Excision of furuncular myiasis larvae using a punch: a simple, practical and aesthetic method

Abstract

Myiasis refers to Diptera larvae infesting vertebrate animals. There are two forms of the disease: primary and secondary. In primary myiasis, fly larvae invade and develop in healthy tissue; in secondary myiasis, flies lay their eggs in skin ulcerations, and the larvae develop in tissue necrosis products. Furuncular myiasis is a type of primary myiasis. Treatment for it consists of techniques such as the production of localized hypoxia to force the emergence of the larvae, and mechanical or surgical removal of the maggots. These techniques, however, are painful and often unsuccessful. We propose a new technique for extraction of myiasis larvae, which might facilitate the surgical procedure and constitute a virtually painless and aesthetic option for the patient.

Breast myiasis: Are we prepared for the correct diagnosis?

“…Treatment includes manual compression, larva asphyxiation by occlusion, or surgical excision 13 . The ideal technique is the one that is practical and less painful and leads to less risk of secondary infection.…”

Furuncular myiasis for the Western dermatologist: treatment in outpatient consultation

“…Lidocaine or liquid nitrogen, widely available to dermatologists, can be used both to paralyze the larva and for local anesthesia. Secondly, a surgical excision with a scalpel or a punch biopsy might be necessary to remove the whole larva . Sutures should be avoided when possible.…”

Cutaneous myiasis in a traveler returning from Argentina

“…Additionally, the injection of lidocaine 1%, the application of ivermectin 1% cream, or liquid nitrogen are used to paralyze the larva and to make the extraction quick and easier (Clyti et al, 2007). When these methods fail, a surgical excision with a scalpel or punch may be necessary to remove the whole larva (Pascoal et al, 2016). Oral ivermectin has been used for extensive diseases with multiple lesions or involvement of the orbit or oral cavity (Lachish et al, 2015).…”