Pinta (Treponema carateum)
Chronic, tropical, nonvenereal spirochetal infections spread by body contact.
🌍 About
- Pinta is a chronic treponemal infection caused by Treponema carateum.
- Occurs mainly in poor rural populations with low hygiene standards.
- Transmission often occurs within families via shared eating and drinking utensils or close contact.
- Unlike syphilis or yaws, pinta affects only the skin (dermis) and does not involve bone or viscera.
🧬 Aetiology
- Organism: Treponema carateum (closely related to T. pallidum).
- Spread through skin-to-skin contact or contaminated utensils in endemic areas (Central & South America).
🩺 Clinical Features
- Lesions limited to skin: No systemic or visceral involvement.
- Begins as a small papule which enlarges and becomes hyperkeratotic.
- Sites: extremities, face, and neck.
- Later, lesions become thickened, flat, and may develop pigmentary changes (hypo- or hyperpigmentation).
- Disfigurement can be significant but rarely life-threatening.
🔬 Investigations
- Serology: Positive syphilis tests (VDRL, TPHA, RPR, FTA-ABS) — indistinguishable from other treponematoses.
- Microscopy: Dark-field detection of spirochetes possible from active lesions.
- Diagnosis is clinical in endemic regions, supported by serology.
💊 Management
- First-line: Azithromycin (PO) single dose 30 mg/kg (max 2 g).
- Alternative: Benzathine penicillin (IM)
- 0.6 million units if <10 years old.
- 1.2 million units if ≥10 years old.
- Mass treatment campaigns recommended in endemic areas to break transmission.
📚 References
