Tungiasis is a cutaneous infestation caused by the sand flea. It affects patients living in tropical South America or Africa. with most patients living in poor conditions. Fortaleza is the capital of Ceara State in northeast Brazil and has communities where tungiasis is common.
Tunga penetrans is referred to as the chigoe, sand or jigger flea.
The adult flea is extremely small and just barely visible to the naked eye. The female flea burrows into the skin and swells many times up to a centimeter in diameter (about the size of a pea). After releasing eggs for several days (up to 3 weeks) the flea dies, shrivels and is eventually sloughed.
Clinical Stage
Stage
flea in the act of penetrating the skin
0
a dark and itching spot in the skin measuring 1-2 mm in diameter with or without local pain
I
lesion with a white halo measuring 3-10 mm in diameter with a central black dot
II
brownish-black circular crust with or without necrosis of the surrounding epidermis; this stage is associated with a mature flea
III
circular residue punched out in the stratum corneum of the sole of the foot or irregular thickening of the nail rim; this stage is associated with a dead flea
IV
lesions associated with patient manipulation using needles or thorns; this may include crater-like sores in the skin or suppurative lesions
V
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