SKIN DISORDERS IN TROPICAL TRAVELLERS

COMMONEST:

cutaneous larva migrans (25%)

various pyodermas (18%)

insect bites (with or without secondary infection) (10%)

myiasis (9%)

tungiasis (6%)

urticaria (5%)

fever and rash (4%)

cutaneous leishmaniasis (3%)

flare-up of pre-existing skin disorders, e.g. psoriasis

ulcers:

ecthyema (secondarily infected insect bite)

leishmaniasis

sporotrichosis

anthrax

cat-scratch disease

Mycobacterium marinum infection

paracoccidioidomycosis

eschar (of tick or scrub typhus and rickettsial pox)

cutaneous amoebiasis

bite of brown recluse spider

papules:

�prickly heat� (miliaria rubra)

arthropod bites (mosquitoes, midgets, sanflies, bedbugs & fleas)

filariasis (onchocerciasis & streptocerciasis)

scabies

drug rashes (e.g. from antimalarials)

papulo-squamous:

candidiasis (usually affects intertriginous areas)

dermatophytes (tinea corporis, pedis and cruris)

phytodermatitis (irritants or antigenic components produced by certain plants, e.g. pineapple contact dermatitis, mango fruit skin (�mango mouth�), toxicodendron palnts)

scaly erythema:

dermatophytes

leprosy (hypoaesthetic)

leishmaniasis

yaws

secondary syphilis

atypical mycobacterial infections

serpiginous lesions:

cutaneous larva migrans (dog & cat hookworms)

straight linear lesions:

plant toxins

phytotoxic reactions

phytophotodermatitis (psoralen-containing fluids, e.g. lime juice)

sporotrichosis

cat-scratch disease

blister beetle dermatitis

leishmaniasis (lymphocutaneous ulcers)

nocardiosis

atypical mycobacteria

insect bites in linear configuration (�breakfast, lunch and dinner�)

hyperpigmented lesions:

pityriasis versicolor

pinta

tinea nigra

phytophotodermatitis (late changes)

late chabges in any inflammatory dermatosis

suntan!

hypopigmented lesions:

leprosy (hypoaesthetic)

pityriasis versicolor

dermatophytes

subcutaneous nodules or swellings:

myiasis (maggots of various larval species of flies, e.g. tumbu fly and botfly)

staphylococcal boils or furuncles

cysticercosis

Calabar swelling (Loa loa)

tungiasis (�jiggers� � female sand flea)

trypanosomiasis inoculation site (chagoma or chancre)

Spirometra spp. tapeworm larva

onchocerciasis

aquatic dermatitis:

generalises rashes:

sea-bather�s eruption

swimmer�s itch (cercarial dermatitis)

seaweed dermatitis

localised, painful lesions:

jellyfish and sea anemones

fire coral and sea urchins

Portuguese man-of-war