Infectious Disease Online

Pathology of Pinta

Dr Sampurna Roy MD

 

                                                                                                                      

 


   I II

I Papillomatous primary yaws lesion (A); disseminated papilloma of secondary yaws (B); labial mucosal plaques of primary bejel (C); disfiguring infiltration of the nose, glabella, and forehead in a patient with secondary bejel (D); squamous plaque of primary pinta (E); late achromic pinta (F). Sources of photographs: O. Mitjā, Papua New Guinea (A, B); A. Abdolrasouli, Iran (C, D); F. Gómez, Mexico (E, F).

II Countries with reported data on yaws, bejel, and pinta from 1980 to 2012

Mitjā O, Šmajs D, Bassat Q (2013) Advances in the Diagnosis of Endemic Treponematoses: Yaws, Bejel, and Pinta. PLoS Negl Trop Dis 7(10): e2283. doi:10.1371/journal.pntd.0002283

 

 

Visit related posts: Pathology of Yaws ;  Pathology of Syphilis ; Neurosyphilis ; Bejel ; Congenital Syphilis.

 

Pinta is a contagious, mild, systemic, nonvenereal treponematosis caused by Treponema carateum, which is morphologically identical to Treponema pallidum.

The disease occus in the Caribbean area, Central America and parts of remote, arid inland regions and river valleys of the Tropical South America.

Mode of transmission:  Exact mode of transmission is not known. It is probably transmitted by direct skin to skin contact.

Clinical presentation: 

The lesions of pinta are confined to the skin and become very extensive.

These are usually located on the extremities.

There is often overlap between the three clinical stages. Initial lesions are erythematous maculopapules, which grow by peripheral extension and often coalesce.

The secondary lesions are widespread, long-lasting scaly plaques that show a striking variety of colours - red, pink, slate blue and purple.

These lesions merge with the late stage, in which depigmentation resembling vitiligo occurs, and sometimes there is epidermal atrophy.

Microscopic features:  Primary and secondary lesions are identical and show hyperkeratosis, parakeratosis and acanthosis.

There is exocytosis of inflammatory cells, sometimes with intraepidermal abscesses.

Hypochromic areas show loss of basal pigmentation with numerous melanophages in the upper dermis.

The dermal infiltrate, like the other changes, is heavier in established than in early lesions and includes lymphocytes, plasma cells and sometimes neutrophils.

The infiltrate is predominantly superficial and perivascular.

The treponemes can be demonstrated by silver methods - they are present mainly in the upper epidermis and are rarely found in the dermis.

Darkfield examination of exudate and serologic tests for syphilis are positive when the secondary lesions appear.

A single dose of long-acting penicillin is curative.

 

Further reading:

Tertiary pinta: case reports and overview.

[Histopathological aspects of tertiary pinta].

[Ultrastructure of pinta].

[Immunity conditions in treponematoses]

The clinical appearance of pinta mimics secondary syphilis

Overview of endemic treponematoses.

Tropical dermatology: bacterial tropical diseases.

The endemic treponematoses.

Pinta in Austria (or Cuba?): import of an extinct disease?

Nonvenereal treponematoses: yaws, endemic syphilis, and pinta.

Epidemiology of endemic non-venereal treponematoses.

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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