[Tungiasis: from travel-associated dermatosis to a neglected tropical disease]

Tungiasis is an ectoparasitic skin disease caused by the penetration of female sand fleas (Tunga penetrans) into the epidermis. It is endemic in Latin America, the Caribbean, and sub-Saharan Africa and occurs in Europe predominantly as a travel-associated dermatosis. Characteristic lesions are whitish-yellow papules or nodules with a central dark punctum, predominantly affecting the feet and often accompanied by erythema, pruritus, and pain. Severe infestations may lead to ulceration, nail dystrophy, and secondary bacterial infections. In low-income endemic communities, particularly among children and vulnerable populations, tungiasis represents not only a relevant public health problem but also a significant social and economic burden. Diagnosis is primarily clinical, based on the characteristic lesions and travel and exposure history. Treatment consists of complete removal of the embedded flea under aseptic conditions; in patients with multiple lesions, topical low-viscosity dimethicone may be used. Preventive measures include wearing closed footwear and avoiding direct skin contact with contaminated soil.