Pinta Workup

  • Author: Natalie C Klein, MD, PhD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Aug 3, 2011
 

Laboratory Studies

  • Pinta is most often a clinical diagnosis.
  • The nontreponemal and treponemal serologic tests used in diagnosing venereal syphilis are used for serodiagnosis of pinta.
  • Treponemes can be demonstrated by darkfield examination of exudates from early lesions.
  • Nontreponemal test results (ie, rapid plasma reagent [RPR], Venereal Disease Research Laboratory [VDRL] test) are positive in all stages of pinta except very early lesions. Confirmatory treponemal test results (ie, T pallidum hemagglutination [TPHA], microhemagglutination T pallidum [MHA-TP], fluorescent treponemal antibody absorption [FTA-Abs]) are also positive but are not practical in remote areas.
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Histologic Findings

Findings of pinta and yaws are similar, but pinta does not cause ulcer formation. In early lesions, mild acanthosis is present with migration of lymphoid cells into the epidermis. In the late stage, irregular acanthosis or epidermal atrophy occurs. Treponemes can be demonstrated in the epidermis in primary and secondary lesions using silver stain. They are absent in late achromic lesions.[12]

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Contributor Information and Disclosures
Author

Natalie C Klein, MD, PhD  Associate Professor, Department of Medicine, Division of Infectious Diseases, SUNY School of Medicine at Stony Brook; Associate Director, Winthrop-University Hospital

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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 America, and Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

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, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Chulay JD. Treponema Species (Yaws, Pinta, Bejel). In: 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. May 15 2005;40(10):1548; author reply 1548-9. [Medline].

  3. Antal GM, Lukehart SA, Meheus AZ. The endemic treponematoses. Microbes Infect. Jan 2002;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. Apr 1991;30(4):231-8. [Medline].

  5. Hook III EW. Treponemal infections. In: 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). Feb 2006;66(1):15-20. [Medline].

  7. Farnsworth N, Rosen T. Endemic treponematosis: review and update. Clin Dermatol. May-Jun 2006;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. Jun 1999;135(6):685-8. [Medline].

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

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

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

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