We congratulate Bauer and coauthors1 for their report on the dermoscopic features of a case of tungiasis. We would like to add some comments based on our very recent observation of a European couple who acquired infestation by the flea Tunga penetrans while traveling in an endemic area. The clinical appearance in the 62-year-old man and in his wife, a 63-year-old woman, was not so characteristic as described in the literature (ie, papule with a central black spot).2 In fact, we observed a solitary whitish papule, 5 to 6 mm in diameter, with only a slightly brownish area in the center (Figure 1). Both lesions developed on the feet, 2 weeks after the 2 patients had walked barefoot on sandy soil in Venezuela.
Di Stefani A, Rudolph CM, Hofmann-Wellenhof R, Müllegger RR. COMMENTS AND OPINIONS. Arch Dermatol. 2005;141(8):1045-1046. doi:10.1001/archderm.141.8.1045