Pinta Clinical Presentation

Updated: Feb 06, 2023
  • Author: Nelson Ivan Agudelo Higuita, MD, DTM&H, CTH®; Chief Editor: Michael Stuart Bronze, MD  more...
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Presentation

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 P 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.

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. Perine 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.

The regional lymph nodes may enlarge.

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

Late pigmented pinta (blue variety). Perine PL, Ho 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.

Approximately 3-9 months after infection, more lesions may appear distal to the initial lesion and expand. Late lesions become treponeme-free and achromic or treponeme-containing and 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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