Countries with pinta: Mexico, Panama, Peru, Columbia, Northern Brazil
Pathogen: Treponema carateum.
The typical patient is in a poor, rural community in the tropics, with exposure during childhood to infectious skin lesions. It is not typically spread as a sexually-transmitted disease.
The disease has 3 stages: primary, secondary and late
The primary infection is associated with skin lesions that are typically on the distal extremities:
(1) hyperkeratotic papules
(2) erythematous plaques
(3) regional lymphadenopathy
The secondary stage appears after several months with secondary disseminated lesions called "pintids" that may coalesce into plaques.
Late lesions may show extensive depigmentation, hyperpigmentation or acral dyschromia (red, blue, violet, brown) with dermal atrophy.
Infections are NOT associated with bone, cardiovascular or neurological manifestations.
It can show serologic cross-reactivity with syphilis and yaws.