WHO Model Prescribing Information: Drugs Used in Skin Diseases
(1997; 132 pages) [French] [Spanish] Voir le document au format PDF
Table des matières
Afficher le documentPreface
Afficher le documentIntroduction
Ouvrir ce répertoire et afficher son contenuParasitic infections
Ouvrir ce répertoire et afficher son contenuInsect and arachnid bites and stings
Ouvrir ce répertoire et afficher son contenuSuperficial fungal infections
Ouvrir ce répertoire et afficher son contenuSubcutaneous fungal infections
Fermer ce répertoireBacterial infections
Afficher le documentStaphylococcal and streptococcal infections
Afficher le documentYaws and pinta
Ouvrir ce répertoire et afficher son contenuViral infections
Ouvrir ce répertoire et afficher son contenuEczematous diseases
Ouvrir ce répertoire et afficher son contenuScaling diseases
Ouvrir ce répertoire et afficher son contenuPapulosquamous diseases
Afficher le documentCutaneous reactions to drugs
Ouvrir ce répertoire et afficher son contenuPigmentary disorders
Ouvrir ce répertoire et afficher son contenuPremalignant lesions and malignant tumours
Ouvrir ce répertoire et afficher son contenuPhotodermatoses
Ouvrir ce répertoire et afficher son contenuBullous dermatoses
Afficher le documentAlopecia areata
Afficher le documentUrticaria
Ouvrir ce répertoire et afficher son contenuConditions common in children
Afficher le documentAcne vulgaris
Afficher le documentPruritus
Afficher le documentTropical ulcers
Ouvrir ce répertoire et afficher son contenuAntimicrobial drugs
Ouvrir ce répertoire et afficher son contenuAntifugal drugs
Ouvrir ce répertoire et afficher son contenuAntiseptic agents
Ouvrir ce répertoire et afficher son contenuKeratoplastic and keratolytic agents
Ouvrir ce répertoire et afficher son contenuScabicides and pediculicides
Ouvrir ce répertoire et afficher son contenuAnti-inflammatory and antipruritic drugs1
Ouvrir ce répertoire et afficher son contenuAntiallergics and drugs used in anaphylaxis
Ouvrir ce répertoire et afficher son contenuUltraviolet radiation-blocking agents (sunscreens)
Ouvrir ce répertoire et afficher son contenuMiscellaneous drugs
Ouvrir ce répertoire et afficher son contenuAnnex
Afficher le documentSelected WHO Publications of Related Interest
Afficher le documentBack cover
 

Yaws and pinta

Yaws and pinta are caused respectively by the spirochaetes Treponema pertenue and T. carateum (invalid). Although closely related to T. pallidum which causes syphilis, neither organism is transmitted by sexual contact. Intensive campaigns organized by WHO and UNICEF virtually eradicated these diseases in the 1950s, but yaws is now widely endemic in tropical areas, while pinta is confined to the American tropics. Both diseases are spread among children by direct contact. Exudate from infectious primary lesions gains access to deeper layers of the skin through minor skin abrasions or cheilitic lesions associated with vitamin B deficiency.

Yaws is heralded, after an incubation period of 3-5 weeks, by a small papule, usually on the lower leg or foot. Occasionally, however, night pain in the legs resulting from periosteal inflammation of the long bones is the first indication of the disease. The primary skin lesion rapidly enlarges into a fleshy, ulcerated papilloma, which exudes a serous fluid containing many treponemes. Secondary cutaneous papillomatous or papulosquamous lesions may appear anywhere, but are typically found in moist areas and at mucocutaneous junctions. Pain and swelling of the small joints of the hand is also typical of the early disseminated phase of the disease. The initial acute inflammatory lesions usually resolve completely within a few months, but subsequent relapses may leave extensive cutaneous scars. Prolonged periostitis results in “sabre tibia” and other characteristic bone deformities. For several years, however, episodes of hyperkeratosis with fissuring and ulceration of the soles of the feet often provide the only indication of continued activity of the disease. Later, gummatous lesions of the skin similar to those of syphilis and destructive lesions of the bone may occur. Gummatous cranial periostitis and destruction of the palatal and nasal cartilage are also typical and serious complications of the late stages of the disease.

Pinta is a comparatively benign condition in which only the skin is involved. The primary lesion is usually psoriasiform in appearance and often attains a diameter of several centimetres. This, and other lesions which may develop subsequently, gradually lose their initial violet colour to leave depigmented and atrophic scars.

Treatment

A single dose of 2.4 million IU of benzathine benzylpenicillin (1.2 million IU for children) should be administered in two intramuscular injections to avert all risk of relapse. Patients who are sensitive to penicillin should receive tetracycline provided they are over 8 years of age, while younger patients should be given erythromycin.

 

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