What are the other Names for this Condition? (Also known as/Synonyms)

• Carate
• Empeines
• Puru-Puru

What is Pinta? (Definition/Background Information)

• Pinta is a rare, infectious skin disease that is transmitted through direct skin-on-skin contact. The infection consists of 3 stages - the early phase, the intermediate phase, and the late phase
• The disease is classified as a treponematosis i.e., infectious disease caused by a Treponema, because of an involvement of the bacterium Treponema carateum. Pinta is generally seen among the younger populations in certain tropical regions of the world
• Individuals with Pinta may present red or colorless papules on the skin, primarily around the arms and legs. In this form of infection, only the skin is affected. Some individuals may experience emotional stress due to cosmetic concerns from the presence of these skin lesions
• A healthcare provider may diagnose the condition through a physical exam and lab tests to detect antibodies in blood. Upon diagnosis, antibiotics are administered to treat Pinta
• Typically, a single dose of antibiotics can eliminate the bacteria from the body. Individuals with Pinta often have an excellent prognosis, since the condition is curable

Who gets Pinta? (Age and Sex Distribution)

• Pinta is a rare condition that affects children and adolescents more than adults; the peak age of incidence is between 15-30 years. However, individuals of any age may be affected
• Both males and females and individuals of any racial or ethnic background may be affected
• The condition only presents itself in the tropical (endemic) areas of the world. This includes Southern Mexico, Central America, and certain rural regions of Columbia. Only a few 100 cases are reported in the endemic regions each year

What are the Risk Factors for Pinta? (Predisposing Factors)

The risk factors for Pinta include the following:

• Residing in or visiting rural areas of certain tropical countries such as places like Southern Mexico, Central America, and Columbia
• Overcrowded spaces
• Coming into direct contact with the infected individuals

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pinta? (Etiology)

Pinta is caused following an infection by Treponema carateum, a spiral-shaped bacterium (spirochete).

• It is transmitted via direct, but non-sexual, skin contact. It can spread from one individual to another
• Some researchers believe that certain insect bites can also result in the transmission of Pinta

What are the Signs and Symptoms of Pinta?

The signs and symptoms of Pinta and its progression can vary from one individual to another. It may be mild in some and severe in others. There are 3 phases of Pinta, namely the following:

• Early phase
• Intermediate phase
• Late phase

The signs and symptoms of the early phase present itself within 7 to 21 days of incubation. It may include:

• Presence of erythematous papules (small reddish skin spots), commonly seen on the arms and legs
• Itchiness and spreading of the papules to other body regions
• Lymphadenitis or swelling of the lymph nodes

The signs and symptoms of the intermediate phase may present itself anywhere from between a month to 12 months following incubation. It may include:

• The presence of ‘pintids’, which are small, scaly, reddish lesions (secondary skin lesions)
• The lesions change to a brown or blue color and eventual cause depigmentation (loss of skin color)

The signs and symptoms of the late phase can occur around 2-5 years after the early phase and may include:

• Presence of achromatic lesions (white or colorless lesions)
• Hyperkeratosis (dry and thickened skin) of the palms of the hand and soles of the feet
• Atrophic (degraded) skin in certain locations

How is Pinta Diagnosed?

Pinta may be diagnosed by a healthcare provider using the following tools:

• Complete physical examination including analysis of previous medical and travel history
• Blood tests for antibodies against the organism
• Microscopic examination of tissue samples
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist may arrive at a diagnosis of Pinta

Note: A skin biopsy may show the presence of the pathogenic organisms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pinta?

• The complications of Pinta may include emotional stress due to one’s physical appearance from the presence of the skin lesions (cosmetic concerns)
• The condition is longstanding and it may take several years to cure, in the absence of appropriate treatment

How is Pinta Treated?

Pinta is a curable disease that is generally treated by healthcare professionals using medications. The healthcare provider may administer the following antibiotics to treat the disease:

• Benzathine penicillin, which is the preferred choice
• Tetracycline or erythromycin may be used in individuals who are allergic to penicillin

How can Pinta be Prevented?

Pinta may be prevented by considering the following measures:

• Practicing proper sanitary techniques, such as washing one’s hands, to avoid the spread of infection
• Avoiding rural endemic areas in the tropical regions of the Southern Mexico, Central America, and Columbia, when possible; or, if unavoidable, considering adequate precautionary techniques
• Treating family members and friends who are in contact with the affected individual, to prevent further spread of the condition

What is the Prognosis of Pinta? (Outcomes/Resolutions)

• The prognosis for Pinta is generally excellent with adequate treatment, since the condition is not life-threatening. Moreover, the skin is the only organ that is affected
• In the absence of suitable treatment, this infectious disease may persist for several years

Additional and Relevant Useful Information for Pinta:

• Treponematosis consists of diseases caused by the bacterial species Treponema. It consists of non-sexually transmitted conditions including Pinta, bejel, and yaws, along-with the sexually transmitted infectious disease syphilis

Please visit our Infectious Diseases Health Center for more physician-approved health information:

https://www.dovemed.com/diseases-conditions/infection-center/