Dermatologic Manifestations of Tungiasis Treatment & Management

  • Author: Neil F Gibbs, MD; Chief Editor: William D James, MD   more...
 
Updated: Jul 12, 2011
 

Medical Care

Reported topical treatments include cryotherapy or electrodesiccation of the nodules. Application of formaldehyde, chloroform, or dichlorodiphenyltrichloroethane (DDT) to the infested skin has been used, but it may cause a person's own morbidity. Topical ivermectin, metrifonate, and thiabendazole have also been reported as effective. Occlusive petrolatum suffocates the organism. Twenty-percent salicylated petroleum jelly (Vaseline) applied 12-24 h in profound infestations caused the death of the fleas and facilitated their manual removal.[9] These treatments do not remove the flea from the skin, and they do not result in quick relief from painful lesions. The flea may also be gently removed with a needle or a forceps.[10, 11]

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Surgical Care

A number of surgical treatment methods are available. The flea can be removed from its cavity with sterile instruments, but this is more difficult when the flea is engorged. The orifice needs to be enlarged, and the entire nodule should be curetted or excised. An antibiotic ointment may be applied, along with systemic antibiotic therapy when indicated. Aggressive treatment of secondary infection and tetanus prophylaxis are important.

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Contributor Information and Disclosures
Author

Neil F Gibbs, MD  Voluntary Associate Professor, Departments of Pediatrics and Medicine, University of California, San Diego School of Medicine; Program Director, Pediatric Dermatologist, Department of Dermatology, Naval Medical Center, San Diego

Neil F Gibbs, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Abdul-Ghani Kibbi, MD  Professor and Chair, Department of Dermatology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Veraldi S, Valsecchi M. Imported tungiasis: a report of 19 cases and review of the literature. Int J Dermatol. Oct 2007;46(10):1061-6. [Medline].

  2. Chadee DD. Tungiasis among five communities in south-western Trinidad, West Indies. Ann Trop Med Parasitol. Jan 1998;92(1):107-13. [Medline].

  3. Feldmeier H, Eisele M, Van Marck E, Mehlhorn H, Ribeiro R, Heukelbach J. Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology. Parasitol Res. Oct 2004;94(4):275-282. [Medline].

  4. Pilger D, Schwalfenberg S, Heukelbach J, Witt L, Mehlhorn H, Mencke N, et al. Investigations on the biology, epidemiology, pathology, and control of Tunga penetrans in Brazil: VII. The importance of animal reservoirs for human infestation. Parasitol Res. Apr 2008;102(5):875-80. [Medline].

  5. Caumes E, Carriere J, Guermonprez G, Bricaire F, Danis M, Gentilini M. Dermatoses associated with travel to tropical countries: a prospective study of the diagnosis and management of 269 patients presenting to a tropical disease unit. Clin Infect Dis. Mar 1995;20(3):542-8. [Medline].

  6. Mashek H, Licznerski B, Pincus S. Tungiasis in New York. Int J Dermatol. Apr 1997;36(4):276-8. [Medline].

  7. Sanusi ID, Brown EB, Shepard TG, Grafton WD. Tungiasis: report of one case and review of the 14 reported cases in the United States. J Am Acad Dermatol. May 1989;20(5 Pt 2):941-4. [Medline].

  8. Bauer J, Forschner A, Garbe C, Rocken M. Dermoscopy of tungiasis. Arch Dermatol. Jun 2004;140(6):761-3. [Medline].

  9. Clyti E, Couppie P, Deligny C, Jouary T, Sainte-Marie D, Pradinaud R. [Effectiveness of 20% salicylated vaseline in the treatment of profuse tungiasis. Report of 8 cases in French Guiana]. Bull Soc Pathol Exot. Jan 2003;96(5):412-4. [Medline].

  10. Heukelbach J, Eisele M, Jackson A, Feldmeier H. Topical treatment of tungiasis: a randomized, controlled trial. Ann Trop Med Parasitol. Oct 2003;97(7):743-9. [Medline].

  11. Heukelbach J, Franck S, Feldmeier H. Therapy of tungiasis: a double-blinded randomized controlled trial with oral ivermectin. Mem Inst Oswaldo Cruz. Dec 2004;99(8):873-6. [Medline].

  12. Ade-Serrano MA, Olomolehin OG, Adewunmi A. Treatment of human tungiasis with niridazole (Ambilhar) a double-blind placebo-controlled trial. Ann Trop Med Parasitol. Feb 1982;76(1):89-92. [Medline].

 
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Histopathologic findings in tungiasis.
 
 
 
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