Epidemiologic and clinical characteristics of treponemal diseases

	Syphilis (Treponema pallidum pallidum)	Yaws (Treponema pallidum pertenue)	Bejel (Treponema pallidum endemicum)	Pinta (Treponema carateum)
Geographical distribution (climate)	Worldwide	Tropics (hot, humid areas)	Deserts of Africa and Saudi Arabia (hot, dry areas)	Central and South America (hot, humid areas)
Age group (peak incidence)	Adults (18 to 30)	Children (2 to 10)	Children (2 to 10)	Adults (15 to 50)
Transmission	Sexual and congenital	Skin-to-skin contact	Mouth to mouth or utensils	Skin-to-skin contact
Initial lesion (frequency)	Common	Common	Rare	Common
Initial lesion (location)	Genitals	Lower extremities	Oral mucosa	Extremities
Dissemination	Widespread and systemic	Widespread to skin and bone	Limited to intertriginous areas and facial bone	Limited to skin
Late complications without treatment	Ulcers (10 percent), neurological (10 percent), cardiovascular (10 to 15 percent)	Destructive lesions of skin and bones (10 percent)	Destruction of nose/palate	Local skin hypoacromia

Adapted from: Perine PL, Hopkins DR. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta, World Health Organization, Geneva 1984.

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