Medical Care
The World Health Organization (WHO) recommends treatment of pinta with a single-dose intramuscular injection of long-acting benzathine penicillin (1.2 MU for adults; 0.6 MU for children). Penicillin renders lesions noninfectious within 24 hours. [2]
Skin lesions heal slowly.
After treatment, nontreponemal titers should decline and can (but do not always) revert to negative.
The WHO started a campaign to eradicate yaws (caused by T pallidum pertenue) by 2020 based on the mass treatment of endemic communities with an oral dose of azithromycin. T carateum is most likely sensitive to azithromycin, and this intervention could therefore have a concomitant effect on pinta in regions of Latin America where both yaws and pinta might still coexist. [2] As of 2023, these efforts are ongoing; the WHO recommends integrating yaws eradication activities with neglected tropical disease (NTD) programmes (for MDA) and Skin NTDs (active surveillance). The WHO published a framework on integrated control of skin NTDs in June 2022 to assist countries with eradication efforts.
Surgical Care
Surgery has no role in pinta treatment.
Complications
Early pinta lesions usually improve with penicillin treatment, although the late changes of pinta are irreversible, often causing stigmatization in communities. [2]
Prevention
Treatment of close contacts and household members is recommended to prevent the development of infection. [1]
Long-Term Monitoring
Long-term monitoring of pinta is unnecessary. Treatment resolves early lesions and, in persons with late infections, arrests progression. A fall in two or more dilutions in the nontreponemal tests may be seen after treatment with penicillin, but serology results might not revert to negative. [1]
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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.
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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.
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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.
