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Chauhan P, Jindal R, Errichetti E. Dermoscopy of skin parasitoses, bites and stings: a systematic review of the literature. J Eur Acad Dermatol Venereol 2022; 36:1722-1734. [PMID: 35735046 DOI: 10.1111/jdv.18352] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/18/2022] [Indexed: 11/30/2022]
Abstract
Besides classic applications, dermoscopy has gained significant appreciation also for non-tumoral dermatoses (general dermatology). In this field, skin parasitoses (infestations), bites and stings have been reported among the conditions that may benefit most from dermoscopic examination. However, published data on this topic are sparse and often lack a standardized analytical approach. In this systematic review of the literature, we sought to summarize available data on dermoscopy of cutaneous parasitoses, bites and stings, analysing dermoscopic features and used setting (polarisation or not/magnification), pathological correlation and level of evidence of published studies as well as trying to align dermoscopic terminology of reported findings following a standardized methodology. A total of 150 publications addressing 29 different dermatoses and reporting 96 different dermoscopic findings were included in the analysis. Most of the them displayed a level of evidence of V (113 single case reports and 36 case series), with only one study featuring a level of evidence of IV (case-control study). Additionally, our analysis also displayed poor uniformity in the terminology used in published articles (even for the same dermatosis). Therefore, albeit promising, dermoscopy of cutaneous parasitoses, bites and stings needs future systematized studies for a better characterization.
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Affiliation(s)
- Payal Chauhan
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Himachal Pradesh, India
| | - Rashmi Jindal
- Department of Dermatology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Enzo Errichetti
- Institute of Dermatology, Department of Medicine, University of Udine, Udine, Italy
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Bakos RM, Reinehr C, Escobar GF, Leite LL. Dermoscopy of skin infestations and infections (entomodermoscopy) - Part I: dermatozoonoses and bacterial infections. An Bras Dermatol 2021; 96:735-745. [PMID: 34620524 PMCID: PMC8790189 DOI: 10.1016/j.abd.2021.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/30/2021] [Accepted: 04/17/2021] [Indexed: 11/30/2022] Open
Abstract
Dermoscopy is an essential in vivo diagnostic technique in the clinical evaluation of skin tumors. Currently, the same can also be said about its implications when approaching different clinical situations in Dermatology. A growing number of reports on dermatological scenarios and diseases have been published, in which dermoscopy has been of great diagnostic help. The term "entomodermoscopy" was coined to describe dermoscopic findings in skin infestations and also in dermatoses of infectious etiology. In part I of this article, the main dermoscopic descriptions of zoodermatoses and bacterial infections will be addressed. In many of them, such as scabies, pediculosis, myiasis, and tungiasis, it is possible to identify the pathogen and, consequently, attain the diagnosis more quickly and use the technique to follow-up therapeutic effectiveness. In other situations that will be described, dermoscopy can allow the observation of clinical findings with greater detail, rule out differential diagnoses, and increase the level of confidence in a clinical suspicion.
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Affiliation(s)
| | - Clarissa Reinehr
- Postgraduation in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Leandro Linhares Leite
- Service of Dermatology, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Clinical implications and treatment options of tungiasis in domestic animals. Parasitol Res 2021; 120:4113-4123. [PMID: 33818640 DOI: 10.1007/s00436-021-07121-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Tunga penetrans, Tunga trimamillata and Tunga hexalobulata are the three species of sand fleas which cause tungiasis in domestic animals. Tunga penetrans and T. trimamillata are zoonotic in the tropical and sub-tropical endemic communities of Latin America and Africa. Tungiasis in animals frequently occurs alongside human tungiasis. Currently, most of the attention given to tungiasis is focusing on the human disease, and animal tungiasis is extremely neglected despite its public health and animal health significance. This review highlights recent findings concerning the clinical implications and treatment options but also summarises the occurrence, major features, public health and economic significance of tungiasis in domestic animals. Pigs, dogs, cats and domestic ruminants have been reported to harbour high intensities of sand fleas in endemic communities. High infection intensities cause significant animal morbidity which is often exacerbated by excoriations and secondary bacterial infections which are potentially fatal. In addition to the potential economic losses accruing from tungiasis-related morbidity, infected domestic animals contribute to transmission and persistence of sand fleas and eventually also to severe human disease. Although control of animal tungiasis is possible by adoption of proper husbandry practices, affected communities may not afford the resources required to implement them. Also, there are no widely acceptable and affordable insecticides for treatment of tungiasis in animals. Extension services aiming at increasing awareness on tungiasis and its control should be intensified. Also, available commercial insecticides should be evaluated for therapeutic and prophylactic properties against animal tungiasis.
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Verzì AE, Lacarrubba F, Dinotta F, Micali G. Dermatoscopy of Parasitic and Infectious Disorders. Dermatol Clin 2018; 36:349-358. [PMID: 30201144 DOI: 10.1016/j.det.2018.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of dermatoscopy in the diagnosis and management of parasitic and infectious skin disorders has been defined as entodermoscopy, and several studies have confirmed its advantages in dermatology. Dermatoscopic patterns of several parasitic, viral, and fungal skin infections have been identified and herein described. A noninvasive, fast, and accurate diagnosis plays an important role in containing the spread of contagious skin disorders.
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Affiliation(s)
- Anna Elisa Verzì
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Francesco Lacarrubba
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Franco Dinotta
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Giuseppe Micali
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy.
