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Correspondence | March 2009

Tunga penetrans: Description of a New Dermoscopic Sign—The Radial Crown

Gionata Marazza, MD; Alexandre Campanelli, MD; Gúrkan Kaya, MD, PhD; Ralph P. Braun, MD; Jean-Hilaire Saurat, MD; Vincent Piguet, MD, PhD

Arch Dermatol. 2009;145(3):348-349. doi:10.1001/archdermatol.2008.611.

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We agree with Bauer et al¹ and Di Stefani et al² regarding the dermoscopic features of Tunga penetrans described in earlier issues of the Archives, and we would like to describe here an additional dermoscopic finding for this disease. Tungiasis is an ectoparasitic skin disease caused by the female sand flea T penetrans. It is endemic to South and Central America, sub-Saharan Africa, the Caribbean, and Asia, where it represents a public health problem. The transmission of the flea occurs by walking barefoot in sands contaminated by feces of pigs and cows. The diagnosis is clinical, but dermoscopy is helpful and shows many characteristic features.¹^- 2

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Figure 1

Dermoscopic features of tungiasis: a peripheral pigmented ring (single black arrow), a central dark area (double black arrows) and a brownish-gray blotch (single white arrow). The new dermoscopic finding is the “radial crown” (double white arrows).

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Figure 2

Histologic features of tungiasis. The posterior portion of the flea abdomen contains numerous developing eggs and organs of the flea (hematoxylin-eosin, original magnification ×5). The arrow indicates the area of the inset, which shows the zone of hemorrhagic parakeratosis in a radial arrangement (original magnification ×40).

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Marazza G, Campanelli A, Kaya G, Braun RP, Saurat J, Piguet V. Tunga penetrans: Description of a New Dermoscopic Sign—The Radial Crown. Arch Dermatol. 2009;145(3):348-349. doi:10.1001/archdermatol.2008.611.

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