Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
Am J Trop Med Hyg. 2013 Jun;88(6):1212-6. doi: 10.4269/ajtmh.12-0645. Epub 2013 Mar 11.
Tungiasis is an ectoparasitic skin disease caused by Tunga penetrans and Tunga trimamillata. There is a lack of histopathological studies that evaluate the recognition of this flea in tissues. We describe the ex vivo dermoscopic and the histopathological patterns of six cases and relate the findings to the developmental stage of the parasite as defined by the Fortaleza classification: two were classified as Fortaleza 3b, 3 as 4a, and 1 as 4b. Two dermoscopic patterns were observed: a brown pigmented ring and a radial crown with a central pore. The most common histopathological findings were an eosinophilic cuticle, eggs in different stages of development, tracheal rings (parasite), and basal hyperplasia (host). The eosinophilic cuticle, eggs in different stages of evolution, and tracheal rings can help to establish the diagnosis when other parts of the parasite are lacking. The Fortaleza staging may represent a tool for pathology reporting purposes.
疥疮是一种由 Tunga penetrans 和 Tunga trimamillata 引起的寄生虫性皮肤病。目前缺乏评估这种跳蚤在组织中识别的组织病理学研究。我们描述了 6 例的离体皮肤镜和组织病理学模式，并将这些发现与福塔莱萨分类法定义的寄生虫发育阶段相关联：2 例为福塔莱萨 3b，3 例为 4a，1 例为 4b。观察到两种皮肤镜模式：棕色色素环和具有中央孔的放射状冠状物。最常见的组织病理学发现是嗜酸性角质层、处于不同发育阶段的卵、气管环（寄生虫）和基底细胞增生（宿主）。当寄生虫的其他部分缺失时，嗜酸性角质层、处于不同进化阶段的卵和气管环有助于确立诊断。福塔莱萨分期可能是病理报告的一种工具。
