Travel- and migration-associated epidermal parasitic skin diseases. A review

Epidermal parasitic skin diseases are a family of parasitic diseases which occur globally or are frequent in special settings. Epidermal parasitic skin diseases occur in travelers and migrants, although epidemiology and/or clinical manifestations differ between these groups. The objective of this study is to summarize the existing knowledge concerning tungiasis, hookworm-related cutaneous larva migrans, scabies, pediculosis capitis and pediculosis corporis in the context of travel and migration, and to identify risk factors for infection. The PUBMED database was searched using the terms tungiasis, cutaneous larva migrans, scabies, pediculosis capitis, pediculosis corporis in combination with travel, migrant, or refugee from 2000 to 2022. Tungiasis and cutaneous larva migrans were the epidermal parasitic skin diseases most commonly reported in travelers. Outbreaks with up to 36 cases occurred in groups of adventure-travelers. The clinical manifestation differed from those in inhabitants of endemic areas and were usually circumscript and moderate. Scabies was very rarely reported in travelers but causes a high disease burden in migrants and refugees. The infestation of refugees with body and head lice caused louse-borne relapsing fever in refugees arriving by boat from Africa. Travel advice concerning prevention of epidermal parasitic skin diseases requires knowledge on their epidemiology in the settings they are endemic.