Pinta is an infectious disease of the skin. It only occurs in tropical regions. However, due to improved hygienic conditions, the number of cases has fallen sharply.
What is Pinta?
The disease got its name from the Spanish word “pinta”, which means spot. In Colombia it also goes by the name carate. See dictionaryforall for Meckel-Gruber Syndrome in Dictionary.
Pinta is a nonvenereal as well as endemic treponematosis. It is transmitted by the pathogen Treponema carateum.
Treponema is a genus of gram-negative bacteria. They belong to the spirochaetes. This type of bacteria is composed of peculiar, helical and very mobile cells. They have a scourge that allows them to move quickly. They are also called screw bacteria.
The best-known causative agent of this genus is that of syphilis. The Treponema pathogen was first discovered in Cuba in 1938. The bacterium that causes pinta is very similar to that of syphilis. Serologically, the two diseases cannot be distinguished from one another.
Causes
Today the causes are scientifically confirmed. However, this was a long process. The detection of the pathogen turned out to be very difficult. The search for the pathogen was like a voyage of discovery like that of Christopher Columbus. In historical writings it can be read that a disease of this kind must have existed as early as the time of the Aztecs.
Pinta is an exclusively bacterial infectious disease. The causative agent of Pinta disease is native only to the tropics. However, just a few decades ago, it was still spreading like an epidemic across the country. This primarily includes Mexico and other areas in Central and South America.
The screw bacterium is transmitted through direct skin contact with infected people. Open, weeping skin lesions and poor hygienic conditions favor the infection and spread of the pathogen. Small children up to the age of five and young adults between the ages of 15 and 30 are particularly affected. Transmission via sexual contact can be largely ruled out.
Symptoms, Ailments & Signs
The symptoms of the pinta show up exclusively on the skin. First, papules form on the skin – this is known as the primary lesion. They can grow to several centimeters as they progress. The individual papules merge into one another and increasingly spread over larger areas. The papules may turn bluish.
Depigmentation of the affected skin areas is typical. Tissue atrophy is also possible. In comparison to the related syphilis, no bone lesions occur in Pinta. The cardiovascular system and the central nervous system are also usually not attacked by the pathogen.
Diagnosis & course of disease
Once the infection begins, Pinta disease requires an incubation period of two to three weeks. The further course of the disease is divided into three phases:
- In the first phase, reddish nodules appear on the skin. These are still sharply demarcated, slightly raised and not very scaly. They are not prone to swelling or decay.
- After five to ten months, the secondary lesion appears, also known as pintide. This resembles the primary lesion and occurs predominantly on the extremities and trunk. These papules go into the deeper skin layers and show the typical incipient depigmentation or a bluish discoloration. The lymph nodes also swell. Only when the disease persists for several years does a third phase develop.
- The epidermis – the upper layer of skin – thickens. This process is also called hyperkeratosis. Furthermore, the named pigmentation disorders are intensified: these can show up as over-pigmentation (hyperpigmentation) or mostly a severe loss of skin pigments (depigmentation).
The lack of pigments in the skin is reminiscent of the so-called vitiligo disease, which is one of the autoimmune diseases. In very rare cases, Pinta disease can lead to late cardiovascular effects.
The diagnosis can already be made visually in the contaminated areas. In the early stages, the diagnosis is made with the help of a microscope or via a serological test. In the early stages it is reminiscent of yaws or in the later stages of vitiligo.
The similarities to leprosy and psoriasis also make a clear diagnosis difficult. At the latest when the blue coloration begins and the depigmentation becomes apparent, it can be assigned to Pinta.
Complications
Pinta can cause a number of complications. If the skin disease remains untreated over a longer period of time, the initially small papules increase in size and number and eventually merge into one another. This leads to pain, itching and other discomfort. Sometimes there is a loss of tissue and scarring of the skin. The cardiovascular and central nervous systems are also rarely affected.
If left untreated, the lymph nodes will swell and result in what is known as hyperkeratosis, i.e. a thickening of the upper layer of skin. Accompanying this, pigment disorders such as a loss of skin pigments or hyperpigmentation occur. Possible late effects of Pinta are cardiovascular problems such as cardiac arrhythmia, circulatory collapse or heart attack. Secondary diseases such as syphilis or Ulcus molle can also be promoted.
