{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T19:40:28Z","timestamp":1770838828127,"version":"3.50.1"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,6,5]]},"abstract":"<jats:p>Tungiasis is an ectoparasitic skin disease caused by <jats:italic>Tunga penetrans<\/jats:italic> and <jats:italic>Tunga trimamillata<\/jats:italic>. There is a lack of histopathological studies that evaluate the recognition of this flea in tissues. We describe the <jats:italic>ex vivo<\/jats:italic> dermoscopic and the histopathological patterns of six cases and relate the findings to the developmental stage of the parasite as defined by the Fortaleza classification: two were classified as Fortaleza 3b, 3 as 4a, and 1 as 4b. Two dermoscopic patterns were observed: a brown pigmented ring and a radial crown with a central pore. The most common histopathological findings were an eosinophilic cuticle, eggs in different stages of development, tracheal rings (parasite), and basal hyperplasia (host). The eosinophilic cuticle, eggs in different stages of evolution, and tracheal rings can help to establish the diagnosis when other parts of the parasite are lacking. The Fortaleza staging may represent a tool for pathology reporting purposes.<\/jats:p>","DOI":"10.4269\/ajtmh.12-0645","type":"journal-article","created":{"date-parts":[[2013,3,12]],"date-time":"2013-03-12T02:20:34Z","timestamp":1363054834000},"page":"1212-1216","source":"Crossref","is-referenced-by-count":15,"title":["Histopathological Features of Tungiasis in Peru"],"prefix":"10.4269","volume":"88","author":[{"given":"Vicente","family":"Maco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente P.","family":"Maco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel E.","family":"Tantalean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Gotuzzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Med Vet Entomol","first-page":"172","article-title":"Sand flea (Tunga spp.) infections in humans and domestic animals: state of the art","volume":"23","author":"Pampiglione","year":"2009"},{"key":"R2","series-title":"J Med Entomol","first-page":"23","article-title":"A new species of Tunga (Siphonaptera: Tungidae) from Brazil with a key to the adult species and neosomes","volume":"49","author":"De Avelar","year":"2012"},{"key":"R3","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"307","article-title":"Tungiasis","volume":"47","author":"Heukelbach","year":"2005"},{"key":"R4","series-title":"Emerg Infect Dis","first-page":"855","article-title":"Evidence of tungiasis in pre-Hispanic America","volume":"17","author":"Maco","year":"2011"},{"key":"R5","series-title":"Am J Trop Med Hyg","first-page":"1076","article-title":"An ectopic case of Tunga spp. infection in Peru","volume":"82","author":"Maco","year":"2010"},{"key":"R6","series-title":"Parasite","first-page":"9","article-title":"Additional description of a new species of Tunga (Siphonaptera) from Ecuador","volume":"10","author":"Pampiglione","year":"2003"},{"key":"R7","series-title":"Parasite","first-page":"282","article-title":"A second species of Tunga (Insecta, Siphonaptera) infecting man: Tunga trimamillata","volume":"10","author":"Fioravanti","year":"2003"},{"key":"R8","series-title":"Parasite","first-page":"241","article-title":"Anatomy of Tunga trimamillata Pampiglione et al., 2002 (Insecta, Siphonaptera, Tungidae) and developmental phases of the gravid female","volume":"12","author":"Pampiglione","year":"2005"},{"key":"R9","series-title":"Parasite","first-page":"51","article-title":"Differential diagnosis between Tunga penetrans (L., 1758) and T. trimamillata Pampiglione et al., 2002 (Insecta, Siphonaptera), the two species of the genus Tunga parasitic in man","volume":"11","author":"Pampiglione","year":"2004"},{"key":"R10","series-title":"Arch Pathol Lab Med","first-page":"714","article-title":"Typical histologic features of Tunga penetrans in skin biopsies","volume":"126","author":"Smith","year":"2002"},{"key":"R11","series-title":"Parasitol Res","first-page":"275","article-title":"Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. 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Natural history of tungiasis in man","volume":"90","author":"Eisele","year":"2003"},{"key":"R15","series-title":"Arch Dermatol","first-page":"761","article-title":"Dermoscopy of tungiasis","volume":"140","author":"Bauer","year":"2004"},{"key":"R16","series-title":"Arch Dermatol","first-page":"643","article-title":"Variability of dermoscopic features of tungiasis","volume":"141","author":"Bauer","year":"2005"},{"key":"R17","series-title":"Arch Dermatol","first-page":"1045","article-title":"An additional dermoscopic feature of tungiasis","volume":"141","author":"Di Stefani","year":"2005"},{"key":"R18","series-title":"Arch Dermatol","first-page":"348","article-title":"Tunga penetrans: description of a new dermoscopic sign\u2013the radial crown","volume":"145","author":"Marazza","year":"2009"},{"key":"R19","series-title":"Dermatology","first-page":"14","article-title":"Entodermoscopy: a new tool for diagnosing skin infections and infestations","volume":"216","author":"Zalaudek","year":"2008"},{"key":"R20","series-title":"J Dtsch Dermatol Ges","first-page":"589","article-title":"Dermoscopy and entomology (entomodermoscopy)","volume":"7","author":"Tschandl","year":"2009"},{"key":"R21","series-title":"Trop Med Int Health","first-page":"559","article-title":"Bacterial superinfection in human tungiasis","volume":"7","author":"Feldmeier","year":"2002"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/88\/6\/article-p1212.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/88\/6\/article-p1212.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/88\/6\/article-p1212.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:30:45Z","timestamp":1723055445000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/88\/6\/article-p1212.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,5]]},"references-count":21,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.12-0645","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,5]]}}}