Imported tungiasis in a Japanese student returning from East Africa

Abstract

Ectoparastiosis by Tunga penetrans is becoming more common in non-tropical countries as people travel more to endemic areas. We present here a classic case of imported tungiasis including a history of visit to an endemic region and its typical presentation. Diagnosis with dermoscopy, treatment and prevention are discussed.

Tungiasis presenting as a soft tissue oral lesion

“…A study on Ugandans with AIDS-associated Kaposi sarcoma found that females more frequently presented with oral lesions [ 25 ]. In this case, histology found an embedded egg-bearing organism with features characteristic of tungiasis [ 17 , 18 , 26 ]. The diagnosis was further underscored by the patient’s tribe and place of origin, given the outbreaks and high infection rates in Busoga [ 21 ].…”

“…Heavy infection has been reported in eastern African communities with poor living conditions, high rat populations and in settlement camps [ 4 , 13 - 15 ]. Travellers, volunteers and immigrants present abroad with infection of the feet [ 16 - 18 ] and at times of the hands [ 19 ]. Many undergo surgical excision; where diagnosis is uncertain and disease is complicated a digit may be amputated [ 20 ].…”

Is This Melanoma? A Quiz

“…However, less common clinical varieties of tungiasis have been described: plantar wart-like lesions, as well as crusted, bullous, pustular and ulcerative lesions (1). Dermoscopy is useful in the diagnosis of infections and infestations of the skin (2, 3), including tungiasis (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The dermoscopic picture of tungiasis is characterized by a whitish to light brown nodule, with a peripheral pigmented ring surrounding a black central pore, corresponding to the posterior portion of the abdomen of the flea (2-4, 7, 10, 12, 13).…”

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

“…1 This small; one-millimeter long flea is endemic in countries of Latin America, Caribbean and sub-Saharan Africa. 1,2 It may evolve with complications, such as secondary infections, lymphedema, bone exposing ulcerations, gangrene and tetanus. 1 The parasite lives in dry soil, so that it can, especially during drought seasons, disperse in the ambient and penetrate the skin of the hosts (feline, swine and rodent), where it produces thousands of eggs whilst feeding on blood.…”

“…1 The parasite lives in dry soil, so that it can, especially during drought seasons, disperse in the ambient and penetrate the skin of the hosts (feline, swine and rodent), where it produces thousands of eggs whilst feeding on blood. 2,3 The diagnosis of tungiasis is clinical, but it can, however be aided by in vivo and ex vivo dermoscopic examinations as described in the following case. 3,4 …”