Primary yaws

**Definition:** Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developing into a large non-tender ulcerating nodule, often resembling a raspberry (hence the name ‘framboesia’). The primary lesion is most commonly located on the legs and ankles may also be found on the buttocks, arms, hands, and face. It usually heals after 3–6 months and is still present at the onset of the secondary stage in only a minority (9-15%).

**Long definition:** The initial or primary lesion (‘mother yaw’) appears at the site of inoculation on an exposed part of the body 2–12 weeks after inoculation. It usually starts as a localized papule, which may develop into a large nodule 2–5 cm in diameter that ulcerates. Ulcers are usually non-tender and have a characteristic granular surface reminiscent of a raspberry (hence the name ‘framboesia’). Ulcers often exude a yellow discharge that may dry to form a crust. The primary lesion is most commonly found on the legs and ankles (65 to 85% of cases), but may be on the buttocks, arms, hands, and face. It usually heals after 3–6 months, regressing into a pitted scar with dark margins, and only in a small proportion of patients (9-15%) does the primary lesion persist at the onset of the secondary stage.

**Inclusions:** - Chancre of yaws - Primary framboesia