{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:04:14Z","timestamp":1771063454027,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Tungiasis is an infestation caused by the penetration into the skin of the flea <jats:italic>Tunga penetrans.<\/jats:italic> Histopathologic studies on imported tungiasis are rare and based on a limited number of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Histopathologic study revealed hyper\u2010 parakeratosis and acanthosis. Fragments of the flea were located in the epidermis and upper dermis and were circumscribed by a pseudo\u2010cystic 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.13410","type":"journal-article","created":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T09:52:13Z","timestamp":1547200333000},"page":"251-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical and histopathologic study of 39 patients with imported tungiasis"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-6497","authenticated-orcid":false,"given":"Gianluca","family":"Nazzaro","sequence":"first","affiliation":[{"name":"Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano, I.R.C.C.S. Foundation, Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7636-958X","authenticated-orcid":false,"given":"Giovanni","family":"Genovese","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano, I.R.C.C.S. Foundation, Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Veraldi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano, I.R.C.C.S. Foundation, Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2007.03280.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00436-002-0817-y"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1689"},{"key":"e_1_2_5_5_1","article-title":"Cutaneous larva migrans and tungiasis: infestations of the affluent society","author":"Veraldi S","year":"2018","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/003693309403900508"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.12792"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2005.02611.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2666"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.12-0645"},{"key":"e_1_2_5_11_1","doi-asserted-by":"crossref","first-page":"714","DOI":"10.5858\/2002-126-0714-THFOTP","article-title":"Typical histologic features of Tunga penetrans in skin biopsies","volume":"126","author":"Smith MD","year":"2002","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00436-004-1197-2"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcup.13410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.13410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cup.13410","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.13410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T12:03:38Z","timestamp":1694433818000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.13410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,4]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/cup.13410"],"URL":"https:\/\/doi.org\/10.1111\/cup.13410","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,4]]},"assertion":[{"value":"2018-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}