Tungiasis

Tungiasis is a parasitic skin disease caused by penetration of the gravid female flea Tunga penetrans. It belongs to the group of neglected tropical diseases (NTDs) observed in tropical and subtropical areas of the world. Risk factors can include lack of footwear and living with domestic reservoir animals such as cats, dogs and pigs. 95 to 98% affects the feet, especially the periungual region, toes, the soles and heels. The parasite dig a skin hole of about 250 μm, and once fertilized, the female flea increases by 2000 times its size within 1 week and remains in contact with the environment through the hole, producing and releasing 100–200 eggs in 2 weeks. Embedded fleas cause an intense inflammatory response and a bacterial superinfection. Diagnosis must be suspected because macroscopically it presents a central dark spot, black nodule, or intra-epidermic foreign body-like structure. Dermoscopic examination allows us the visualization of the epidermal and superficial dermal structures. The best treatment is sterile surgical extraction, but local villagers extract the mature flea using sterile needle and on poor areas, people are forced to try to get rid of the flea using thorn or other sharp materials. Tungiasis affects the quality of life and household economy, limiting their productivity.