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Bejel also called is endemic syphilis. Bejel is very common in dry, hot climates especially in the countries of the eastern Mediterranean region and in Saharan West Africa. Bejel is an infectious disease that is rare in the United States. Bejel is a chronic skin and tissue disease caused by infection by a subspecies of the spirochete Treponema pallidum. The infection is very similar to syphilis but is not sexually transmitted. Most frequently, transmission is by means of non-sexual skin contact or by common use of eating and drinking utensils. The organism that causes bejel belongs to the same family as the bacterium that causes syphilis, pinta and yaws.It is known as treponema. Treponemas are spiral-shaped bacteria (spirochetes). Bejel affects the skin, bones, and mucous membranes of the mouth. Symptoms begin with a slimy patch on the inside of the mouth followed by blisters on the trunk, arms, and legs. Bone infection develops later, mainly in the legs. Yaws affects the skin and bones. It begins several weeks after exposure to Treponema as a slightly raised sore at the site of infection, usually on a leg. The sore heals, but soft nodules of tissue (granulomas) erupt on the face, arms, legs, and buttocks. These granulomas heal slowly and may recur.Pinta involves only the skin. It begins as flat, reddened areas on the hands, feet, legs, arms, face, or neck. After several months, slate blue patches develop in the same areas on both sides of the body and over bony places, such as the elbow. Both sexes are equally affected, especially in the pediatric population. This varies with the geographic region. 25% of cases occur before age 6 years, and 55% of cases occur before age 16 years. It is treatable with penicillin or other antibiotics, resulting in a complete recovery.
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