Background Tungiasis is an infestation caused by the penetration into the skin of the flea Tunga penetrans. Histopathologic studies on imported tungiasis are rare and based on a limited number of cases. Methods We carried out a review of 39 biopsy specimens collected from 39 patients with imported tungiasis. In all patients, ethnicity, gender, age, location, and clinical features of the lesions, Fortaleza classification and countries of infestation were recorded. Results Histopathologic study revealed hyper- parakeratosis and acanthosis. Fragments of the flea were located in the epidermis and upper dermis and were circumscribed by a pseudo-cystic cavity. Inside this cavity, we observed: the exoskeleton, made up of a thickened and eosinophilic cuticle; the striated muscle; the tracheal rings and the digestive organs (observed only in some specimens); the ovaries, very rich in eggs, and an inflammatory infiltrate, made up of lymphocytes and neutrophils, with numerous eosinophils. The hypodermic layer was never observed. Conclusion Histopathologic examination is helpful for the correct diagnosis of tungiasis in travelers returning from tropical and subtropical countries in which the infestation may be characterized by an atypical clinical presentation.

Clinical and histopathologic study of 39 patients with imported tungiasis / G. Nazzaro, G. Genovese, S. Veraldi. - In: JOURNAL OF CUTANEOUS PATHOLOGY. - ISSN 0303-6987. - 46:4(2019 Apr), pp. 251-255. [10.1111/cup.13410]

Clinical and histopathologic study of 39 patients with imported tungiasis

G. Nazzaro
Primo
;
G. Genovese
Secondo
;
S. Veraldi
Ultimo
2019

Abstract

Background Tungiasis is an infestation caused by the penetration into the skin of the flea Tunga penetrans. Histopathologic studies on imported tungiasis are rare and based on a limited number of cases. Methods We carried out a review of 39 biopsy specimens collected from 39 patients with imported tungiasis. In all patients, ethnicity, gender, age, location, and clinical features of the lesions, Fortaleza classification and countries of infestation were recorded. Results Histopathologic study revealed hyper- parakeratosis and acanthosis. Fragments of the flea were located in the epidermis and upper dermis and were circumscribed by a pseudo-cystic cavity. Inside this cavity, we observed: the exoskeleton, made up of a thickened and eosinophilic cuticle; the striated muscle; the tracheal rings and the digestive organs (observed only in some specimens); the ovaries, very rich in eggs, and an inflammatory infiltrate, made up of lymphocytes and neutrophils, with numerous eosinophils. The hypodermic layer was never observed. Conclusion Histopathologic examination is helpful for the correct diagnosis of tungiasis in travelers returning from tropical and subtropical countries in which the infestation may be characterized by an atypical clinical presentation.
Tunga penetrans; dermatopathology; histopathology; tropical dermatology; tungiasis
Settore MED/35 - Malattie Cutanee e Veneree
Settore MED/17 - Malattie Infettive
apr-2019
10-gen-2019
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/620569
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