosis, because syphilis serological tests are positive in patients with yaws, since the bacteria that cause both diseases are closely related.
Carrying out other tests, such as an x-ray of bony parts, should be assessed in each case depending on the degree of involvement.
Treatment of yawsGiven that it is an infectious disease, the treatment of yaws consists of administration of antibiotics. The treatment of choice is azithromycin, administered in a single dose by oral, or benzathine penicillin by via intramuscular, administered in a single dose. In the case of penicillin, half that dose in adults is used in children less than 10 years.
If the patient is allergic to these antibiotics can be others such as tetracyclines, erythromycin or doxycycline.
The prognosis for yaws is good enough in most cases, getting the cure complete in most of the patients. However, if no treatment is not established, 10% of patients suffer complications such as deformities and disabilities present greater difficulty to mobilize certain joints.
Prevention of yawsThere is no vaccine against yaws that prevents their appearance. Prevention of this disease is aimed at interrupting the transmission between people through the diagnosis early, thus preventing contagion. Health education and the development of measures to achieve a better personal hygiene are essential components of prevention.
All those who live, or have been in close contact with patients diagnosed with pian should go to your doctor to be examined and begin treatment as soon as possible if they have compatible lesions