Spot Diagnosis

Tungiasis - A threat to the travelers feet

Marta Santos Figueiredo, Rita Belo Morais
Pediatrics Department, São Francisco Xavier Hospital, CHLO, Lisboa, Portugal

Address for Correspondence: Marta Santos Figueiredo, Rua D. Brites nº41, 4ºdto, 2605-655 Belas, Lisbon.
Email: msfigueiredo@chlo.min-saude.pt
Keywords : Tungiasis, Tunga penetrans, sand flea
Question :
An 11-year-old boy presented with a 3 day history of a painful pale-yellow papule with a dark brown center, 2 mm wide, on his left second toe. There were no other inflammatory signs. He had just returned from Sao Tome and Principe in Africa, where he walked barefoot on the beach.
Physical removal of the pigmented part of the lesion and flea eggs was performed as well as local wound care. Up to date tetanus vaccination was confirmed. He had a full recovery with no complications.

Figure 1.Pale-yellow papule with a dark center (diameter, 2 mm) in the second toe of the left foot, before flea removal.
<b>Figure 1.</b>Pale-yellow papule with a dark center (diameter, 2 mm) in the second toe of the left foot, before flea removal.


Figure 2. Residual cavity (diameter, 2mm) in the second toe of the left foot, after removal of the flea and eggs.
<b>Figure 2.</b> Residual cavity (diameter, 2mm) in the second toe of the left foot, after removal of the flea and eggs.


What is the diagnosis?
 
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