Pinta: specific disease or anomalous skin reaction?

Sir—Although Giuliani et al. [1] refer to pinta as a separate disorder, and it has been suggested that its pathology is limited to the skin, review of the literature on pinta actually revealed the presence of bone involvement [2]. That pattern of bone involvement in the pinta-afflicted individuals was no different from the endemic pattern of treponematoses found in the area [3]. Pinta simply appears to represent an anomalous dermatologic reaction complicating treponemal disease, which, in the case described by Kim et al. [4], was syphilis. The name " pinta " does have an intriguing history. Ruiz Diaz de Isla, the physician of the commander of the ship Pinta in Columbus's fleet, was the first to recognize then the new disease we now call syphilis [3]. Thus, pinta comes full circle in the saga of the treponematoses.