• 1.

    Pampiglione S, Fioravanti ML, Gustinelli A, Onore G, Mantovani B, Luchetti A, Trentini M, 2009. Sand flea (Tunga spp.) infections in humans and domestic animals: state of the art. Med Vet Entomol 23: 172186.

    • Search Google Scholar
    • Export Citation
  • 2.

    De Avelar DM, Linhares AX, Linardi PM, 2012. A new species of Tunga (Siphonaptera: Tungidae) from Brazil with a key to the adult species and neosomes. J Med Entomol 49: 2328.

    • Search Google Scholar
    • Export Citation
  • 3.

    Heukelbach J, 2005. Tungiasis. Rev Inst Med Trop Sao Paulo 47: 307313.

  • 4.

    Maco V, Tantalean M, Gotuzzo E, 2011. Evidence of tungiasis in pre-Hispanic America. Emerg Infect Dis 17: 855862.

  • 5.

    Maco V, Maco VP, Gotuzzo E, 2010. An ectopic case of Tunga spp. infection in Peru. Am J Trop Med Hyg 82: 10761078.

  • 6.

    Pampiglione S, Trentini M, Fioravanti ML, Onore G, Rivasi F, 2003. Additional description of a new species of Tunga (Siphonaptera) from Ecuador. Parasite 10: 915.

    • Search Google Scholar
    • Export Citation
  • 7.

    Fioravanti ML, Pampiglione S, Trentini M, 2003. A second species of Tunga (Insecta, Siphonaptera) infecting man: Tunga trimamillata. Parasite 10: 282283.

    • Search Google Scholar
    • Export Citation
  • 8.

    Pampiglione S, Fioravanti ML, Gustinelli A, Onore G, Rivasi F, Trentini M, 2005. Anatomy of Tunga trimamillata Pampiglione et al., 2002 (Insecta, Siphonaptera, Tungidae) and developmental phases of the gravid female. Parasite 12: 241250.

    • Search Google Scholar
    • Export Citation
  • 9.

    Pampiglione S, Trentini M, Fioravanti ML, Gustinelli A, 2004. Differential diagnosis between Tunga penetrans (L., 1758) and T. trimamillata Pampiglione et al., 2002 (Insecta, Siphonaptera), the two species of the genus Tunga parasitic in man. Parasite 11: 5157.

    • Search Google Scholar
    • Export Citation
  • 10.

    Smith MD, Procop GW, 2002. Typical histologic features of Tunga penetrans in skin biopsies. Arch Pathol Lab Med 126: 714716.

  • 11.

    Feldmeier H, Eisele M, Van Marck E, Mehlhorn H, Ribeiro R, Heukelbach J, 2004. Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology. Parasitol Res 94: 275282.

    • Search Google Scholar
    • Export Citation
  • 12.

    Urteaga O, Salas A, Calderon J, Moncloa F, 1955. Foot tungiasis treated with Acarol [in Spanish]. Arch Peru Patol Clin 9: 3751.

  • 13.

    Beltran M, 2005. Tungiasis and Tunga penetrans [in Spanish]. Rev Peru Med Exp Salud Publica 22: 323324.

  • 14.

    Eisele M, Heukelbach J, Van Marck E, Mehlhorn H, Meckes O, Franck S, Feldmeier H, 2003. Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: I. Natural history of tungiasis in man. Parasitol Res 90: 8799.

    • Search Google Scholar
    • Export Citation
  • 15.

    Bauer J, Forschner A, Garbe C, Rocken M, 2004. Dermoscopy of tungiasis. Arch Dermatol 140: 761763.

  • 16.

    Bauer J, Forschner A, Garbe C, Rocken M, 2005. Variability of dermoscopic features of tungiasis. Arch Dermatol 141: 643644.

  • 17.

    Di Stefani A, Rudolph CM, Hofmann-Wellenhof R, Mullegger RR, 2005. An additional dermoscopic feature of tungiasis. Arch Dermatol 141: 10451046.

  • 18.

    Marazza G, Campanelli A, Kaya G, Braun RP, Saurat JH, Piguet V, 2009. Tunga penetrans: description of a new dermoscopic sign–the radial crown. Arch Dermatol 145: 348349.

    • Search Google Scholar
    • Export Citation
  • 19.

    Zalaudek I, Giacomel J, Cabo H, Di Stefani A, Ferrara G, Hofmann-Wellenhof R, Malvehy J, Puig S, Stolz W, Argenziano G, 2008. Entodermoscopy: a new tool for diagnosing skin infections and infestations. Dermatology 216: 1423.

    • Search Google Scholar
    • Export Citation
  • 20.

    Tschandl P, Argenziano G, Bakos R, Gourhant JY, Hofmann-Wellenhof R, Kittler H, Rosendahl C, Minas S, Zalaudek I, 2009. Dermoscopy and entomology (entomodermoscopy). J Dtsch Dermatol Ges 7: 589596.

    • Search Google Scholar
    • Export Citation
  • 21.

    Feldmeier H, Heukelbach J, Eisele M, Sousa AQ, Barbosa LM, Carvalho CB, 2002. Bacterial superinfection in human tungiasis. Trop Med Int Health 7: 559564.

    • Search Google Scholar
    • Export Citation
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Histopathological Features of Tungiasis in Peru

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  • Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru; Servicios de Salud Guadalupe, Lima, Peru; Facultad de Medicina Veterinaria y Zootecnia, UPCH, Lima, Peru
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Tungiasis is an ectoparasitic skin disease caused by Tunga penetrans and Tunga trimamillata. There is a lack of histopathological studies that evaluate the recognition of this flea in tissues. We describe the ex vivo dermoscopic and the histopathological patterns of six cases and relate the findings to the developmental stage of the parasite as defined by the Fortaleza classification: two were classified as Fortaleza 3b, 3 as 4a, and 1 as 4b. Two dermoscopic patterns were observed: a brown pigmented ring and a radial crown with a central pore. The most common histopathological findings were an eosinophilic cuticle, eggs in different stages of development, tracheal rings (parasite), and basal hyperplasia (host). The eosinophilic cuticle, eggs in different stages of evolution, and tracheal rings can help to establish the diagnosis when other parts of the parasite are lacking. The Fortaleza staging may represent a tool for pathology reporting purposes.

Author Notes

* Address correspondence to Vicente Maco, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia (UPCH), Av. Honorio Delgado 430, Lima 31, Peru. E-mail: vicente_maco@hotmail.com

Authors' addresses: Vicente Maco, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York, and Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru, E-mail: vicente_maco@hotmail.com. Vicente P. Maco, Servicios de Salud Guadalupe, Lima, Peru, E-mail: vmaco@speedy.com.pe. Manuel E. Tantalean, Facultad de Medicina Veterinaria y Zootecnia, UPCH, Lima, Peru, E-mail: mtantaleanv@hotmail.com. Eduardo Gotuzzo, Instituto de Medicina Tropical Alexander von Humboldt, UPCH, Lima, Peru, E-mail: eduardo.gotuzzo@upch.pe.

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