Clinical and histopathologic study of 39 patients with imported tungiasis.
Tunga penetrans
dermatopathology
histopathology
tropical dermatology
tungiasis
Journal
Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
04
07
2018
revised:
10
12
2018
accepted:
23
12
2018
pubmed:
12
1
2019
medline:
25
6
2019
entrez:
12
1
2019
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
251-255Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.