The symptoms and progression of pinta may vary among affected individuals. Pinta usually progresses in three separate stages: an early phase with initial lesions; an intermediate phase with widespread (disseminated) lesions; and a late phase. The incubation period may range from seven to 21 days. The skin is the only organ involved in pinta.
In most cases, the initial Lesions (primary) are small, reddish (erythematous) spots (papules) that occur most often on exposed areas of the arms and legs. The face, neck, chest and abdomen may also be affected. Papules are often Itchy (pruritic) and may spread combining to form large plaques. In some cases, nearby lymph nodes may be inflamed (lymphadenitis).
One month to one year after the development of initial lesions, affected individuals may develop secondary skin eruptions called pintids. Pintids are small scaly, reddish Lesions that normally affect the same sites as primary lesions. They may be dry and crusted (psoriatic pintids).
Anywhere from three months to a year, secondary Lesions and, in some cases, primary Lesions may slowly change color from red to brown or slate blue. These Lesions may eventually lose their color (depigmentation) becoming white, leaving the skin with a mottled appearance. Pintids may recur for up to 10 years.
The late phase of pinta occurs approximately two to five years after the development of initial Lesions and is characterized by white or colorless (achromatic) lesions. During this phase, affected individuals may also develop unusually dry, Thickened skin on the soles of the feet and palms of the hands (hyperkeratosis). Eventually, affected individuals may develop dry, wrinkled thin (atrophic) skin in certain areas.