Endemic syphilis, also known as Bejel, Firjal, Loath, Njovera, Dichuchwa, and Siti, is an endemic treponemal infection caused by the spirochete Treponema pallidum ssp pallidum. It is found in rural areas of western and sub-Saharan Africa and among the nomads of the Arabian peninsula and aborigines of central Australia.

It is considered a chronic disease of children with a peak incidence between 2 and 15 years of age. It primarily affects the skin, bone, and cartilage. The disease is spread by person-to-person contact or by indirect contact (eg, via eating utensils). Risk factors include broken skin, overcrowding, and poor hygienic conditions.

A primary lesion is rarely seen. The earliest lesions are generally seen on the mucosa. Other early manifestations include painful osteoperiostitis of the long bones, condylomata lata, lymphadenopathy, and angular stomatitis (split papules). These early changes resolve with or without scarring. After many years, some patients develop destructive gummatous lesions of the skin and bones.