Organism Treponema carateum.

Clinical features The disease has many similarities to yaws, commencing as a primary, painless papule. Secondary lesions, which develop in 3-12 months, are flat and erythe-matous, but cover large areas of the body. Tertiary lesions result in pigmentary changes often with large patches of leuco-derma. Only the skin is involved in pinta with lesions commonly on the face and extremities.

Diagnosis is made on clinical grounds with supporting evidence from positive sero-logical tests for syphilis. T. carateum can be found in the serous exudates from lesions by dark ground microscopy.

Transmission Direct contact or carriage by flies has been suggested as the means of transmission. Trauma, especially to the

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lower limbs, might facilitate entry of organisms.

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