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4. Skin diseases
Treponematoses
– B acterial in fection s caused by 3 d ifferen t typ es of trep on em a (other than Treponema
pallidum).
– H um an -to-hum an tran sm ission m ay be d irect or in d irect.
– T h e 3 n on - ven ereal trep on em atoses result in p ositive syp h ilis serology ( T P H A -
V D R L ), but this test is n ot n ecessary as d iagn osis is clin ical.
– F or treatm en t of syp hilis see Genital infections, p age 2 2 9 . 4
Clinical features
S ee table follow in g p age.
Treatment
– For the 3 treponematoses
benzathine benzylpenicillin I M
C hild ren un d er 6 years: 6 0 0 0 0 0 I U as a sin gle in jection
C hild ren over 6 years an d ad ults: 1 .2 M IU as a sin gle in jection
F or p atien ts allergic to p en icillin :
erythromycin P O
C hild ren : 5 0 m g/ k g/ d ay in 2 or 3 d ivid ed d oses for 1 4 d ays
A d ults: 2 to 3 g/ d ay in 2 or 3 d ivid ed d oses for 1 4 d ays
or
doxycycline P O (excep t for child ren un d er 8 years an d p regn an t an d lactatin g w om en
C hild ren over 8 years: 1 0 0 to 2 0 0 m g on ce d aily or in 2 d ivid ed d oses for 1 4 d ays
A d ults: 2 0 0 m g on ce d aily or in 2 d ivid ed d oses for 1 4 d ays
Notes:
•A n tibiotic treatm en t w ill cure early stage cases an d m ay relieve the p ain of osteitis.
I t m ay be in effective for late stage in fection s.
•S yp hilis serology w ill rem ain p ositive d esp ite clin ical cure.
– Prophylactic treatment of contacts
E xam in e con tacts an d treat w ith benzathine benzylpenicillin I M as a sin gle d ose as
above (also treat p atien ts in the laten t stage w ith p ositive serology in en d em ic z on es).
111
Treponematoses
– B acterial in fection s caused by 3 d ifferen t typ es of trep on em a (other than Treponema
pallidum).
– H um an -to-hum an tran sm ission m ay be d irect or in d irect.
– T h e 3 n on - ven ereal trep on em atoses result in p ositive syp h ilis serology ( T P H A -
V D R L ), but this test is n ot n ecessary as d iagn osis is clin ical.
– F or treatm en t of syp hilis see Genital infections, p age 2 2 9 . 4
Clinical features
S ee table follow in g p age.
Treatment
– For the 3 treponematoses
benzathine benzylpenicillin I M
C hild ren un d er 6 years: 6 0 0 0 0 0 I U as a sin gle in jection
C hild ren over 6 years an d ad ults: 1 .2 M IU as a sin gle in jection
F or p atien ts allergic to p en icillin :
erythromycin P O
C hild ren : 5 0 m g/ k g/ d ay in 2 or 3 d ivid ed d oses for 1 4 d ays
A d ults: 2 to 3 g/ d ay in 2 or 3 d ivid ed d oses for 1 4 d ays
or
doxycycline P O (excep t for child ren un d er 8 years an d p regn an t an d lactatin g w om en
C hild ren over 8 years: 1 0 0 to 2 0 0 m g on ce d aily or in 2 d ivid ed d oses for 1 4 d ays
A d ults: 2 0 0 m g on ce d aily or in 2 d ivid ed d oses for 1 4 d ays
Notes:
•A n tibiotic treatm en t w ill cure early stage cases an d m ay relieve the p ain of osteitis.
I t m ay be in effective for late stage in fection s.
•S yp hilis serology w ill rem ain p ositive d esp ite clin ical cure.
– Prophylactic treatment of contacts
E xam in e con tacts an d treat w ith benzathine benzylpenicillin I M as a sin gle d ose as
above (also treat p atien ts in the laten t stage w ith p ositive serology in en d em ic z on es).
111
