Cutaneous larva migrans
(Redirected from Cutaneous larvae migrans)
Background
- Also known as creeping eruption or sandworm disease[1]
- Caused by movement of hookworm (helminth) larvae through epidermis[2]
- Ancylostoma caninum and Ancylostoma braziliense are most common pathogens
- Typically occurs due to contact with dog/cat feces in soil/sand
- More common in warm/tropical areas, particularly during rainy season
- History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment[1]
Clinical Features
Complications
- Loeffler's Syndrome[5]
- Respiratory symptoms, pulmonary infiltrates, and peripheral eosinophilia.
- Believed by some to be a systemic immune reaction to the parasite but exact pathogenesis unknown.
- Treatment: treating parasitic infection leads to resolution of the pulmonary symptoms.
Differential Diagnosis
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Evaluation
- Clinical diagnosis, based on history and physical exam
Management
- Self-limited condition - larvae die within 2-8 weeks[2]
- Goal of treatment is to relieve severe pruritus
- First Line: ivermectin 200ug/kg, single dose. [6]
- