Pinta is a non-venereal treponematosis caused by Treponema carateum.
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name: Pinta
creation_date: '2026-01-26T15:40:02Z'
updated_date: '2026-04-04T23:04:34Z'
category: Infectious Disease
description: >-
Pinta is a non-venereal treponematosis caused by Treponema carateum.
disease_term:
term:
id: MONDO:0000979
label: pinta disease
preferred_term: Pinta
parents:
- Bacterial Infection
- Neglected tropical disease
infectious_agent:
- name: Treponema carateum
description: Treponemal agent of pinta.
evidence:
- reference: PMID:24396138
reference_title: "The endemic treponematoses."
supports: SUPPORT
snippet: "T. pallidum subsp. pertenue, T. pallidum subsp. endemicum, and T. carateum are the agents of the endemic treponematoses yaws, bejel (or endemic syphilis), and pinta, respectively."
explanation: The abstract identifies T. carateum as the agent of pinta.
phenotypes:
- name: Abnormality of skin pigmentation
category: Dermatologic
frequency: COMMON
phenotype_term:
preferred_term: Abnormality of skin pigmentation
term:
id: HP:0001000
label: Abnormality of skin pigmentation
evidence:
- reference: PMID:23332859
reference_title: "From badge of pride to cause of stigma: combatting mal del pinto in Mexico."
supports: SUPPORT
snippet: "Mal del pinto is a dermatological disease characterized by discoloured patches of skin on the face and body."
explanation: The abstract describes discoloured patches of skin in pinta.
treatments:
- name: Penicillin injection
description: Single-dose intramuscular penicillin treats all stages of pinta.
treatment_term:
preferred_term: Pharmacotherapy
term:
id: NCIT:C15986
label: Pharmacotherapy
evidence:
- reference: PMID:26304920
reference_title: "Pinta: Latin America's Forgotten Disease?"
supports: SUPPORT
snippet: "All stages of pinta are treatable with a single intramuscular injection of penicillin."
explanation: The abstract states that penicillin injection treats pinta.
references:
- reference: DOI:10.1111/ijd.15264
title: Mal de Pinta, first autochthonous case from South of Brazil
found_in:
- Pinta-deep-research-falcon.md
findings:
- statement: Mal de Pinta, first autochthonous case from South of Brazil
supporting_text: Mal de Pinta, first autochthonous case from South of Brazil
- reference: DOI:10.1371/journal.pntd.0002283
title: 'Advances in the Diagnosis of Endemic Treponematoses: Yaws, Bejel, and Pinta'
found_in:
- Pinta-deep-research-falcon.md
findings:
- statement: 'Advances in the Diagnosis of Endemic Treponematoses: Yaws, Bejel, and Pinta'
supporting_text: 'Advances in the Diagnosis of Endemic Treponematoses: Yaws, Bejel, and Pinta'
- reference: DOI:10.15585/mmwr.rr7301a1
title: CDC Laboratory Recommendations for Syphilis Testing, United States, 2024
found_in:
- Pinta-deep-research-falcon.md
findings:
- statement: CDC Laboratory Recommendations for Syphilis Testing, United States, 2024
supporting_text: CDC Laboratory Recommendations for Syphilis Testing, United States, 2024
- reference: DOI:10.3389/fimmu.2023.1126170
title: 'Syphilis vaccine: challenges, controversies and opportunities'
found_in:
- Pinta-deep-research-falcon.md
findings:
- statement: Syphilis is a sexually or vertically (mother to fetus) transmitted disease caused by the infection of Treponema pallidum subspecie pallidum (TPA).
supporting_text: Syphilis is a sexually or vertically (mother to fetus) transmitted disease caused by the infection of Treponema pallidum subspecie pallidum (TPA).
