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

Criado PR, Landman G, Reis VM, Belda W - An Bras Dermatol (2013 Jul-Aug)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, University of São Paulo, Medical School, Clinics Hospital, São Paulo(SP), Brazil.

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.

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A - Yellowish-white plantar papule with a central black dot1B: Figure 1A seen in greater detail. 1C:In vivo dermoscopy performed without skin contact showing a white halo with a centralorifice containing a light-brown structure (original augmentation 10x).1D: Figure 1C seen in greater detail, showingbluish-grey areas (likely corresponding to the parasite’s exoskeleton or his gut)(●), White halo (corresponding to the parasite’s dilated abdomen containing the eggs)(❋) Light-brown structure appearing in the center of the orifice (posterior segmentof the parasite) (◆)
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f01: A - Yellowish-white plantar papule with a central black dot1B: Figure 1A seen in greater detail. 1C:In vivo dermoscopy performed without skin contact showing a white halo with a centralorifice containing a light-brown structure (original augmentation 10x).1D: Figure 1C seen in greater detail, showingbluish-grey areas (likely corresponding to the parasite’s exoskeleton or his gut)(●), White halo (corresponding to the parasite’s dilated abdomen containing the eggs)(❋) Light-brown structure appearing in the center of the orifice (posterior segmentof the parasite) (◆)

Mentions: A 12 year-old male patient reported since two weeks before, the presence of a painfullesion on the left plantar area. There was a history of traveling to the rural area in thecountryside of São Paulo State. The clinical exam showed a 0.5 cm papule, yellowishwhite,with a black dot in its center (Figures 1A and 1B). With the aid of the dermatoscope (DermLite DL3,3Gen, EUA), and without any skin contact we could observe a white halo, with bluish-grayareas and one central orifice containing a light-brown structure (Figures 1C and 1D). It waspossible to observe movements on the bluish-gray areas inside the white halo (see video).We proceeded with the saucerization of the lesion, followed by hemostasis byfulguration.


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

Criado PR, Landman G, Reis VM, Belda W - An Bras Dermatol (2013 Jul-Aug)

A - Yellowish-white plantar papule with a central black dot1B: Figure 1A seen in greater detail. 1C:In vivo dermoscopy performed without skin contact showing a white halo with a centralorifice containing a light-brown structure (original augmentation 10x).1D: Figure 1C seen in greater detail, showingbluish-grey areas (likely corresponding to the parasite’s exoskeleton or his gut)(●), White halo (corresponding to the parasite’s dilated abdomen containing the eggs)(❋) Light-brown structure appearing in the center of the orifice (posterior segmentof the parasite) (◆)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3760950&req=5

f01: A - Yellowish-white plantar papule with a central black dot1B: Figure 1A seen in greater detail. 1C:In vivo dermoscopy performed without skin contact showing a white halo with a centralorifice containing a light-brown structure (original augmentation 10x).1D: Figure 1C seen in greater detail, showingbluish-grey areas (likely corresponding to the parasite’s exoskeleton or his gut)(●), White halo (corresponding to the parasite’s dilated abdomen containing the eggs)(❋) Light-brown structure appearing in the center of the orifice (posterior segmentof the parasite) (◆)
Mentions: A 12 year-old male patient reported since two weeks before, the presence of a painfullesion on the left plantar area. There was a history of traveling to the rural area in thecountryside of São Paulo State. The clinical exam showed a 0.5 cm papule, yellowishwhite,with a black dot in its center (Figures 1A and 1B). With the aid of the dermatoscope (DermLite DL3,3Gen, EUA), and without any skin contact we could observe a white halo, with bluish-grayareas and one central orifice containing a light-brown structure (Figures 1C and 1D). It waspossible to observe movements on the bluish-gray areas inside the white halo (see video).We proceeded with the saucerization of the lesion, followed by hemostasis byfulguration.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, University of São Paulo, Medical School, Clinics Hospital, São Paulo(SP), Brazil.

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.

Show MeSH
Related in: MedlinePlus