Imágenes en Dermatología
Caso exuberante de tungiasis procedente de Brasil
Exuberant Case of Tungiasis from Brazil
F. Tavares Rodrigues
, V. Farnezi, A. Macedo D’Acri
Corresponding author
Gaffree e Guinle Universitary Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brasil
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"apellidos" => "Macedo D’Acri" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Gaffree e Guinle Universitary Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brasil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Exuberant Case of Tungiasis from Brazil" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 148277 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Un granjero brasileño de 54 años de edad con bajo estatus socioeconómico acudió a nuestro centro de urgencias con historia de lesiones pruriginosas diseminadas en el pie, de 2 meses de evolución, tras trabajar descalzo en una porqueriza. Dichas lesiones se componían de muchas pápulas redondeadas, costrosas y queratósicas del tamaño de la cabeza de un clavo, con un centro elevado negruzco, rodeado ocasionalmente por una tunga amarillenta, que ni siquiera evitaba las uñas (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). Aparte de esto no reportó otras comorbilidades, compromiso previo de los pies, ni antecedentes familiares de lesiones similares.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La tungiasis puede encontrarse en humanos y cerdos y se adquiere en localizaciones arenosas y establos, siendo una enfermedad cutánea parasitaria olvidada, causada por la penetración permanente de la pulga hembra. Puede encontrarse en África, la costa del Caribe y Sudamérica, y también en los viajeros que visitan dichas zonas. Existen solo 2 especies de pulga que infectan al hombre: <span class="elsevierStyleItalic">Tunga penetrans</span>, de 1<span class="elsevierStyleHsp" style=""></span>mm de longitud, que es la pulga de menor tamaño que se conoce, y <span class="elsevierStyleItalic">Tunga trimamillata</span>, una entidad de los Andes peruanos raramente descrita<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se trata de una enfermedad autolimitada, porque la hembra hematófaga muere tras ovular en la piel del huésped. La extracción manual de los parásitos es el tratamiento estándar. También pueden utilizarse permetrina tópica, tiabendazol oral e ivermectina oral<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">2,3</span></a>. Nuestro paciente utilizó una pomada tópica compuesta de permetrina 5%, y 10<span class="elsevierStyleHsp" style=""></span>mg/g de sulfadiazina argéntica 2 veces al día durante 10 días, tras extraerse parcialmente los parásitos el día de su visita, lográndose la exterminación sucesiva de los mismos, y la desaparición de las lesiones.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 148277 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imported tungiasis: a report of 19 cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Veraldi" 1 => "M. Valsecchi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2007.03280.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2017" "volumen" => "46" "paginaInicial" => "1061" "paginaFinal" => "1066" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17910715" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tungiasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Heukelbach" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Inst Med Trop." "fecha" => "2005" "volumen" => "47" "paginaInicial" => "307" "paginaFinal" => "313" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disseminated tungiasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.M. Krüger" 1 => "L.S. Loro" 2 => "L.C. Takita" 3 => "G. Filho Hans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20177239" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol." "fecha" => "2017" "volumen" => "92" "paginaInicial" => "727" "paginaFinal" => "728" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29166519" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00017310/0000011300000006/v1_202206190516/S0001731021004439/v1_202206190516/es/main.assets" "Apartado" => array:4 [ "identificador" => "83194" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imágenes en Dermatología" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011300000006/v1_202206190516/S0001731021004439/v1_202206190516/es/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731021004439?idApp=UINPBA000044" ]
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