A school-aged child was brought to the dermatology department with a 1-month history of lesions on the hands and feet that were not responsive to oral ivermectin. The family lived in a poor, rural region in Brazil, and the mother reported similar lesions in his siblings, all of whom regularly walked barefoot.
On examination, there were multiple yellow-brown papules with dark central dots on several fingers, toes, and interdigital folds, with development of bullae (Figure 1).
Cagnon GV, Carvalho dos Santos D, Miot HA. Tungiasis. JAMA Dermatol. 2019;155(10):1181. doi:10.1001/jamadermatol.2019.1813
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