dermatologic disorders
Cutaneous Myiasis
Furuncular Myiasis
Many of the common sources are known as bot flies.Dermatobia hominis, native to South and Central America, is the most common cause in travelers returning to the United States. Other species includeCordylobia anthropophaga(in sub-Saharan Africa), variousCuterebraspecies (in North America), andWohlfahrtiaspecies (in North America, Europe, and Pakistan). Many of the flies do not lay their eggs on humans but on other insects (eg, mosquitoes) or objects (eg, drying laundry) that may contact skin. Eggs on the skin hatch into larvae, which burrow into the skin and develop through successive stages (instars) into mature larvae; mature larvae may be 1 to 2 cm long, depending on the species. If the infestation is untreated, larvae eventually emerge from the skin and drop to the ground to continue their life cycle. Typical symptoms include itching, a sensation of movement, and sometimes lancinating pain. The initial lesion may resemble an arthropod bite or bacterial furuncle but may be distinguished by the presence of a central punctum with serosanguineous drainage; sometimes a small portion of the end of the larva is visible.D. hominislesions are more common on the face, scalp, and extremities, whereasC. anthropophagalesions tend to occur in areas that are covered by clothing and appear on the head, neck, and back. The optimal treatment approach is uncertain and approaches vary depending on the availability of interventions, ranging from expectant management to surgical removal. Because larvae require atmospheric oxygen, occlusion of the skin opening may cause them to depart or at least come closer to the surface, facilitating manual removal ( Furuncular myiasis reference ). The numerous occlusive methods include use of petrolatum, nail polish, bacon, or a paste of tobacco. However, larvae that die during occlusion are difficult to remove and often trigger an intense inflammatory reaction. Larvae may be extracted through a small incision. 1.Solomon M, Lachish T, Schwartz E: Cutaneous myiasis.Curr Infect Dis Rep. 8(9):28, 2016. doi: 10.1007/s11908-016-0537-6 