Pinta in Austria (or Cuba?): import of an extinct disease?

BACKGROUND: Pinta, 1 of the 3 nonvenereal treponematoses, is supposed to be extinct in most areas in South and Central America, where it was once endemic. Only scattered foci may still remain in remote areas in the Brazilian rain forest, and the last case from Cuba was reported in 1975.

OBSERVATION: A native Austrian woman, who had lived for 7 years in Cuba and was married to a Cuban native, developed a singular psoriasiform plaque on her trunk and several brownish papulosquamous lesions on her palms and soles during a visit to her home in Austria. Positive serological findings for active syphilis and the detection of spirochetes in the trunk lesion indicated early secondary syphilis, but an extensive case history and the clinical appearance fulfilled all criteria for pinta.

CONCLUSION: The acquisition of a distinct clinical entity, pinta, in a country where it was formerly endemic but now is believed to be extinct raises the question of whether the disease is in fact extinct or whether syphilis and pinta are so similar that no definite distinction is possible in certain cases.