Tungiasis is a medical condition in which a person's skin becomes infected by a type of flea. The flea burrows underneath the skin, causing painful lesions. These lesions mostly occur on the feet and lower legs of patients, since the flea does not jump very high. A variety of treatment options are available, however the lesions may also heal on their own. If they do not, a doctor may remove the flea or apply a medication to that area of skin.
Christopher Columbus' crew on the Santa Maria first reported incidences of tungiasis in Haiti in the 1500s. Subsequent Spanish conquerors were also afflicted with this skin condition, to the point that they had trouble walking. Today, researchers have pinpointed a specific type of flea responsible for the malady: the burrowing flea, or Tunga penetrans, also called the sand flea. The Tunga flea prefers dry, warm climates and is native to the Caribbean and the West Indies. Those who live in or travel to Latin America, Africa, Pakistan, and India may also pick up this tiny hitchhiker on their feet.
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When the Tunga flea first burrows underneath the skin, it leaves a tiny black dot. Soon thereafter, patients will notice a spreading area of redness with an enlarging black dot in the center. Over the course of the next few weeks, tungiasis causes a distinct, white nodule on the skin, about the size of a pea. Many people may suffer from multiple lesions.
The skin surrounding the lesion will often be red and swollen. Many patients report itchiness and pain, which can sometimes be severe. If tungiasis is left untreated or the patient suffers from a severe infection, life-threatening complications and secondary infections can develop. Ulcers can form, along with gangrene, which may lead to the loss of toes, feet, or legs. Tungiasis may also lead to cellulitis, tetanus, and death.
Some patients may heal on their own without the risk of life-threatening complications. The Tunga flea dies in about two weeks and it will eventually leave the body as old skin cells are shed. Otherwise, patients may respond to the application of a thick wax layer over the lesion, which can suffocate the flea. The doctor may also apply anti-parasitic drugs to the skin, which may include thiabendazole, ivermectin, and metrifonate.
In more severe cases, tungiasis may need to be addressed with cryotherapy, which involves freezing the lesion off with liquid nitrogen. The doctor may also recommend physically removing the flea. This can involve opening up the lesion or removing it entirely.