Pinta is a neglected chronic skin disease and the most benign of the endemic treponematoses, in that it is classically described as involving only the skin (without the destructive bone/cartilage manifestations typical of late yaws). It has been described historically in Latin America for centuries and is also referred to as “mal del pinto” and “carate.” (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2)
Within the retrieved full-text evidence set, explicit ontology/coding identifiers (MONDO, MeSH descriptor IDs, ICD-10/ICD-11 codes, Orphanet, OMIM) were not directly stated, and therefore cannot be asserted here with citations. The most authoritative retrieved recent resource is the CDC’s 2024 laboratory recommendations, which provide organism-level taxonomy and a brief epidemiologic locator but do not provide ICD/MeSH/MONDO mappings. (papp2024cdclaboratoryrecommendations pages 3-4, papp2024cdclaboratoryrecommendations pages 25-26)
Common synonyms reported in peer-reviewed literature include “mal del pinto” and “carate.” (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2)
Most of the disease-level information for pinta in the retrieved set is aggregated from reviews/perspectives and clinical microbiology/dermatology references, with limited modern case-based literature (e.g., a 2021 case report). (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2)
Primary cause: infection with the spirochete Treponema carateum. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3, papp2024cdclaboratoryrecommendations pages 3-4)
Taxonomic framing (current debate): Recent immunology review articles emphasize that the treponemal diseases are genetically and antigenically highly similar and historically were considered related; one 2023 review explicitly states that pinta is caused by “a different species … namely Treponema carateum.” (avilanieto2023syphilisvaccinechallenges pages 1-2)
Transmission route: nonvenereal direct skin-to-skin contact with infectious lesions. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3, papp2024cdclaboratoryrecommendations pages 3-4)
Sociodemographic/environmental context: classically described in poor rural tropical communities, often acquired in childhood or adolescence. (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2)
Geography as a risk determinant: tropical Latin America/Central and South America (including persistence in remote settings). CDC 2024 states: “Treponema carateum infection results in pinta which, although rare, is found in tropical areas of Latin America.” (papp2024cdclaboratoryrecommendations pages 3-4)
No pinta-specific protective genetic variants, host factors, or environmental protective factors were identified in the retrieved evidence set.
No host gene–environment interaction evidence was identified in the retrieved evidence set.
Pinta is commonly described as a staged cutaneous illness: - Primary stage: papules/erythematous scaly plaques at the inoculation site appearing after infection (classically around weeks). (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3) - Secondary stage: disseminated lesions (“pintids”) with pigmentary changes developing months after infection; lesions may persist and remain infectious for years. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3) - Late/tertiary stage: dyschromia/achromia and cutaneous atrophy occurring years after infection (e.g., 2–5 years in one classic description). (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 3-5)
A 2021 dermatology case report similarly emphasizes a three-stage evolution with early localized lesions, later generalized rash with hyper-/hypopigmented lesions, and late pigmentary change that can resemble vitiligo. (rosa2021maldepinta pages 1-2)
Because late pinta can manifest as dyschromic patches, key differentials include tinea versicolor, vitiligo, melasma, leprosy, and other dermatoses. (mitja2013advancesinthe pages 2-3)
Mitjà et al. summarize stage-linked pathology, including early “loss of melanin in basal cells and liquefaction degeneration” and late “epidermal atrophy and the presence of many melanophages in the dermis.” (mitja2013advancesinthe pages 3-5)
A staged phenotype-to-HPO mapping based on the retrieved literature is provided below.
| Stage/phenotype | Description | Timing | Suggested HPO terms | Evidence (citation IDs) | URL | Publication date |
|---|---|---|---|---|---|---|
| Primary lesion | Initial pruritic, erythematous, scaly papule or plaque at inoculation site; enlarges and typically does not ulcerate | ~3 weeks after infection; alternatively reported as 1–8 weeks after infection | Pruritus (HP:0000989); Erythema (HP:0010783); Papule (HP:0200034); Plaque of skin (HP:0032316); Scaly skin (HP:0000958) | (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2, mitja2013advancesinthe pages 2-3, mitja2013advancesinthe pages 3-5) | https://doi.org/10.4269/ajtmh.15-0329; https://doi.org/10.1111/ijd.15264; https://doi.org/10.1371/journal.pntd.0002283 | 2015-11; 2021-11; 2013-10 |
| Secondary disseminated lesions (“pintids”) | Months to years after primary lesion, disseminated skin lesions develop with generalized rash and pigmentary change; lesions may remain active/infectious for years | Months after infection in classic staging; generalized rash reported over 2–4 years | Rash (HP:0000988); Abnormal skin pigmentation (HP:0000953); Hyperpigmentation of the skin (HP:0000952); Hypopigmentation of the skin (HP:0001010); Acral dyschromia (suggested, mapped broadly to abnormal skin pigmentation) | (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2, mitja2013advancesinthe pages 2-3) | https://doi.org/10.4269/ajtmh.15-0329; https://doi.org/10.1111/ijd.15264; https://doi.org/10.1371/journal.pntd.0002283 | 2015-11; 2021-11; 2013-10 |
