Image 32: This adult female had travelled in West Africa for several weeks and developed a number of uncomfortable lesions on the toes of both feet. This one was noted to be extruding small white specks, that when examined under a microscope were the objects in the insert (~650 µm in length). The diagnosis was:

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Image 32: This was an infection with Tunga penetrans, the chigoe or jigger flea. The eggs were extruded (spit out) every minute or so. This particular lesion was lighter in colour than those under the distal parts of the toe nails.