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Kittler H, Marghoob AA, Argenziano G, Carrera C, Curiel-Lewandrowski C, Hofmann-Wellenhof R, Malvehy J, Menzies S, Puig S, Rabinovitz H, Stolz W, Saida T, Soyer HP, Siegel E, Stoecker WV, Scope A, Tanaka M, Thomas L, Tschandl P, Zalaudek I, Halpern A. Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy. J Am Acad Dermatol 2016; 74:1093-106. [PMID: 26896294 DOI: 10.1016/j.jaad.2015.12.038] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/15/2015] [Accepted: 12/20/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Evolving dermoscopic terminology motivated us to initiate a new consensus. OBJECTIVE We sought to establish a dictionary of standardized terms. METHODS We reviewed the medical literature, conducted a survey, and convened a discussion among experts. RESULTS Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a descriptive terminology based on 5 basic terms. In a survey among members of the International Society of Dermoscopy (IDS) 23.5% (n = 201) participants preferentially use descriptive terminology, 20.1% (n = 172) use metaphoric terminology, and 484 (56.5%) use both. More participants who had been initially trained by metaphoric terminology prefer using descriptive terminology than vice versa (9.7% vs 2.6%, P < .001). Most new terms that were published since the last consensus conference in 2003 were unknown to the majority of the participants. There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms. LIMITATIONS A consensus seeks a workable compromise but does not guarantee its implementation. CONCLUSION The new consensus provides a revised framework of standardized terms to enhance the consistent use of dermoscopic terminology.
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Affiliation(s)
- Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.
| | - Ashfaq A Marghoob
- Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Giuseppe Argenziano
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
| | - Cristina Carrera
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain
| | | | - Rainer Hofmann-Wellenhof
- Department of Dermatology and Venerology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Scott Menzies
- Sydney Melanoma Diagnostic Center, Sydney Cancer Center, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain
| | | | - Wilhelm Stolz
- Department of Dermatology, Klinikum München, Munich, Germany
| | - Toshiaki Saida
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - H Peter Soyer
- Dermatology Research Center, University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia
| | - Eliot Siegel
- University of Maryland Medical Center, Baltimore Department of Veterans Affairs Medical Center, Baltimore, Maryland
| | - William V Stoecker
- Department of Dermatology, University of Missouri Health Sciences Center, Columbia, Missouri
| | - Alon Scope
- Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Masaru Tanaka
- Department of Dermatology, Keio University, Tokyo, Japan
| | - Luc Thomas
- Service de Dermatologie, Center Hospitalier Universitaire de Lyon, Lyon, France
| | - Philipp Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Iris Zalaudek
- Department of Dermatology and Venerology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - Allan Halpern
- Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
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Criado PR, Landman G, Reis VMSD, Belda W. Tungiasis under dermoscopy: in vivo and ex vivo examination of the cutaneous infestation due to Tunga penetrans. An Bras Dermatol 2014; 88:649-51. [PMID: 24068146 PMCID: PMC3760950 DOI: 10.1590/abd1806-4841.20132071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 10/24/2012] [Indexed: 12/01/2022] Open
Abstract
The female flea Tunga penetrans is responsible for a cutaneous parasitosis known as
Tungiasis. We report the clinical case of a 12 year-old Caucasian boy who sought
treatment in a dermatological private office due to a painful lesion in the plantar
area and whose dermoscopic examination, without skin contact, allowed the
visualization of parasite's movement inside the skin. The diagnosis of tungiasis is
clinical, but it can be aided by in vivo and ex vivo
dermoscopic examination of the lesion.
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Affiliation(s)
- Paulo Ricardo Criado
- Dermatology Department, University of São Paulo, Medical School, Clinics Hospital, São Paulo(SP), Brazil
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Arranz J, Taberner R, Llambrich A, Nadal C, Torné I, Vila A, Parera E, Terrasa F. Four imported cases of tungiasis in Mallorca. Travel Med Infect Dis 2011; 9:161-4. [PMID: 21530410 DOI: 10.1016/j.tmaid.2011.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 03/28/2011] [Accepted: 03/30/2011] [Indexed: 10/18/2022]
Abstract
Tungiasis is an endemic disease in many resource-poor communities some of which are in South America, which are visited frequently by Spanish travelers. Its diagnosis can be improved with the knowledge of the typical presentation and the correct management of its injuries. We report the first four cases identified of imported tungiasis in Mallorca. All four patients visited beaches in Brazil and presented the classical black lesions after their return. Two of the patients were diagnosed at primary care level and all were treated by dermatologists with surgical techniques. Dermoscopy was used for the initial approach to the injuries. Tungiasis can be suspected easily by examining carefully the black lesions and asking about previous travel. It can be treated readily by minor surgical techniques.
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Affiliation(s)
- J Arranz
- Mallorca Department of Primary Care, IBSALUT, C/Reina Esclarmunda 9, Palma de Mallorca, Balearic Islands, Spain.
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Yotsu RR, Tamaki T, Ujiie M, Takeshita N, Kanagawa S, Kudo K, Hayashi T. Imported tungiasis in a Japanese student returning from East Africa. J Dermatol 2010; 38:185-9. [PMID: 21269317 DOI: 10.1111/j.1346-8138.2010.00952.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ectoparastiosis by Tunga penetrans is becoming more common in non-tropical countries as people travel more to endemic areas. We present here a classic case of imported tungiasis including a history of visit to an endemic region and its typical presentation. Diagnosis with dermoscopy, treatment and prevention are discussed.
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Affiliation(s)
- Rie R Yotsu
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan.
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