| Late pigmentary disease | Late/tertiary pinta characterized by dyschromia, achromic or hypochromic lesions, and persistent depigmentation; cosmetic disfigurement may remain despite cure | Usually 2–5 years after infection; other reports describe 3–10 years for late changes | Dyschromia (suggested, mapped to Abnormal skin pigmentation HP:0000953); Achromia/Hypopigmentation of the skin (HP:0001010); Hyperpigmentation of the skin (HP:0000952); Vitiligo-like depigmentation (suggested, mapped to HP:0001010) | (stamm2015pintalatinamericas pages 1-3, rosa2021maldepinta pages 1-2, mitja2013advancesinthe pages 2-3) | https://doi.org/10.4269/ajtmh.15-0329; https://doi.org/10.1111/ijd.15264; https://doi.org/10.1371/journal.pntd.0002283 | 2015-11; 2021-11; 2013-10 |
| Skin atrophy | Chronic late lesions may show cutaneous thinning/atrophy accompanying pigment loss | Late stage, usually years after untreated infection | Skin atrophy (HP:0000962) | (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 3-5) | https://doi.org/10.4269/ajtmh.15-0329; https://doi.org/10.1371/journal.pntd.0002283 | 2015-11; 2013-10 |
| Histopathologic early lesion correlate | Early lesions show loss of melanin in basal cells and liquefaction degeneration | Early/primary stage biopsy finding | Decreased skin pigmentation (suggested, mapped to Hypopigmentation of the skin HP:0001010) | (mitja2013advancesinthe pages 3-5) | https://doi.org/10.1371/journal.pntd.0002283 | 2013-10 |
| Histopathologic late lesion correlate | Late lesions show epidermal atrophy and numerous dermal melanophages | Late stage biopsy finding | Skin atrophy (HP:0000962); Abnormality of skin pigmentation (HP:0000953) | (mitja2013advancesinthe pages 3-5) | https://doi.org/10.1371/journal.pntd.0002283 | 2013-10 |
| Disease distribution/severity pattern | Pinta is generally the most benign endemic treponematosis and is limited to the skin, without the ulcerative or destructive bone disease typical of some other treponematoses | Chronic, slowly progressive if untreated | Cutaneous abnormality (HP:0011121) | (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3, mitja2013advancesinthe pages 3-5) | https://doi.org/10.4269/ajtmh.15-0329; https://doi.org/10.1371/journal.pntd.0002283 | 2015-11; 2013-10 |
| Prognostic note on treatment response | Early lesions heal over months after treatment, but late pigmentary changes may be irreversible or only partially reversible | After therapy; chronic untreated disease worsens cosmetically over years | Abnormal skin pigmentation (HP:0000953) | (rosa2021maldepinta pages 1-2, stamm2015pintalatinamericas pages 3-5) | https://doi.org/10.1111/ijd.15264; https://doi.org/10.4269/ajtmh.15-0329 | 2021-11; 2015-11 |
Table: This table summarizes the main clinical stages and phenotypes of pinta, with suggested HPO mappings, timing, and severity/progression notes. It is useful for phenotype annotation and natural-history curation in a disease knowledge base.
The retrieved evidence emphasizes disfigurement/cosmetic persistence of late pigmentary changes even after cure, implying psychosocial and quality-of-life impact; however, no quantitative QoL instruments (e.g., SF-36, EQ-5D) were identified for pinta in the retrieved set. (rosa2021maldepinta pages 1-2, stamm2015pintalatinamericas pages 3-5)
Not applicable as a primary genetic disorder. No host genetic susceptibility loci were identified in the retrieved evidence set.
Because pinta is a skin-limited treponemal infection with pigmentary pathology: - GO (Biological Process) suggestions (inferred from histology/clinical pathology): inflammatory response; immune response; melanin biosynthetic process (as a downstream phenotype driver); response to bacterium. (mitja2013advancesinthe pages 3-5) - CL (Cell Ontology) suggestions: melanocyte; macrophage (consistent with dermal melanophages); plasma cell (reported in biopsy infiltrates in a 2021 case). (rosa2021maldepinta pages 1-2, mitja2013advancesinthe pages 3-5)
The evidence emphasizes exposure in tropical rural environments and direct skin contact transmission, rather than toxins/radiation/pollution. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3)
Primary agent: Treponema carateum. (stamm2015pintalatinamericas pages 1-3, papp2024cdclaboratoryrecommendations pages 3-4)
1) Initial infection via direct skin-to-skin contact introduces T. carateum into skin. (stamm2015pintalatinamericas pages 1-3, papp2024cdclaboratoryrecommendations pages 3-4) 2) Primary localized lesion develops (scaly papule/plaque) without typical ulceration. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3, mitja2013advancesinthe pages 3-5) 3) Dissemination within skin produces secondary lesions (“pintids”) and pigmentary change. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3) 4) Chronic inflammatory and pigmentary remodeling results in long-lasting dyschromia/achromia and possible skin atrophy, with histology including melanophages in dermis and epidermal atrophy in late lesions. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 3-5)
No pinta-specific transcriptomic/proteomic/metabolomic datasets were identified in the retrieved evidence set.
