Introduction:
Pinta disease is a chronic skin disease that is caused by a bacteria called Treponema carateum. Other Treponema species are responsible for causing yaws and syphilis (sexually transmitted infection caused by spirochete Treponema pallidum). Yaws is a chronic skin infection affecting bones and is caused by the bacterium Treponema pallidum pertenue. Pinta disease only affects the skin. The condition is characterized as a raised papule followed by eruption of flat and reddened areas. These papules or bumps grow and change color. If the condition is left untreated, it leads to significant changes and permanent discoloration. Public education and improved living conditions can prevent the spread of the condition. The article discusses Pinta disease, its causes, symptoms, treatment, and prevention.
What Is a Pinta Disease?
Pinta disease is a relatively non-cancerous, mild, or non-progressive human skin infection. It is a group of bacterial infections known as endemic treponematoses, which also include other bacterial infections, such as yaws and syphilis. The bacteria causing Pinta and syphilis are somewhat similar, but Pinta disease is not a sexually transmitted infection. It affects other people through skin-to-skin contact.
The disease was first described in the 16th century in the Caribbean, Mexico, and by Aztec Amerindians. The condition was endemic to Mexico, Central America, and South America and may have been eradicated. The latest case of Pinta disease occurred in Brazil in 2020. The other names of Pinta disease include tina, Azul, lota, carate, mal del pinto, and empeines. In 1950, the prevalence of the condition was about one million, and now, only a hundred cases are reported yearly.
What Are the Causes of Pinta Disease?
Pinta is usually found in rural or tropical areas, spreading easily and affecting others. The main bacteria causing this skin infection is Treponema carateum. The bacteria is closely related to syphilis and is specifically adapted to affect the skin. Pinta usually spreads through skin-to-skin contact with an infected person. This occurs in conditions where people have frequent physical contact. In addition, the warm and humid climate creates an environment conducive to the spread of bacteria. Furthermore, poor sanitation, limited access to clean water, and limited access to medical facilities can increase the risk of Pinta. Poor hygiene practices can increase the transmission of the bacteria.
What Are the Signs and Symptoms of Pinta Disease?
The incubation period of Pinta disease is two or three weeks. The main symptom associated with Pinta disease is the formation of an abscess or rash. The condition goes through three stages that have been described below:
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Primary Pinta: The early Pinta starts as a small raised rash, papules, or bumps when a person gets infected with the bacterium. The incubation period of primary Pinta is two to three weeks. These bumps slowly enlarge and become large, flat, itchy, red scaly plaques. These become thick and hard. These skin lesions usually affect the face, neck, back of the hands, exposed areas of the legs, and forearms. There will be an enlargement of the lymph nodes near the affected area. However, no systemic symptoms have developed.
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Secondary Pinta: The second phase starts after six months to three years of bump appearance. There will be widespread skin eruption. Small papules or large plaques with abnormal pigmentation and scaling all over the body will appear, which are called pintids. The skin becomes thick. The skin lesions may appear red or white but turn blue, gray, or brown and are often very itchy.
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Tertiary Pinta: These are also called late lesions because they appear years later. White or brown skin lesions, called dyschromic macules, will appear. There will be a complete loss of pigment and color (achromic), and the skin will become thin (atrophic). In the tertiary stage, the skin changes are permanent.
How Is Pinta Disease Diagnosed?
The diagnosis process of Pinta disease is as follows:
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Physical Examination: The healthcare provider may physically examine the patient to check the extent of the skin lesion and look for the associated symptoms, such as rash or bumps.
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Laboratory Tests: The laboratory tests distinguish Treponema carateum from other Treponema species.
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Dark Field Microscopy: The healthcare provider will take a swab and rub it across the early skin lesions, then send the sample to the laboratory to examine under a microscope. This will help to identify the bacteria causing the infection.
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Serological Blood Tests: The blood test distinguishes syphilis from Pinta disease. The test will be positive for syphilis.
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Biopsy: The biopsy reveals characteristic microscopic changes. For primary or early lesions, treponemas may be demonstrated using a silver stain.
How Is Pinta Disease Treated?
The effective treatment for Pinta disease is antibiotics. These drugs eliminate the infection and prevent complications. Primary and secondary Pinta can be managed with the help of antibiotics, and the rashes heal over time. The skin damage caused at the late stage is permanent and irreversible and cannot be managed with antibiotic treatment. The treatment strategies for Pinta disease are as follows:
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Antibiotics: Antibiotics are the first drug of choice for managing the condition. The primary treatment for Pinta disease is a Benzathine penicillin G intramuscular injection. The healthcare provider may inject a single dose of antibiotic to cure the infection.
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Alternative to Drug Penicillin: If an individual is allergic to Penicillin, the healthcare provider may use other antibiotics, such as Tetracycline, Erythromycin, and Doxycycline. These drugs are taken orally for around two weeks.
What Are the Preventive Measures for Pinta Disease?
The preventive measures for Pinta disease are as follows:
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Health Education: Healthcare professionals, including doctors, nurses, and pharmacists, may educate people about the transmission of Pinta and the importance of hygiene, which helps reduce the spread of skin infections.
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Maintenance of Hygiene: Good hygiene and sanitation may prevent the spread of Pinta.
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Community Health Programs: Community health programs, including screening and treatment programs, can help early identify and manage Pinta cases, reducing the spread or transmission of skin infections within the community.
Conclusion:
Pinta disease is a chronic and rare inflammatory skin lesion causing a rash or bumps on the face, neck, and exposed areas of the legs and forearms. It can be transmitted through skin-to-skin contact. The healthcare provider may diagnose the condition by blood tests and biopsy. Antibiotics are the primary treatment option to manage the condition. Community health programs and health education are the preventive measures to reduce the spread of Pinta disease.
