Nazzaro Gianluca, Genovese Giovanni, Veraldi Stefano
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Cutan Pathol. 2019 Apr;46(4):251-255. doi: 10.1111/cup.13410. Epub 2019 Feb 4.
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.
潜蚤病是由穿皮潜蚤侵入皮肤引起的一种寄生虫感染。关于输入性潜蚤病的组织病理学研究较少，且基于有限数量的病例。
我们对39例输入性潜蚤病患者的活检标本进行了回顾性研究。记录了所有患者的种族、性别、年龄、病变部位、临床特征、福塔莱萨分类以及感染国家。
组织病理学研究显示角化不全和棘层肥厚。蚤的碎片位于表皮和真皮上层，并被一个假囊肿腔包绕。在这个腔内，我们观察到：由增厚且嗜酸性的角质层组成的外骨骼；横纹肌；气管环和消化器官（仅在部分标本中观察到）；富含卵子的卵巢，以及由淋巴细胞和中性粒细胞组成的炎症浸润，伴有大量嗜酸性粒细胞。未观察到皮下层。
组织病理学检查有助于正确诊断从热带和亚热带国家归来的旅行者中的潜蚤病，在这些国家，感染可能表现为非典型临床表现。
