Skin conditions in the returned traveler

PATHOGENS

Classifications according to potential presentations:

• Papular eruptions: Sarcoptes scabiei, Onchocerca volvulus, non-human schistosomes (e.g., avian), Edwardsiella lineata larva (sea anemone), Linuche unguinculata (jellyfish), bedbugs, flea bites
• Nodules/subcutaneous swellings: myiasis due to Cordylobia anthropophaga larvae, Dermatobia hominis larvae or Tunga penetrans; Loa loa; Trypanosoma brucei gambiense and T.b. rhodesiense (more common to see nodule in this form).
• Ulcers: Staphylococcus aureus, Group A streptococci; Leishmania (Viannia) braziliensis complex; Mycobacterium marinum; Boutonnese fever (Rickettsia conorii group); Orientalis tsutsugamushi; Haemophilus ducreyi; Chlamydia trachomatis L serovars; Klebsiella granulomatis; Treponema pallidum; herpes simplex virus.
• Geographic migratory and linear lesions: examples
  1. Non-human nematode larvae: Ancylostoma braziliense, A. caninum, Gnathostoma spp, zoonotic Strongyloides, Spururina spp.
  2. Human nematode larvae: Strongyloides stercoralis.
  3. Migratory maggots (myiasis).
  4. Adult nematodes: Loa loa; Dracunculus medinensis.
  5. Trematode larvae: Fasciola giganta.
  6. Mites: Sarcoptes scabei.

• Exanthema: Dengue virus serotypes 1, 2, 3 and 4; chikungunya virus; Rickettsia africae; R. conorii; other location-specific arthropod-borne rickettsioses.
• Animal bites: Capnocytophaga spp, Corynebacterium spp, Neisseria spp, Pasturella spp; Staphylococcus aureus, streptococci, anaerobes, rabies virus, herpes B virus
• Additional systemic infections of travelers associated with skin lesions: (not a comprehensive list)
  
  • Bartonella bacilliformis (Oroya fever, Verruga peruana, carrion disease)
  • Brucella spp.
  • Ehrlichia spp.
  • Enteroviruses
  • Neisseria gonorrheae
  • Acute HIV infection
  • Leishmania major (visceral leishmaniasis)
  • Leptospira spp.
  • Borrelia burgdorferi (Lyme disease)
  • Measles
  • Burkholderia pseudomallei
  • Neisseria meningitidis
  • Parvovirus
  • Streptobacillus moniliformis (rat-bite fever)
  • Spirillum minus(rat-bite fever)
  • Borrelia recurrentis(louse-borne relapsing fever)
  • Borrelia hermsii(or other species, Ttck-borne relapsing fever)
  • Trypanosoma cruzi (Chagas disease)
  • Coccidioides spp.
  • Paracoccidioides brasiliensis
  • Agents of dermatophytoses (fungal infections of the superficial keratinized areas of the body)
  • Rickettsial spp. (15 species in the spotted fever group, 2 species in the typhus group, 3 serogroups in the scrub typhus/Orientalis biogroup)
    • Tick-borne lymphadenopathy (TIBOLA)
    • Dermacentor-borne necrosis eschar lymphadenopathy (DEBONEL)
  • Mpox virus (previously known as monkeypox)