Pinta

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

Background

Pinta is an endemic treponematosis caused by Treponema carateum. [1] It is an ancient disease that was first described in the 16th century in Aztec and Carib Amerindians. In 1938, treponemes indistinguishable from those that cause yaws and syphilis were demonstrated in lesions of a Cuban patient. [2] Pinta is characterized by chronic skin lesions that occur primarily in young adults. [3, 4, 5, 6, 7]

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Pathophysiology

Like other treponematoses, pinta is classified into an early and late stage. The early stage comprises the initial lesion and the secondary lesions, while the late stage comprises the latent phase and tertiary stage.

After an incubation period of approximately 2-3 weeks, the initial lesion appears on the skin. The primary lesion is a papule or erythematosquamous plaque usually found on exposed surfaces of the legs, dorsum of the foot, forearm, or hands. The lesion slowly enlarges and becomes pigmented and hyperkeratotic. It is often accompanied by regional lymphadenopathy.

Disseminated lesions, referred to as pintids, are similar to the primary lesion and may appear 3-9 months after infection. These secondary lesions vary in size and location and become pigmented with age.

Late or tertiary pinta is characterized by disfiguring pigmentary changes, hypochromia, achromic lesions, and hyperpigmented and atrophic lesions. The pigmentary changes often produce a mottled appearance of the skin. Lesions may appear red, white, blue, violet, and brown.

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Epidemiology

Frequency

United States

Pinta does not occur in the United States.

International

Pinta occurs in scattered foci in rural areas of Central and South America. [8] In the 1950s, about 1 million cases of pinta were reported in Central and South America. In the 1980s, 20% seropositivity was found in remote rural areas of Panama. The current prevalence of pinta is unknown, but only a few hundred cases have been reported per year. [9, 10]

Mortality/Morbidity

Pinta is the most benign of the endemic treponematoses. The skin is the only organ involved.

No neurologic, bone, or cardiac manifestations occur. No congenital form exists.

Sex

Both sexes are affected with equal frequency.

Age

Pinta affects children and adults of all ages. [11]

The peak age of incidence is 15-30 years.

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