Pinta (meaning “spotted”) is also called mal de pinto and carate. It is the least destructive of the treponematoses that are pathogenic for humans. Although the taxonomy of these treponemes is by no means resolved, pinta is sufficiently distinctive to argue for a separate causal species, Treponema carateum. As a specific treponemal variety, it was not described until 1938. The disease is chronic, predominantly affects the skin, and is now found only among isolated rural groups in Central and South America and Mexico, where it is endemic. Local names for the illness are tiña, empeines, and vitiligo.

Distribution and Incidence

According to one historian of treponemal diseases, pinta may have had a considerable world distribution at the end of the Paleolithic period, some 10,000 years ago. However, its past geographic distribution is in some doubt, and an alternative view suggests that it may have evolved purely in Amerindian communities of the New World, as a final level of micro-evolutionary change in the treponematoses there. Because it is not a very destructive condition, and may remain untreated in many individuals of the Third World countries of Latin America, it has been estimated that as many as a million individuals may have the disease.

Epidemiology and Etiology

Pinta is caused by T. carateum, which cannot be distinguished from Treponema pallidum (the causative agent of endemic and venereal syphilis). These treponemes are found mainly in the lower Malpighian layers of the epidermis, and may be present for years before the skin lesions eventually become inactive and depigmented. Large areas may be infected, and the disease may remain infectious for a long period.