Primary affected organ: skin (cutaneous-only disease emphasized in multiple sources). (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3)
Affected tissues/cell processes include epidermis/dermis with pigmentary abnormalities; histology in late lesions includes melanophages. (mitja2013advancesinthe pages 3-5)
Modern surveillance data are limited; however, the retrieved literature provides several quantitative historical/field observations: - Historical burden: an estimated ~1 million cases occurred in Mexico, Central America, and northern South America in the 1950s (historical estimate cited in a 2015 perspective). (stamm2015pintalatinamericas pages 1-3) - Field prevalence example: a Panama village survey (1982–83) reported ~20% of the population with clinical evidence of pinta (active/inactive), cited in both a 2015 perspective and the 2013 PLoS NTD review. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3) - Current burden: the 2015 perspective emphasizes that the “current prevalence … is unknown due to the lack of surveillance data.” (stamm2015pintalatinamericas pages 1-3)
A 2013 review reports peak incidence in adults (15–50 years), while other sources emphasize acquisition in children/adolescents; these differences may reflect heterogeneous data sources and limited modern surveillance. (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 2-3)
Pinta is primarily associated with tropical areas of Latin America/Central and South America; CDC 2024 characterizes it as rare in tropical Latin America. (mitja2013advancesinthe pages 2-3, papp2024cdclaboratoryrecommendations pages 3-4)
Diagnosis relies on compatible clinical lesions (scaly plaques progressing to dyschromic patches) plus epidemiologic context (residence/travel in historically endemic regions) and exclusion of mimics such as tinea versicolor or vitiligo. (mitja2013advancesinthe pages 2-3)
Across endemic treponematoses, diagnostics generally follow syphilis paradigms using both nontreponemal and treponemal tests: - Nontreponemal tests: RPR, VDRL. - Treponemal tests: TPHA/TPPA, FTA-Abs, ELISA. A core limitation is repeatedly emphasized: serology cannot distinguish pinta from other endemic treponematoses or venereal syphilis. (mitja2013advancesinthe pages 3-5, stamm2015pintalatinamericas pages 1-3)
A 2021 pinta case report illustrates this diagnostic approach with very high VDRL titer and positive FTA-Abs IgM/IgG in a compatible clinical context. (rosa2021maldepinta pages 1-2)
Mitjà et al. emphasize that direct methods are constrained by inability to culture treponemes and the impracticality/low sensitivity of some direct tests in field settings; they note increasing use of PCR and genomic fingerprinting for endemic treponematoses in general, but definitive molecular diagnosis remains limited by availability. (mitja2013advancesinthe pages 1-2, mitja2013advancesinthe pages 3-5)
Recent (2024) authoritative diagnostic context: The CDC laboratory recommendations (2024) describe that direct detection is evolving toward molecular methods while serology remains central; the report also notes there are no FDA-cleared molecular tests marketed in the U.S. for T. pallidum (which has implications for distinguishing among treponematoses when patients have relevant travel histories). (papp2024cdclaboratoryrecommendations pages 25-26)
Important differentials include tinea versicolor, vitiligo, melasma, leprosy, and other dermatoses causing pigmentary change. (mitja2013advancesinthe pages 2-3)
No mortality or survival statistics specific to pinta were identified in the retrieved evidence set; pinta is generally characterized as skin-limited and “benign” relative to other treponematoses. (stamm2015pintalatinamericas pages 1-3)
The main long-term morbidity described is chronic pigmentary change (dyschromia/achromia) and possible skin atrophy, which may be persistent despite cure. (stamm2015pintalatinamericas pages 3-5, rosa2021maldepinta pages 1-2)
Long-acting intramuscular benzathine penicillin is widely described as curative across stages: - A 2015 perspective reports that a single intramuscular dose can render lesions noninfectious in <24 hours and provides dosing guidance (adults 1.2 million units; children 0.6 million units). (stamm2015pintalatinamericas pages 3-5) - A 2021 case report describes treatment with benzathine penicillin 2.4 million units IM and similarly notes rapid loss of infectiousness (within ~24 hours). (rosa2021maldepinta pages 1-2)
A key implementation-relevant point is that mass azithromycin campaigns for yaws eradication could also affect pinta if T. carateum is azithromycin-sensitive (not directly proven in the retrieved evidence, but proposed as plausible). (stamm2015pintalatinamericas pages 3-5)
Early lesions may heal over months after treatment; late pigmentary changes may persist. (stamm2015pintalatinamericas pages 3-5, rosa2021maldepinta pages 1-2)
No pinta-specific interventional clinical trials were identified in the retrieved evidence set.
