Pinta

Caused by Treponema pallidum subspecies carateum

Occurs endemically in rural areas of Latin America, especially in Mexico, Colombia, and Cuba, and in some areas of the Pacific

Nonulcerative, erythematous primary papule

• Spreads slowly into a papulosquamous plaque

• Shows a variety of color changes (slate, lilac, black)

Secondary lesions

• Resemble the primary one and appear within a year after it

• Appear successively, new lesions together with older ones

• Occur most common on the extremities

• Later show atrophy and depigmentation

Some cases show pigmentary changes and atrophic patches on the soles and palms, with or without hyperkeratosis, that are indistinguishable from "crab yaws"

Organisms can be demonstrated in infectious lesions with darkfield microscopy or immunofluorescence but cannot be cultured in artificial media

Serologic tests for syphilis are positive

Penicillin, 2.4 million units of benzathine penicillin G intramuscularly, is generally curative in any stage of the non–sexually transmitted treponematoses

In cases of penicillin hypersensitivity, tetracycline, 500 mg orally four times a day for 10–14 days, is the recommended alternative