Tungiasis under dermoscopy: in vivo and ex vivo examination of the cutaneous infestation due to Tunga penetrans

Abstract

The female flea Tunga penetrans is responsible for a cutaneous parasitosis known as Tungiasis. We report the clinical case of a 12 year-old Caucasian boy who sought treatment in a dermatological private office due to a painful lesion in the plantar area and whose dermoscopic examination, without skin contact, allowed the visualization of parasite's movement inside the skin. The diagnosis of tungiasis is clinical, but it can be aided by in vivo and ex vivo dermoscopic examination of the lesion.

Entodermoscopy update: A contemporary review on dermoscopy of cutaneous infections and infestations

“…The eggs appear as gray-blue blotches or as whitish oval structures linked together to form chain-like structures. [ 53 ] Dermoscopy appears to be useful in confirming the diagnosis ex vivo by showing the flea with an inflated jelly sac abdomen full of eggs following the extraction of the intact parasite. [ 54 ]…”

Tungiasis: a poorly-known diagnosis in Europe. Two paradigmatic cases from Portugal

“…The classical characteristics, all seen in the patient in whom we performed dermoscopy, are a brown to black central pore corresponding to the posterior part of the parasite, a white halo corresponding to the enlarged abdomen of the parasite, and peripheral bluish-gray areas corresponding to the parasite exoskeleton (8,9).…”

Alternative uses of dermoscopy in general dermatology

“…The characteristic dermatoscopic pattern of tungiasis is a brown-to-black ring with a central pore, corresponding to the pigmented chitin surrounding the posterior portion of the parasite's body [54,55] . Additional dermatoscopic features include a -gray-blue blotch‖, indicating either the developing eggs within the abdomen of the parasite or the presence of hematin in its gastrointestinal 72 doi:10.18282/jsd.v2.i2.122 tract [56,57] .…”