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Cutaneous larva migrans

Last reviewed: 17 Apr 2025
Last updated: 31 Aug 2023

Summary

Definition

History and exam

Key diagnostic factors

  • recent travel to tropics or subtropics
  • barefoot beachgoer/sunbather
  • creeping, raised, erythematous track
  • intense pruritus
Full details

Other diagnostic factors

  • vesiculobullous or papular lesions
  • folliculitis
Full details

Risk factors

  • recent travel to or residence in an endemic area
  • walking barefoot and/or sunbathing on contaminated beach
Full details

Diagnostic tests

1st tests to order

  • no test required: diagnosis is clinical
Full details

Tests to consider

  • skin scrapings/biopsy
Full details

Emerging tests

  • epiluminescence microscopy

Treatment algorithm

ACUTE

nonpregnant adults and children

pregnant

ONGOING

no response to initial treatment or relapse

Contributors

Authors

David J. Diemert, MD, FRCP(C)
David J. Diemert

Professor

Departments of Medicine and Microbiology, Immunology and Tropical Medicine

The George Washington University School of Medicine and Health Sciences

Washington

DC

Disclosures

DJD declares that he has no competing interests.

Peer reviewers

Eric Caumes, MD

Professor of Infectious and Tropical Diseases

Universite Pierre et Marie Curie

Vice Chairman

Department of Infectious and Tropical Diseases

Hopital Pitie-Salpetriere

Paris

France

Disclosures

EC is an author of a number of references cited in this topic.

Jorg Heukelbach, MD, PhD

Professor

Department of Community Health

School of Medicine

Federal University of Ceara

Ceara

Brazil

Disclosures

JH is an author of a number of references cited in this topic.

Jill Weatherhead, MD, PhD, CTropMed

Assistant Professor of Pediatric Tropical Medicine

Baylor College of Medicine

Houston

TX

Disclosures

JW declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Feldmeier H, Schuster A. Mini review: hookworm-related cutaneous larva migrans. Eur J Clin Microbiol Infect Dis. 2012 Jun;31(6):915-8. Abstract

Tremblay A, MacLean JD, Gyorkos T, et al. Outbreak of cutaneous larva migrans in a group of travellers. Trop Med Int Health. 2000 May;5(5):330-34.Full text  Abstract

Davies HD, Sakuls P, Keystone JS. Creeping eruption. A review of clinical presentation and management of 60 cases presenting to a tropical disease unit. Arch Dermatol. 1993 May;129(5):588-91. Abstract

Reichert F, Pilger D, Schuster A, et al. Epidemiology and morbidity of hookworm-related cutaneous larva migrans (HrCLM): Results of a cohort study over a period of six months in a resource-poor community in Manaus, Brazil. PLoS Negl Trop Dis. 2018 Jul 19;12(7):e0006662.Full text  Abstract

Heukelbach J, Feldmeier H. Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans. Lancet Infect Dis. 2008 May;8(5):302-9. Abstract

Blackwell V, Vega-Lopez F. Cutaneous larva migrans: clinical features and management of 44 cases presenting in the returning traveller. Br J Dermatol. 2001 Sep;145(3):434-7. Abstract

Caumes E, Carrière J, Datry A, et al. A randomized trial of ivermectin versus albendazole for the treatment of cutaneous larva migrans. Am J Trop Med Hyg. 1993 Nov;49(5):641-4. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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