Erosive (or ulcerative) myiasis occurs in the presence of severe malnutrition or other conditions that inhibit tissue repair processes. The usual furuncle-like presentation of cutaneous myiasis culminates in deep cutaneous ulcerations revealing underlying fascia. Life-threatening infection can ensue. The usual forms of local treatment must be supplemented by antibiotics given for systemic effect and major nutritional therapy to ensure recovery.
Cutaneous myiasis is found in most tropical nations and many temperate zones and is caused by the larvae of many different flies of the Diptera order. Each species has its own distinct means of propagation but all involve the burrowing into live flesh by a larva that then develops over a period of days to months, after which it emerges. With species that have large larva, an indurated dome-like lesion known as a warble (which measures up to 3 to 4 cm in diameter) may occur, with ultimate ulceration, extrusion
Guillozet N. Erosive Myiasis. Arch Dermatol. 1981;117(1):59-60. doi:10.1001/archderm.1981.01650010065031