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Pinta, yaws, and venereal syphilis in Colombia.

Three treponemal infections of man have coexisted in Colombia, South America for centuries. In former years, Colombia and Mexico were the world's most highly endemic countries for pinta. Within Colombia, highest rates of infection with pinta occurred among the mestizo and Indian populations in the Andean and Caribbean departments of Huila, Tolima, Antiochia, Magdalena and Cesar. Yaws occurred primarily in rural areas along the Pacific coast among descendants of African slaves. Infectious syphilis is most often reported from the three largest urban areas, and from three other densely populated departments in the Andean region. During the 21-year period from 1954 to 1974, almost four times as many cases of pinta as yaws were reported. The incidence rates of yaws and pinta have declined almost in parallel in Colombia, even though there has been a national campaign against yaws, but not against pinta. The incidence of primary and secondary syphilis increased only slightly during the same period. The total burden of reported treponematoses (excluding tertiary and congenital syphilis) declinded by over 40 per cent, while the ratios of reported yaws, pinta and infectious syphilis rose from 1:3:4 in 1954 to 1:7:975 in 1974.

Colombia

Specificity of antibodies from patients with pinta for antigens of Treponema pallidum subspecies pallidum.

Inhabitants of a remote Panamanian village were examined for clinical and serological evidence of pinta infection. Of 104 persons examined, 21 (20%) had clinical evidence of active or inactive pinta, and 54 (52%) were seropositive. Sera were evaluated for antibody to individual Treponema pallidum antigens. Sera from all four patients with active pinta contained antibody to the 47-48 kilodalton major antigen; the intensity of reactivity and the number of antigens recognized increased with age and, presumably, duration of infection. Sera from six children with inactive pinta reacted strongly with multiple T. pallidum antigens, whereas adults with inactive pinta had less intense reactivity against fewer molecules. Seronegative controls demonstrated only weak reactivity to fewer than five molecules. The development of antibody reactivity to the full spectrum of T. pallidum antigens during the course of infection demonstrates the high degree of antigenic relatedness of T. pallidum and Treponema carateum and is similar to the development of humoral responsiveness during syphilis infection.

Adolescent

[Immunology of tertiary pinta].

We've studied the immunological performed of twenty two natives Tikunas suffering from tertiary pinta. Among those, patients had been treated previously (two years earlier) which 2,400,000 IU of G benzathine penicillin, and twelve had no treatment. Both groups demonstrated an increment in the IgM synthesis (72.72%), IgG (50%), indicating the presence of strong antigenic stimuli. The great majority presenting a negative response revealed also a reduction in the cellular immune competence to at least two of the tests performed (92.3%), when were realized the PPD, DNCB and skin grafts tests.

Humans

[Histopathological aspects of tertiary pinta].

A study was made of twenty-two biopsies of achromic lesions of Tikuna Indians, carriers of tertiary pinta, inhabitants of the Umariuassu island, on the Peruvian border, ten of the subjects had been treated two years previously with a single dose of penicillin. The histopathological picture was similar for both groups. In most cases (86.36%) slight hyperkeratosis was found on the epidermis, as well as acanthosis (18.18%), with atrophy in only two cases (9.09%). In all cases there was a reduction of the melanin of the basal layer. The inflammatory lymphocyte infiltrate was predominantly perivascular (88.18%). There wasn't any endothelial swelling.

Biopsy