No vaccine exists for pinta. Prevention is primarily via reducing skin-to-skin exposure to infectious lesions and through community-level detection and treatment strategies. (stamm2015pintalatinamericas pages 1-3, papp2024cdclaboratoryrecommendations pages 3-4)
No evidence for a non-human animal reservoir or naturally occurring pinta in other species was identified in the retrieved evidence set. (Note: other treponematoses have been discussed in non-human primates in general literature, but pinta-specific evidence was not retrieved here.)
Pinta-specific experimental models are extremely limited in contemporary literature because T. carateum is not available as an isolate and is not cultivable in standard systems; this limits the feasibility of modern animal models, in vitro systems, and functional genomics. (stamm2015pintalatinamericas pages 3-5, stamm2015pintalatinamericas pages 1-3)
1) Updated authoritative guidance acknowledging pinta in laboratory diagnostic context (2024): The CDC’s 2024 syphilis laboratory recommendations explicitly remind laboratorians and clinicians that nonvenereal treponematoses exist, and state: “Treponema carateum infection results in pinta which, although rare, is found in tropical areas of Latin America,” emphasizing travel/endemic-area context when interpreting serology and treponemal testing. URL: https://doi.org/10.15585/mmwr.rr7301a1 (Published Feb 2024). (papp2024cdclaboratoryrecommendations pages 3-4, papp2024cdclaboratoryrecommendations pages 1-3)
2) Modern immunology framing of treponemal disease relatedness (2023): A 2023 Frontiers in Immunology review on syphilis vaccines explicitly distinguishes pinta’s etiologic agent at the species level (“Treponema carateum”) while emphasizing the broader high similarity of pathogenic treponemes, reinforcing why serology alone cannot reliably separate treponemal syndromes and why genomic methods are central to treponemal taxonomy. URL: https://doi.org/10.3389/fimmu.2023.1126170 (Published Apr 2023). (avilanieto2023syphilisvaccinechallenges pages 1-2)
3) Genomics advances inform the broader treponemal complex but not pinta directly (2024 evidence set): Recent paleogenomic work on T. pallidum subspecies emphasizes very high sequence identity among syphilis/yaws/bejel genomes and the importance of ancient DNA to resolve evolutionary history; pinta is generally referenced as part of the treponemal disease complex, but the retrieved 2024 ancient-genome evidence does not provide pinta-specific genomes, highlighting the ongoing gap in T. carateum genomic characterization. (barquera2024ancientgenomesrevealb pages 1-4)
Diagnostic ambiguity is intrinsic to biology, not just test choice: Multiple sources converge that T. carateum infection produces serologic patterns indistinguishable from syphilis and other endemic treponematoses, so clinical epidemiology and careful differential diagnosis are essential to avoid misclassification (e.g., labeling pinta as sexually transmitted syphilis). (stamm2015pintalatinamericas pages 1-3, mitja2013advancesinthe pages 3-5)
The major bottleneck for “modernizing” pinta knowledge is lack of isolates/genomes: Reviews repeatedly emphasize that absence of T. carateum isolates and genomic data limits taxonomic certainty, molecular diagnostics, antimicrobial resistance surveillance, and vaccine-relevant antigen discovery, in contrast to accelerating genomics in syphilis/yaws/bejel research. (stamm2015pintalatinamericas pages 3-5, stamm2015pintalatinamericas pages 1-3)
These gaps likely reflect the rarity of modern cases and limited laboratory material availability for T. carateum. (stamm2015pintalatinamericas pages 1-3, papp2024cdclaboratoryrecommendations pages 25-26)
References
(stamm2015pintalatinamericas pages 1-3): Lola V. Stamm. Pinta: latin america's forgotten disease? The American journal of tropical medicine and hygiene, 93 5:901-3, Nov 2015. URL: https://doi.org/10.4269/ajtmh.15-0329, doi:10.4269/ajtmh.15-0329. This article has 20 citations.
