Treatment is normally by a single intramuscular injection of long-acting benzathine benzylpenicillin, or less commonly by a course of other antibiotics, such as azithromycin or tetracycline tablets. Penicillin has been the front-line treatment since at least the 1960s, but there is no solid evidence of the evolution of penicillin resistance in<unk> . The historical strategy for the eradication of<unk>  (1952–1964) was: Prevalence of clinically active<unk>  Treatment strategy Hyperendemic: above 10% Benzathine benzylpenicillin to the whole community (total mass treatment) Mesoendemic: 5–10% Treat all active cases, all children under 15 and all contacts of infectious cases (juvenile mass treatment) Hypoendemic: under 5% Treat all active cases and all household and other contacts (selective mass treatment) Benzathine benzylpenicillin requires a cold chain and staff who can inject it, and there is a small risk of anaphylaxis. It was also not reliably available during the 2010s; there have been supply shortages. In the 2010s, a single oral dose of azithromycin was shown to be as effective as intramuscular penicillin. Unlike penicillin, there is strong evidence that<unk>  is evolving antibiotic resistance to azithromycin; there are two known mutations in the bacterium, each of which can cause resistance and make the treatment ineffective. This has threatened eradication efforts. Within 8–10 hours of penicillin treatment, bacteria can no longer be found in lesion biopsies. Primary and secondary lesions usually heal in 2–4 weeks; bone pain may improve within two days. If treated early enough, bone deformities may reverse and heal. Primary and secondary stage lesions may heal completely, but the destructive changes of tertiary<unk>  are largely irreversible. If lesions do not heal, or RPR test results do not improve, this may indicate treatment failure or re-infection; the treatment is typically repeated. WHO guidelines says that any presumed treatment failures at 4 weeks require macrolide resistance testing. File:Large, “moist cauliflower” papillomas on left axilla.Secondary<unk>  in the left armpit of a ten-year-old, 2020 File:Yaws papillomas on axilla significantly reduced in size 2 weeks and completely resolved 3-and-a-half months after one-dose azithromycin was taken.Same person, 2 weeks and 3.5 months after a single-dose azithromycin File:Yaws treatment.Before and two weeks after a single injection of benzathine penicillin, 1950s.
Yaws
Enanthem
Scrubs 
Exanthem
Chilblains
Tuberculosis hut
Scabies
Saddle sore