Pinta, the Rare Skin Disease: Symptoms, Diagnosis, Treatment, and More

Pinta disease, caused by Treponema carateum, was first described in the 16th century among Aztec and Carib Amerindians in Mexico, Central America, and South America. However, Brumpt first identified the pathogen as the cause of pinta in 1939.

The word ‘Pinta’ translates to ‘painted’ in Spanish, denoting the skin lesions that are a hallmark of the disease. 

Pinta is also known by other names like: 

• Mal de pinto in Cuba and Mexico (pinto means spotted, and mal refers to disease. Mal de pinto refers to the spotted disease, referring to the skin lesions)
• Enfermedad azul (blue sickness) in Chile and Peru. Enfermedad azul means ‘blue sickness’ in Spanish. Azul is blue and may refer to the late-stage skin discoloration from pinta. 
• Carate in Colombia and Venezuela. 

Other historical milestones in the discovery, diagnosis, and treatment of pinta are:

• 1910: the first serological test for syphilis was developed. This scientific milestone helped in the detection of not only syphilis but also other treponemal diseases like pinta and yaws.
• 1928: Other medical discoveries helped further the research on pinta. For example, the discovery of penicillin transformed the face of medicine as we know it, including the treatment and management of pinta.

1998: Fraser et al. unraveled the genetic makeup of Treponema pallidum, paving the way for deeper insights into other treponemal pathogens such as Treponema carateum.

Notable Outbreaks

• 1950s: About 1 million cases of pinta were reported in Central and South America, highlighting its significant impact on the region. 
• 1982-1983: Pinta cases were found in a remote village in Panama.
• 1987 and 1993: Pinta cases were reported in the Amazon borders of Brazil, Peru, and Columbia. 
• 2020: Autochthonous cases were reported in southern Brazil, indicating that Pinta may still exist in certain areas. Autochthonous refers to locally acquired or locally originating infections).

At-risk populations

• Pinta affects individuals across all age groups, with the highest rates of occurrence observed among those aged 15 to 30. The disease affects males and females equally.

Endemic regions

• Pinta is endemic to Mexico, Central America, and South America. Cases of pinta have been identified in specific areas such as Brazil, Colombia, Peru, Panama, and Cuba.

Epidemiology data and references were obtained from GIDEON, a leading infectious diseases database. For information on the A-Z of infectious diseases, visit gideononline.com.

Pinta is primarily spread through direct skin-to-skin contact with an infected person. There are no known animal reservoirs for the disease. It’s important to note that this bacterial infection is not a sexually transmitted infection (STI).

Pinta is an infectious disease that only affects the skin.

Pinta primarily affects the skin. 

There are three distinct stages of pinta symptoms: 

• Primary pinta: This early phase starts with one or more small bumps (papules) that grow into large, itchy, red, scaly patches (plaques). These patches mostly appear on exposed parts of the skin, like the tops of the feet, legs, hands, back, and forearms. The lymph nodes nearby might swell, but there are usually no other symptoms throughout the body. 
• Secondary pinta: This stage manifests as a broader skin eruption with a variety of papules and large plaques. These larger plaques are called ‘pintids’. These lesions can develop six months to three years after initial symptoms occur and have abnormal pigmentation and scaling. They may be present in different colors, ranging from red, white, and blue to violet or brown.
• Tertiary pinta: This represents late-stage lesions and shows up as skin changes, where the color fades, and skin gets thinner.

Pinta diagnosis is usually through a set of recommendations based on clinical evaluation and laboratory tests to confirm the disease-causing agent. 

• • Patient history: A detailed patient history is very important, and questions about recent travel are particularly significant because pinta is usually endemic to Central and South America.

• Clinical evaluation: A physical examination is conducted to detect skin lesions and note symptoms.

Laboratory tests: Tissue samples are gathered from the skin lesions and studied in the lab to identify Treponema carateum. Blood tests may also be performed; these include the VDRL (Venereal Disease Research Laboratory) and the Treponemal antibody absorption test (FTA-ABS).

Differential diagnosis: When diagnosing skin diseases in Latin American children, adolescents, or people who have traveled to South America, it’s important to consider pinta as a possible cause. This can help distinguish the disease from other skin-related conditions like eczema, psoriasis, syphilis, and leprosy.

According to the World Health Organization (WHO), treatment for pinta involves long-acting benzathine penicillin. Penicillin can make pinta lesions non-infectious within 24 hours. 

If a person is allergic to penicillin or has an intolerance to it, doxycycline is an alternative therapy.

While antibiotics can cure the disease, they cannot reverse skin changes that may have occurred in late-stage pinta. Also, pinta lesions can continue to persist without treatment.

Some ways to prevent pinta include: 

• Avoiding direct contact: Avoiding skin-to-skin contact with infected individuals or people suspected to have the infection can help prevent disease transmission. 
• Improved personal hygiene: Regular handwashing and skin care can help reduce the risk of infection.
• Wearing protective clothing: Wearing protective clothing that covers exposed skin areas can help prevent insect bites or direct skin contact with infected individuals.

Pinta is a rare infectious disease caused by the bacteria Treponema carateum. The pathogen is from the same family as the bacteria that causes syphilis, but it is not sexually transmitted. 

The infection has been endemic to Central and South America since the 16th century. However, due to globalization and climate change, there’s a growing need for global healthcare awareness to prevent its spread.

With roots tracing back to the Aztecs and significant outbreaks noted throughout the centuries, understanding pinta’s history, symptoms, and treatments is crucial. Doctors, epidemiologists, and other infectious disease experts should look for signs of pinta and help manage the spread of the disease.

GIDEON is one of the most well-known and comprehensive global databases for infectious diseases. Data is refreshed daily, and the GIDEON API allows medical professionals and researchers access to a continuous stream of data. Whether your research involves quantifying data, learning about specific microbes, or testing out differential diagnosis tools– GIDEON has you covered with a program that has met standards for accessibility excellence.

Learn more about more bacterial infections on the GIDEON platform.