Abstract
Cutaneous parasitosis caused by fleas belonging to the Tunga genus is a common disease in certain regions of the globe like Latin America or Sub-Saharan Africa, but rare in western countries. Its clinical course varies from self-limiting disease to severe systemic infection, making it clear that early diagnosis and treatment are of great importance. We describe a case of imported tungiasis of the lower limb in a patient with a recent travel to Tanzania. The patient presented with dark lesions on the toes, pain, oedema, and pruritus. Clinical and dermoscopic evaluation raised the suspicion of parasitic infection. The lesions were removed surgically, and microscopic and pathologic examination of the tissue revealed the Tunga penetrans flea and its eggs, confirming the diagnosis. The procedure was followed by antibiotic treatment and the infection was resolved without complications. Given the rarity of tungiasis in developed countries, a careful clinical inspection in combination with a detailed history including travel history is vital to suspect such diseases. Laboratory and pathological findings are important to establish the diagnosis and lead to early treatment and complication avoidance.