(stamm2015pintalatinamericas pages 3-5): Lola V. Stamm. Pinta: latin america's forgotten disease? The American journal of tropical medicine and hygiene, 93 5:901-3, Nov 2015. URL: https://doi.org/10.4269/ajtmh.15-0329, doi:10.4269/ajtmh.15-0329. This article has 20 citations.
(papp2024cdclaboratoryrecommendations pages 3-4): John R. Papp, Ina U. Park, Yetunde Fakile, Lara Pereira, Allan Pillay, and Gail A. Bolan. Cdc laboratory recommendations for syphilis testing, united states, 2024. MMWR Recommendations and Reports, 73:1-32, Feb 2024. URL: https://doi.org/10.15585/mmwr.rr7301a1, doi:10.15585/mmwr.rr7301a1. This article has 199 citations.
(rosa2021maldepinta pages 1-2): Ralph Vighi da Rosa, Daniele Damares Rodrigues de Souza, André Cartell, and Paulo Ricardo Martins Souza. Mal de pinta, first autochthonous case from south of brazil. International Journal of Dermatology, Nov 2021. URL: https://doi.org/10.1111/ijd.15264, doi:10.1111/ijd.15264. This article has 1 citations and is from a peer-reviewed journal.
(mitja2013advancesinthe pages 2-3): Oriol Mitjà, David Šmajs, and Quique Bassat. Advances in the diagnosis of endemic treponematoses: yaws, bejel, and pinta. PLoS Neglected Tropical Diseases, 7:e2283, Oct 2013. URL: https://doi.org/10.1371/journal.pntd.0002283, doi:10.1371/journal.pntd.0002283. This article has 88 citations and is from a domain leading peer-reviewed journal.
(avilanieto2023syphilisvaccinechallenges pages 1-2): Carlos Ávila-Nieto, Núria Pedreño-López, Oriol Mitjà, Bonaventura Clotet, Julià Blanco, and Jorge Carrillo. Syphilis vaccine: challenges, controversies and opportunities. Frontiers in Immunology, Apr 2023. URL: https://doi.org/10.3389/fimmu.2023.1126170, doi:10.3389/fimmu.2023.1126170. This article has 54 citations and is from a peer-reviewed journal.
(mitja2013advancesinthe pages 3-5): Oriol Mitjà, David Šmajs, and Quique Bassat. Advances in the diagnosis of endemic treponematoses: yaws, bejel, and pinta. PLoS Neglected Tropical Diseases, 7:e2283, Oct 2013. URL: https://doi.org/10.1371/journal.pntd.0002283, doi:10.1371/journal.pntd.0002283. This article has 88 citations and is from a domain leading peer-reviewed journal.
(papp2024cdclaboratoryrecommendations pages 25-26): John R. Papp, Ina U. Park, Yetunde Fakile, Lara Pereira, Allan Pillay, and Gail A. Bolan. Cdc laboratory recommendations for syphilis testing, united states, 2024. MMWR Recommendations and Reports, 73:1-32, Feb 2024. URL: https://doi.org/10.15585/mmwr.rr7301a1, doi:10.15585/mmwr.rr7301a1. This article has 199 citations.
(mitja2013advancesinthe pages 1-2): Oriol Mitjà, David Šmajs, and Quique Bassat. Advances in the diagnosis of endemic treponematoses: yaws, bejel, and pinta. PLoS Neglected Tropical Diseases, 7:e2283, Oct 2013. URL: https://doi.org/10.1371/journal.pntd.0002283, doi:10.1371/journal.pntd.0002283. This article has 88 citations and is from a domain leading peer-reviewed journal.
(papp2024cdclaboratoryrecommendations pages 1-3): John R. Papp, Ina U. Park, Yetunde Fakile, Lara Pereira, Allan Pillay, and Gail A. Bolan. Cdc laboratory recommendations for syphilis testing, united states, 2024. MMWR Recommendations and Reports, 73:1-32, Feb 2024. URL: https://doi.org/10.15585/mmwr.rr7301a1, doi:10.15585/mmwr.rr7301a1. This article has 199 citations.
(barquera2024ancientgenomesrevealb pages 1-4): R Barquera, TL Sitter, CL Kirkpatrick, and DA Ramirez. Ancient genomes reveal a deep history of treponemal disease in the americas. Unknown journal, 2024.