{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:04Z","timestamp":1787028664806,"version":"build-2736575974"},"reference-count":93,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Parasitic skin-related conditions represent a frequent and evolving challenge in human dermatology, as they often mimic other dermatoses, and are increasingly complicated by therapeutic resistance. With this study, we aimed to provide a practical, clinician-oriented overview of our experience, contextualising it within the current literature. Materials and Methods: We conducted a retrospective, single-centre observational study, reporting a case series of 88 patients diagnosed with parasitic or arthropod-related skin infestations at the San Raffaele Hospital Dermatology Unit (Milan) between 2019 and 2024, and integrated a concise narrative review of contemporary evidence on diagnosis, non-invasive imaging and management. For each case, we documented clinical presentation, dermoscopic or reflectance confocal microscopy (RCM) findings, and treatment response. Non-invasive tools (dermoscopy, videodermoscopy, RCM) were used when appropriate. Results: The spectrum of conditions included flea bites, bed bug bites, cutaneous larva migrans, subcutaneous dirofilariasis, Dermanyssus gallinae dermatitis, pediculosis, tick bites (including Lyme disease), myiasis, scabies, and cutaneous leishmaniasis. One case of eosinophilic dermatosis of haematologic malignancy was also considered due to its possible association with arthropod bites. Non-invasive imaging was critical in confirming suspected infestations, particularly in ambiguous cases or when invasive testing was not feasible. Several cases highlighted suspected therapeutic resistance: a paediatric pediculosis and three adult scabies cases required systemic therapy after standard regimens failed, raising concerns over putative resistance to permethrin and pyrethroids. In dirofilariasis, the persistence of filarial elements visualised by RCM justified the extension of antiparasitic therapy despite prior surgical removal. Conclusions: Our findings underline that accurate diagnosis, early intervention, and tailored treatment remain essential for the effective management of cutaneous infestations. The observed vast spectrum of isolated parasites reflects broader health and ecological dynamics, including zoonotic transmission, international mobility, and changing environmental conditions. At the same time, diagnostic delays, inappropriate treatments, and neglected parasitic diseases continue to pose significant risks. To address these challenges, clinicians should remain alert to atypical presentations, and consider a multidisciplinary approach including the consultation with parasitologists and veterinarians, as well as the incorporation of high-resolution imaging and alternative therapeutic strategies into their routine practice.<\/jats:p>","DOI":"10.3390\/jcm15020851","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T17:20:42Z","timestamp":1768929642000},"page":"851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ectoparasite- and Vector-Borne-Related Dermatoses: A Single-Centre Study with Practical Diagnostic and Management Insights in a One Health Perspective"],"prefix":"10.3390","volume":"15","author":[{"given":"Giovanni","family":"Paolino","sequence":"first","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-8436","authenticated-orcid":false,"given":"Barbara","family":"Moroni","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, Via Bologna 148, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Podo Brunetti","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4804-3870","authenticated-orcid":false,"given":"Anna","family":"Cerullo","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, Via Bologna 148, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-2489","authenticated-orcid":false,"given":"Carlo","family":"Mattozzi","sequence":"additional","affiliation":[{"name":"Private Medical Practice, Via Vittorio Veneto 148, 91026 Mazara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Gaiera","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Cirami","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, 20097 San Donato Milanese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dino","family":"Zilio","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, 20097 San Donato Milanese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9140-9263","authenticated-orcid":false,"given":"Mario","family":"Valenti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8231-2205","authenticated-orcid":false,"given":"Andrea","family":"Carugno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6665-2712","authenticated-orcid":false,"given":"Giuseppe","family":"Esposito","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, Via Bologna 148, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2177-9677","authenticated-orcid":false,"given":"Nicola","family":"Zerbinati","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-951X","authenticated-orcid":false,"given":"Carmen","family":"Cantisani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-581X","authenticated-orcid":false,"given":"Franco","family":"Rongioletti","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, IRCCS San Raffaele Hospital, 20132 Milan, Italy"},{"name":"Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santo Raffaele","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy"},{"name":"Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7199-0804","authenticated-orcid":false,"given":"Matteo Riccardo","family":"Di Nicola","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, Via Bologna 148, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/S0140-6736(04)15738-3","article-title":"Ectoparasites\u2014The Underestimated Realm","volume":"363","author":"Heukelbach","year":"2004","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0738-081X(01)00248-6","article-title":"An Overview: The Changing Face of Cutaneous Infections and Infestations","volume":"20","author":"Skerlev","year":"2002","journal-title":"Clin. 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