The diagnosis of cutaneous paragonimiasis after the external migration of the parasite from a punch biopsy site

Fig 1. Erythema and edematous plaque of the right labia majora, measuring 4 cm 3 6 cm. INTRODUCTION Paragonimiasis, caused by the lung fluke of the genus Paragonimus, affects an estimated 22 million people yearly worldwide. Humans acquire these parasites mostly by ingestion of raw or poorly cooked freshwater crustaceans (second intermediate hosts), or by eating raw meat from wild animals. Paragonimiasis is closely associatedwith some special eating habits or incomplete sanitary systems in developing countries. Cutaneous features are reported rarely and may occur without pleuropulmonary involvement. Certain microenvironmental stressors of the host are likely the main triggers that lead to the migration of parasites. Here we report a case in which a migratory parasite was found to exit from the patient’s body. This was most likely triggered by regional anesthesia or a surgical procedure.