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2025 ICD-10-CM code A66.4

Gummata and ulcers of yaws. This is a late stage manifestation of yaws, a tropical infection caused by the bacterium Treponema pallidum pertenue.

Use additional codes to identify any drug resistance (Z16.-) or complications. Do not use codes from other chapters for localized infections related to Yaws. Exclude carrier status (Z22.-) and Yaws complicating pregnancy, childbirth, or the perinatal period (O98.-, P35-P39).

Medical necessity for treatment is established by the diagnosis of Yaws, confirmed by clinical findings and laboratory testing.The severity of the infection and the potential for complications justify the need for antibiotic therapy and other supportive care.

Diagnosis involves evaluating symptoms, exposure history, physical exam, and environmental factors. Dark-field microscopy of skin lesion samples can confirm the presence of T. pallidum pertenue. Treatment typically includes penicillin or alternative antibiotics like tetracycline, erythromycin, or doxycycline for penicillin-allergic patients.Preventative measures include educating travelers to endemic regions about avoiding contact with infected individuals.

In simple words: Yaws is a bacterial infection common in tropical areas with poor sanitation. It's spread through skin contact. In its late stages, after many years, it can cause large sores and ulcers on the skin and mucous membranes.

Gummata and ulcers appearing on the skin and mucous membranes characterize the tertiary stage of yaws, a chronic infectious disease caused by the spirochete Treponema pallidum pertenue.Transmission typically occurs through direct contact with infectious lesions.This stage of yaws often manifests 5-15 years after the initial infection.Gummata are tumor-like masses of necrotic tissue, while ulcers are open sores on the skin or mucous membranes.

Example 1: A child living in a rural tropical community presents with multiple large ulcers and raised, tumor-like lesions on their legs and arms.Dark-field microscopy confirms Yaws., An adult who immigrated from a tropical country 10 years prior develops a destructive ulcer on their palate.Serology and lesion biopsy confirm Yaws., A traveler returning from Southeast Asia presents with a non-healing ulcer on their foot.They report having cut their foot while wading in a river.After other diagnoses are ruled out, Yaws is considered, and testing is performed.

Documentation should include the patient's signs and symptoms, relevant medical history (including travel history and potential exposure), physical examination findings, and laboratory results (dark-field microscopy, serology).Photographs of the lesions can also be helpful.

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