Complications can also occur in the treatment of pinta. In the context of antibiotic therapy, side effects and interactions can occur, which are often particularly intense due to the weakened immune system. Removal of the papules is associated with the formation of scars and immediately leads to profuse bleeding, which often becomes infected and leads to the development of other skin diseases.
When should you go to the doctor?
If unusual skin changes occur after a stay in Mexico or a Central or South American country, it is advisable to consult a doctor. Pinta is a mostly chronic disease that requires lengthy treatment. If you notice the symptoms mentioned, it is best to consult your family doctor or dermatologist. Children, pregnant women, the elderly and people with an immune deficiency should see a doctor immediately if the above symptoms occur. The general practitioner, a dermatologist or a specialist in tropical diseases is responsible.
A serious course, which manifests itself, among other things, in conspicuously light or dark areas of skin, must be examined by a specialist immediately. During the therapy, which is drug-based, the patient should always consult the doctor responsible because of the high risk of side effects. If gastrointestinal problems or infections occur, it may be necessary to switch to a different preparation. Affected people ideally keep a complaint diary and keep a record of the course of the disease and the associated symptoms.
Treatment & Therapy
It took decades to localize the pathogen. Today it is known that this chronic infectious disease is a bacterium that responds very well to antibiotic therapy. The treatment is similar to that used for yaws. A single dose of penicillin is usually given for this purpose .
Clinical healing is rapid, especially in the early stages. Alternative antibiotics – such as doxycycline – are available for existing penicillin intolerance. After just 24 hours, those affected are no longer considered infectious. However, the atrophies and depigmentations that occur in the late stage are irreversible. Serological cure is also impossible. Those affected carry the pathogen for life.
Outlook & Forecast
Pinta is a rare skin disease that offers a relatively poor prognosis. The skin condition is usually chronic and can persist for years. In severe cases, those affected suffer from Pinta for the rest of their lives and have to accept various health problems as a result. The quality of life is restricted, for example, by the severe itching and the conspicuous pigment disorders. The treatment also carries risks. Pinta is usually treated with benzylpenicillin, which can lead to headaches, hair loss and other symptoms in patients.
The outlook and prognosis are based on the severity of the disease. It is provided by an internist who carries out various examinations and also looks at the previous course of the disease. Pinta does not reduce life expectancy. However, comorbidities can lead to other health problems that can reduce life expectancy. These include, for example, infections that can lead to blood poisoning.
The prospect of recovery is good if the condition is caught early, ideally within the roughly three-week incubation period. Treatment is then often possible before the condition develops into a chronic disease.
Prevention
The disease can be prevented above all by observing basic hygiene measures. Since it is a resistant bacterium that is only transmitted through skin contact, direct contact should be avoided. Furthermore, regular, thorough washing of hands – this also includes observing a contact time for the soaps and disinfectants used – is absolutely necessary.
Aftercare
In most cases, direct aftercare measures for Pinta are relatively severely limited. The person concerned is primarily dependent on a quick and, above all, early diagnosis of the disease so that no further complications or symptoms can occur. The sooner a doctor is consulted, the better the further course of the disease, so that the person concerned should consult a doctor as soon as the first signs and symptoms appear.
With Pinta, most of those affected are dependent on taking various medicines that can alleviate and limit the symptoms. The person concerned should always ensure that the dosage is correct and that it is taken regularly in order to alleviate the symptoms. When taking antibiotics, it should also be noted that they should not be taken together with alcohol.
If anything is unclear or if there are severe side effects, a doctor should always be consulted first. As a rule, no further follow-up measures are necessary for Pinta after the treatment. The disease does not reduce the life expectancy of the patient, although it can break out again despite treatment.
You can do that yourself
If Pinta is suspected, the family doctor should be consulted first. Depending on the type and severity of the disease, a number of tips and home remedies can be used alongside medical therapy to reduce the symptoms and support the recovery process.
First, the doctor will recommend strict personal hygiene. The affected areas must be carefully cared for and disinfected with a medical disinfectant. This prevents the resistant bacterium from spreading further. Regular and thorough hand washing is just as important. The tumors must not be touched or scratched for the first few days. Patients must choose clothing that will not chafe or cling to the open areas.
In addition, general measures such as exercise, a healthy diet and sufficient sleep apply. If stress is avoided at the same time, the symptoms usually subside quickly. If these measures have no effect, the doctor must be consulted. The condition may have another cause that needs to be diagnosed first. The doctor can also give further tips and, if necessary, refer the patient to a naturopath.