The sand flea is normally found in the sandy terrain of warm, dry climates. It prefers deserts, beaches, stables, stock farms, and the soil and dust close to farms.
While both male and female sand fleas intermittently feed on their warm-blooded hosts, it is the pregnant female flea that burrows into the skin of the host and causes the cutaneous lesion. She does not have any specialized burrowing organs; rather, she simply attaches to the skin by her anchoring mouth and claws violently into the epidermis. Since this process is painless, it is thought that the flea may release some keratolytic enzymes. After penetrating the stratum corneum, the flea burrows to the stratum granulosum, leaving her posterior end exposed. The "black dot" of the nodule is this posterior end of the flea sticking out. The opening provides the flea with air and an exit route for feces and eggs. With its head in the dermis, the flea begins to feed on the host's blood and enlarges up to 1cm in diameter. Over the next two weeks, over 100 eggs are released through the exposed opening and fall to the ground. The flea then dies and is slowly sloughed by the host's skin.
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