Tungiasis, or penetrating sarcopsillosis, is an ectoparasitosis, which is a parasitic disease produced by the Tunga penetrans flea . It is a tiny insect, less than 1 mm in size, which penetrates under the skin and produces intense itching, mainly attacking the feet.
The disease is common in tropical forest regions, America, Africa and Asia. However, it is increasingly rare due to the development of larger and larger villages. The use of shoes and tiled or cemented floors prevent their spread.
The flea responsible for the development of tungiasis does not have a specific host. The term “host” refers to the organism that hosts another one inside, establishing a symbiotic relationship, that is, of mutual benefit.
Aside from humans, this flea also attacks chickens, dogs and pigs. The habitat in which it is found is dry, sandy, shady and warm. It is also found in the floors of huts and stables for animals.
Symptoms of tungiasis
This parasitic disease manifests itself with different symptoms. In most cases it affects the feet. However, there are reported cases where the legs, knees, thighs, hands, elbows and other parts of the body have been affected.
It can present with a single lesion or with multiple lesions, with itching, pain or asymptomatic. Penetration of the flea under the skin is painless. However, after 24 hours, an erythematous and itchy macule or papule begins to be observed.
A papular-like lesion will appear on the skin of the host subject with a central black point, consisting of the excretory apparatus of the flea, surrounded by a reddish (erythematous) and / or yellowish ring if a bacterial infection or other microorganism has been added to the lesion. Often there are also some eggs, glued to the skin near the lesion.
When the flea dies, the lesion becomes covered with a black scab. This scab is mainly made up of clotted blood and other substances and evolves leaving a scar on the skin.
Although tungiasis tends to disappear spontaneously over a period of 4-6 weeks, relapse is very common. Indeed, the patient typically suffers from other concomitant infections, such as:
- And, in severe cases, septicemia and death.
Specialists have drawn up a classification known as Classification to standardize clinical descriptions and facilitate the recognition of lesions as they evolve.
Classification of tungiasis lesions
Tungiasis is divided into five stages, ranging from penetration to involution of the lesion. There are less frequent clinical variants with lesions:
- Verrucose. With a similar appearance to plantar warts.
Stage 2 begins 1-2 days after infection. In this case, a 1-2 mm hypochromic macula or papule appears with a dark central point (as we have explained it is the abdomen of the Tunga), surrounded by an erythematous halo.
Stage 3 corresponds to the period from 2 to 21 days after infection. In this phase, a whitish and painful papule 3-10 mm in diameter appears, with a dark center point. Hyperkeratosis and a yellowish exudate may be noted. The expelled eggs of the flea may be visible.
Between 3-5 weeks after infection, stage 4 begins, the one in which the parasite dies. Later a halo of necrotic skin covered with a crust forms around the original lesion.
Finally, in stage 5, from 6 weeks to a few months after infection, the lesion is reduced, with the formation of a small epidermal scar, which disappears over time.
Treatment of tungiasis
First of all, you need to extract the intact flea. To do this, you need to enlarge the entrance hole and then press along the edges to extract the parasite. This procedure must be done under aseptic conditions.
A topical antiseptic should be applied to avoid other infections and reduce the risk of complications. Typically, prophylactic tetanus treatment is also given.