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The patient, a 76-year-old Japanese woman, presented with multiple painful eruptions on her feet (Figure 1). She had been to Venezuela 2 weeks earlier. When walking on the sand without shoes, she had the sensation of being stung on the feet. Lesions first appeared as black dots, before enlarging. Physical examination revealed round, creamy-white eruptions of 3 to 4 mm in diameter on her soles, toes, and periungual areas (Figure 1). Wriggling tubular structures were observed in some of the eruptions (Figure 1D: arrows and video). What is your diagnosis?
Figure 1.
Clinical photographs (A) and dermoscopic image (B–D) of the patient’s feet. Arrow: dark-reddish wriggling tubular structure.
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