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Pinta Clinical Presentation

  • Author: Natalie C Klein, MD, PhD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
 
Updated: Oct 07, 2015
 

History

The exact mode of transmission is unknown, but pinta is probably transmitted by direct skin or mucous membrane contact.

The initial lesion is usually found on an exposed part of the body.

Pinta causes no constitutional symptoms.

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Physical

The initial lesion is a papule that slowly enlarges to become a pruritic plaque (as seen in the image below).

Erythematosquamous plaque of early pinta. Perine PErythematosquamous plaque of early pinta. Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.

The dorsum of the foot and legs are the most common sites of lesions (as seen in the image below).

Violaceous psoriatic plaque of early pinta. PerineViolaceous psoriatic plaque of early pinta. Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.

The regional lymph nodes may enlarge.

Lesions become pigmented with age and may change colors from copper to grey to slate blue (as seen in the image below).

Late pigmented pinta (blue variety). Perine PL, HoLate pigmented pinta (blue variety). Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.

Late lesions become achromic or hyperpigmented.

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Causes

T carateum is the causative agent and is considered to be a separate species from Treponema pallidum.

T carateum can be grown only in primates, and less is known about this treponeme than any of the others.

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Contributor Information and Disclosures
Author

Natalie C Klein, MD, PhD Associate Director, Infectious Disease Division, Associate Professor of Medicine, The School of Medicine at Stony Brook University Medical Center

Natalie C Klein, MD, PhD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, New York County Medical Society, American Medical Association, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard B Brown, MD, FACP Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine

Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Additional Contributors

Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of Ohio, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References
  1. Chulay JD. Treponema Species (Yaws, Pinta, Bejel). Mandell, Douglas, Bennett eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000. (2)2490-4.

  2. Giuliani M, Latini A, Palamara G, Maini A, Di Carlo A. The clinical appearance of pinta mimics secondary syphilis: another trap of treponematosis?. Clin Infect Dis. 2005 May 15. 40(10):1548; author reply 1548-9. [Medline].

  3. Antal GM, Lukehart SA, Meheus AZ. The endemic treponematoses. Microbes Infect. 2002 Jan. 4(1):83-94. [Medline].

  4. Engelkens HJ, Niemel PL, van der Sluis JJ, Meheus A, Stolz E. Endemic treponematoses. Part II. Pinta and endemic syphilis. Int J Dermatol. 1991 Apr. 30(4):231-8. [Medline].

  5. Hook III EW. Treponemal infections. Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases: Principles, Pathogens, and Practice. Philadelphia, Pa: Churchill Livingstone; 1999. 527-34.

  6. Morand JJ, Simon F, Garnotel E, Mahé A, Clity E, Morlain B. [Overview of endemic treponematoses]. Med Trop (Mars). 2006 Feb. 66(1):15-20. [Medline].

  7. Farnsworth N, Rosen T. Endemic treponematosis: review and update. Clin Dermatol. 2006 May-Jun. 24(3):181-90. [Medline].

  8. Woltsche-Kahr I, Schmidt B, Aberer W, Aberer E. Pinta in Austria (or Cuba?): import of an extinct disease?. Arch Dermatol. 1999 Jun. 135(6):685-8. [Medline].

  9. Engelkens HJ, Vuzevski VD, Stolz E. Nonvenereal treponematoses in tropical countries. Clin Dermatol. 1999 Mar-Apr. 17(2):143-52; discussion 105-6. [Medline].

  10. Lupi O, Madkan V, Tyring SK. Tropical dermatology: bacterial tropical diseases. J Am Acad Dermatol. 2006 Apr. 54(4):559-78; quiz 578-80. [Medline].

  11. Parish JL. Treponemal infections in the pediatric population. Clin Dermatol. 2000 Nov-Dec. 18(6):687-700. [Medline].

  12. Rothschild B. Pinta: specific disease or anomalous skin reaction?. Clin Infect Dis. 2005 Sep 15. 41(6):914. [Medline].

  13. Centurion-Lara A, Giacani L, Godornes C, Molini BJ, Brinck Reid T, Lukehart SA. Fine Analysis of Genetic Diversity of the tpr Gene Family among Treponemal Species, Subspecies and Strains. PLoS Negl Trop Dis. 2013 May. 7(5):e2222. [Medline]. [Full Text].

  14. de Caprariis PJ, Della-Latta P. Serologic cross-reactivity of syphilis, yaws, and pinta. Am Fam Physician. 2013 Jan 15. 87(2):80. [Medline].

  15. Harper KN, Ocampo PS, Steiner BM, George RW, Silverman MS, Bolotin S. On the origin of the treponematoses: a phylogenetic approach. PLoS Negl Trop Dis. 2008. 2(1):e148. [Medline].

  16. Marks M, Solomon AW, Mabey DC. Endemic treponemal diseases. Trans R Soc Trop Med Hyg. 2014 Oct. 108 (10):601-7. [Medline].

  17. Giacani L, Lukehart SA. The endemic treponematoses. Clin Microbiol Rev. 2014 Jan. 27 (1):89-115. [Medline].

  18. Mitjà O, Šmajs D, Bassat Q. Advances in the diagnosis of endemic treponematoses: yaws, bejel, and pinta. PLoS Negl Trop Dis. 2013. 7 (10):e2283. [Medline].

  19. de Caprariis PJ, Della-Latta P. Serologic cross-reactivity of syphilis, yaws, and pinta. Am Fam Physician. 2013 Jan 15. 87 (2):80. [Medline].

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Erythematosquamous plaque of early pinta. Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.
Violaceous psoriatic plaque of early pinta. Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.
Late pigmented pinta (blue variety). Perine PL, Hopkins DR, Niemel PLA, et al. Handbook of Endemic Treponematoses: Yaws, Endemic Syphilis, and Pinta. Geneva, Switzerland: World Health Organization; 1984.
 
 
 
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