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 Mal-pighian 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. It is unusual for other areas of the body, such as the genitals, to be involved. In contrast to the other human treponematoses, the skeleton is never affected.

This chronic clinical condition usually begins in childhood and lasts into adulthood, if not for most of the lifetime of an infected individual. Social and hygienic factors result in the differential incidence of the disease in varying components of Latin American societies, with native Indians, mestizos, and blacks being most affected. Infection seems most likely to be by skin contact. Insect vectors have also been suggested as a means of transmission, but this has not been substantiated.

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