A 33-year-old previously healthy man presented to the dermatology clinic with an approximately 2-week history of localized painful swelling in the scalp. Eleven days earlier, he had traveled to Puerto Maldonado, a city located in the heart of the Peruvian jungle. The physical examination revealed a painful 2-cm × 1-cm erythematous edematous plaque over the vertex of his scalp and tender occipital and left retroauricular lymphadenopathy. The scalp over the lesion was shaved and a dermatoscopic examination was performed, revealing a small follicular opening with serous secretion (Fig 1, A). Subtle movement was perceived within the follicle during the dermatoscopic evaluation. Suffocation with ointment led to the spontaneous extraction of a larva (Fig 1, B; video available online at www.jaad.org)...