Cutaneous larva migrans is one of the most common parasitic infestations affecting travelers returning from beach destinations in the Caribbean, Mexico, Brazil, and Southeast Asia.
Characterized by intensely pruritic serpiginous or linear raised erythematous tracks. Lesions occur on unprotected skin (most commonly involving the feet) that has come into contact with sandy, moist soil contaminated by dog or cat feces containing hookworm eggs.
Diagnosis made on clinical grounds.
Although usually self-limited, treatment with oral anthelmintic therapy speeds up resolution of symptoms and is considered curative.
Cutaneous larva migrans (CLM) is a self-limited dermatosis caused by the migration of animal hookworm larvae (most commonly the dog hookworm Ancylostoma caninum and the cat hookworm Ancylostoma braziliense) in the skin. It is characterized by serpiginous or linear raised erythematous tracks that are usually intensely pruritic and occur on unprotected skin (most commonly involving the feet) that has come into contact with sandy, moist soil contaminated by dog or cat feces containing hookworm eggs in areas of the tropics and subtropics.
History and exam
Key diagnostic factors
- recent travel to tropics or subtropics
- barefoot beachgoer/sunbather
- creeping, raised, erythematous track
- intense pruritus
Other diagnostic factors
- vesiculobullous or papular lesions
- recent travel to or residence in an endemic area
- walking barefoot and/or sunbathing on contaminated beach
1st investigations to order
- no test required: diagnosis is clinical
Investigations to consider
- skin scrapings/biopsy
- epiluminescence microscopy
nonpregnant adults and children
no response to initial treatment or relapse
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