Pinta

Definition

Pinta is a bacterial infection of the skin that causes lesions, red to bluish-black colored spots and splotches, and discoloration of the skin.

Description

Pinta is a skin infection caused by the bacterium Treponema carateum , a relative of the bacterium that causes syphilis. The word "pinta" comes from Spanish and means "painted." Pinta is also known as "azula" (blue), and "mal de pinto" (pinto sickness). It is one of several infections caused by different Treponema bacteria, which are called "endemic" or "non-venereal" treponematoses.

Transmission

Pinta is spread from one person to another by direct skin-to-skin contact. The bacteria enter the skin through a small cut, scratch, or other skin damage. Once inside the body, warmth and moisture allow the bacteria to multiply. The bacterial infection causes red, scaly lesions on the skin.

Demographics

Pinta is primarily found in rural, poverty-stricken areas of northern South America, Mexico, and the Caribbean. The disease is usually acquired during late childhood and adolescence . It is very rare in the United States. In the 1950s, it is estimated that there were about one million cases of Pinta in South and Central America. That number has been reduced drastically, and recently there are believed to be only a few hundred cases a year in those areas.

Causes and symptoms

Pinta is caused by an infection with the bacterium Treponema carateum . Symptoms occur two to four weeks after exposure to the bacteria. The first sign of infection is a red, scaly, slowly enlarging bump on the skin. This is called the primary lesion. The primary lesion usually appears at the site where the bacteria entered the skin, most often on the arms, legs, or face. Smaller lesions then form around the primary lesion. These are called satellite lesions. Lymph nodes located near the infected area may become enlarged, but are painless.

The second stage of pinta occurs between one and 12 months after the primary lesion stage. Many flat, red, scaly, itchy lesions called pintids occur either near the primary lesion, or scattered around the body. Pintid lesions progress through a range of color changes, from red to bluish-black. The skin of older lesions will become depigmented (lose normal color).

When to call the doctor

If the parent notices red scaly lumps, strange patterns of discoloration, or lesions on a child's skin the doctor should be contacted.

Diagnosis

Pinta can be diagnosed by dermatologists (doctors who specialize in skin diseases) and infectious disease specialists. The appearance of the lesions helps in the diagnosis. A blood sample will be taken from the patient's arm to test for antibodies to Treponema carateum . A scraping of a lesion will be examined under the microscope to look for Treponema bacteria.

Treatment

Pinta is usually treated with a single injection of benzathine penicillin G (Bicillin). This is very effective and is the treatment of choice. However if the child is allergic to penicillin, alternate antibiotics can be prescribed.

Prognosis

Approximately 24 hours after the treatment the skin lesions are no longer infectious and the child can no longer transmit the disease to others. Treatment results in a complete cure, but will not undo any skin damage caused by the late stages of disease. The lesions heal slowly over many months. If pinta spreads to the eyes, irreversible eyelid deformities may persist.

Prevention

Good personal hygiene may help prevent pinta. In general, children should avoid physical contact with persons who have skin lesions.

Parental concerns

Pinta only affects the skin and does not affect life expectancy, even if not treated, and it can usually be cured completely. The most significant concern is that if pinta is not diagnosed and treated promptly, the pigmentation changes in the skin may be permanent. This can cause the child to have a negative self-image and possibly lead to rejection by other children.

Resources

BOOKS

Desowitz, Robert S. Who Gave Pinta to the Santa Maria?: Torrid Diseases in a Temperate World San Diego: Harcourt Brace, 1998

Weinberg, Samuel, Neil S. Prose and Leonard Kristal Color Atlas of Pediatric Dermatology New York: McGraw-Hill Health Professions Division, 1998.

ORGANIZATIONS

National Organization for Rare Disorders, Inc. 55 Kenosia Ave, PO Box 1968, Danbury, CT 06813-1968. (203) 744-0100. http://www.rarediseases.org

Tish Davidson, A.M.
Belinda Rowland, PhD