Ectoparasitoses (infestations with parasites that live on or in the skin) are usually considered as vexing disorders and do not attract much clinical attention. But depending on the socioeconomic setting, these infections can carry substantial morbidity and affect much of a population. Ectoparasitic infestations can be sporadic, endemic, or epidemic.

Hookworm-related cutaneous larva migrans is caused by the migration of animal hookworm larvae in the human skin. The disease mainly occurs in resource-poor communities in the developing world, but it is also reported sporadically in high-income countries and in tourists who have visited the tropics.

Epidermal parasitic skin diseases (EPSD) are a heterogeneous category of infectious diseases in which parasite–host interactions are confined to the upper layer of the skin. The six major EPSD are scabies, pediculosis (capitis, corporis and pubis), tungiasis and hookworm-related cutaneous larva migrans.

Human scabies is a parasitic skin disease that affectspeople worldwide. To improve public-health decisionmaking, measurement of the global burden ofscabies is key. In this issue of The Lancet InfectiousDiseases, Chante Karimkhani and colleagues1 reporta cross-sectional analysis of the Global Burden ofDisease (GBD) 2015 big data to show a robust estimateof the extent and impact of this ubiquitous mite on human health.

Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015.

Tungiasis (sand flea disease) is a parasitic skin disease with origins in South America. It was introduced into sub- Saharan Africa in the 19th century [1– 3]. Sand flea disease is a zoonosis caused by the penetration of female sand fleas into the skin. In humans, tungiasis predominantly affects marginalized populations. Children and elderly people are especially susceptible to severe disease.