Review Cutaneous myiasis: a review of the common types of myiasis Kerri Robbins 1 , MD, and Amor Khachemoune 2 , MD, CWS 1 Department of Dermatology, School of Medicine, University of Nevada, Reno, NV, and 2 Department of Dermatology, State University of New York, New York, NY, USA Correspondence Amor Khachemoune, MD Department of Dermatology State University of New York 450 Clarkson Avenue Box 46 Brooklyn NY 11203 USA E-mail: amorkh@pol.net Abstract Myiasis is derived from the Greek word, myia, meaning fly. The term was first introduced by Hope in 1840 and refers to the infestation of live human and vertebrate animals with dipterous (two-winged) larvae (maggots) which, at least for a certain period, feed on the host’s dead or living tissue, liquid body-substance, or ingested food. Myiasis is the fourth most common travel-associated skin disease and cutaneous myiasis is the most frequently encountered clinical form. Cutaneous myiasis can be divided into three main clinical manifestations: furuncular, creeping (migratory), and wound (traumatic) myiasis. The flies that produce a furuncular myiasis include Dermatobia hominis, Cordylobia anthropophaga, Wohlfahrtia vigil, and the Cuterebra species. Gasterophilus and Hypoderma are two flies that produce a creeping myiasis. Flies that cause wound myiasis include screwworm flies such as Cochliomyia hominivorax and Chrysomya bezziana, and Wohlfahrtia magnifica. This article reviews current literature, provides general descriptions, and discusses life cycles of each species. It also gives treatment techniques and descriptions of each type of illness that results from interaction/infestation. Introduction Myiasis is derived from the Greek word, myia, meaning fly. The term was first introduced by Hope in 1940 1 and refers to the infestation of live human and vertebrate ani- mals with dipterous (two-winged) larvae (maggots) which, at least for a certain period, feed on the host’s dead or living tissue, liquid body-substance, or ingested food. 2 The disease is of great importance to veterinary medicine and occurs more commonly, although not exclu- sively, in tropical climates. 3 Travel to and from these regions has led to an increase in the presentation of this disease in nonendemic countries. One study revealed that myiasis is the fourth most common travel-associated skin disease. 4 Myiasis may be classified into two different ways. The first pertains to the location of the affected area such as cutaneous, nasopharyngeal, ocular, intestinal/enteric, and urogenital. The second classification describes the relation- ship between the host and the parasite such as obligatory, facultative, or accidental. 5 Cutaneous myiasis is the most frequently encountered clinical form 3 and can be divided further into three main clinical manifestations: furuncular, creeping (migratory), and wound (traumatic) myiasis. 6 Myiasis-producing flies are members of the superfamily Oestrodiae. 3 Oestrodiae consists of three major families: Oestridae, Calliphoridae, and Sarcophagidae. 3 Subfamilies of Oestridae include Oestrinae, Gasterophiliane, Hypo- dermatinae, and Cuterebridae, with all species of this family being obligate parasites. 3 The families of Calli- phoridae and Sarcophagidae contain both obligate and facultative organisms. 3 Below is a discussion of the main flies that cause cuta- neous myiasis in humans. Furuncular myiasis Dermatobia hominis General description The most common cause of furuncular myiasis in the Americas is caused by D. hominis, a human botfly. 5,7–10 Dermatobia hominis is a member of the Oestridae family. In appearance, it is approximately 1.5 cm in length, yellow-brownish in color, and has a plumose arista (a bristle-like branch off the antennae). 5 It is a devastating pest for many cattle 9,10 and is found most commonly in the regions of Mexico as well as Central and South America. 5,8–10 Many vacationers will acquire this parasite in tropical America and return to the United States before the completion of larval development. 5 Life cycle/human infestation The life cycle consists of the adult flies laying eggs on foliage, or directly depositing eggs on various bloodsucking flies (such as mosquitoes) and attaching 1092 International Journal of Dermatology 2010, 49, 1092–1098 ª 2010 The International Society of Dermatology