Diagnosis: Cutaneous larva migrans
Cutaneous larva migrans is also known as creeping eruption or sandworm disease. The disease is caused by movement of hook worm (helminth) larvae through epidermis layer of the skin. This typically is the result of contact with dog or cat stool/feces in soil. CLM is more common in warm and tropical regions. Typical patient history [ ]
Cutaneous larva migrans is also known as creeping eruption or sandworm disease. The disease is caused by movement of hook worm (helminth) larvae through epidermis layer of the skin. This typically is the result of contact with dog or cat stool/feces in soil. CLM is more common in warm and tropical regions. Typical patient history involves sunbathing, walking on soil, walking on beach or travel in a tropical environment.
Patient returning from tropical beach vacation with intensely pruritic, serpiginous track on feet or buttocks. History of walking barefoot on sandy beaches.
Ivermectin 200 mcg/kg single dose (treatment of choice). Albendazole 400 mg daily for 3 days. Topical thiabendazole for limited disease. Symptom relief: antihistamines, topical corticosteroids.
• Larva currens (Strongyloides) • Tinea corporis • Contact dermatitis • Scabies • Phytophotodermatitis • Erythema chronicum migrans
• Caused by hookworm larvae (Ancylostoma braziliense most commonly) that cannot complete life cycle in humans • Classic presentation: serpiginous, erythematous, pruritic track that advances 1-2 cm/day • Most commonly seen on feet, buttocks, and hands — areas in contact with contaminated soil/sand • Self-limited (larvae die within weeks-months) but treatment shortens course • Travel history to tropical/subtropical regions important • Hookworm-related cutaneous larva migrans is different from visceral larva migrans
Tags: CLM, cutaneous larva migrans, dermatologist, dermatology, kodachromes