Summary
Definition
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
- folliculitis
Risk factors
- recent travel to or residence in an endemic area
- walking barefoot and/or sunbathing on contaminated beach
Diagnostic tests
1st tests to order
- no test required: diagnosis is clinical
Tests to consider
- skin scrapings/biopsy
Emerging tests
- epiluminescence microscopy
Treatment algorithm
nonpregnant adults and children
pregnant
no response to initial treatment or relapse
Contributors
Authors
David J. Diemert, MD, FRCP(C)
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.
Differentials
- Larva currens
- Gnathostomiasis
- Fascioliasis
More Differentials- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer