Bejel

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Synonyms and keywords: Nonvenereal endemic syphilis; endemic syphilis; treponematosis, bejel type; dichuchwa; frenga; njovera; siti;

Overview

Bejel, or endemic syphilis, is a chronic skin and tissue disease caused by infection by a subspecies of the spirochete Treponema pallidum.

Causes

Although the organism that causes bejel, Treponema pallidum endemicum, is morphologically and serologically indistinguishable from Treponema pallidum pallidum, which causes venereal syphilis, transmission of bejel is not venereal in nature, generally resulting from mouth-to-mouth contact or sharing of domestic utensils, and the courses of the two diseases are somewhat different.

Diagnosis

Symptoms

• Skin ulcers
• Bone pain
• Mouth ulcers

Physical Examination

Skin

• Ulcers

Head

• Small mucous patch, often on the interior of the mouth
• Gummas on the soft palate

Nose

• Gummas on the nose

Extremities

• Raised, eroding lesions on the limbs and trunk. Periostitis (inflammation) of the leg bones is commonly seen

Epidemiology and Demographics

Bejel is mainly found in arid countries of the eastern Mediterranean region and in West Africa, where it is known as sahel.

Treatment

• Penicillin - in large doses
• Alternatives inlcude:
  • Chloramphenicol
  • Tetracycline - usually not prescribed for children aged less than 8 years.

See also

• Pinta (disease)
• Syphilis
• Yaws

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