Disease caused by a parasite known as Tunga penetrans that burrows into the human skin. This parasite is a sand flea that is usually found in warm and tropical areas of Africa, South America, the Caribbean and some parts of Asia.
Tungiasis is caused when these sand flies burrow into the skin, usually when walking barefoot on soil contaminated by the parasites' eggs.
The most common symptoms are severe itching, swelling, localised pain and the appearance of small nodular lesions on the skin, which can become infected if not treated properly.
It is diagnosed by assessing the skin lesions and identifying the sand fly or its remains under the skin.
Treatment is based on extracting the sand fly with sterile needles and disinfecting the injury. In severe or complicated cases, topical or oral medication may be used to treat the infection. It is also important to maintain good personal hygiene and avoid walking barefoot in areas where sand flies are present to prevent further infection.
- Lederman ER, Weld LH, Elyazar IR, et al. Dermatologic conditions of the ill returned traveler: an analysis from the GeoSentinel Surveillance Network. Int J Infect Dis 2008; 12:593.
- Sanusi ID, Brown EB, Shepard TG, Grafton WD. Tungiasis: report of one case and review of the 14 reported cases in the United States. J Am Acad Dermatol 1989; 20:941.
- Matono T, Kato Y, Yotsu R, Ohmagari N. Tungiasis: diagnosis at a glance. Lancet 2016; 388:275.
- Abrha S, Heukelbach J, Peterson GM, et al. Clinical interventions for tungiasis (sand flea disease): a systematic review. Lancet Infect Dis 2021; 21:e234.

