Nodular Skin Lesions in the Returning Traveler
Furuncular Myiasis:
 • Pathogens: Dermatobia hominis, Cordylobia spp, Cuterebra spp
 • Region: Global
 • Features: One or more nodules with central puncta. Sensation of movement or lancinating pain.
Furunculosis:
 • Pathogens: Staphylococcus aureus, Pseudomonas aeruginosa
 • Region: Global
 • Features: Cutaneous abscesses, can be associated with adjacent cellulitis
Tungiasis:
 • Pathogens: Tunga penetrans (Sand flea)
 • Region: South/Central America, Africa, India
 • Features: Small papule with black center. Typically on the feet, including heel and toes
Nodular Lymphangitis:
 • Pathogens: Sporothrix schenckii, Mycobacterium spp, Nocardia spp
 • Region: Global
 • Features: Nodular lesions with spread via lymphatics with associated lymphangitis.
Cutaneous Leishmaniasis:
 • Pathogens: Leishmania spp
 • Region: Latin America, Middle East, Saharan Africa, SC Asia
 • Features: Typically ulcerative but can present as nodular or verrucous plaques

Andrea Boggild, MD @BoggildLab

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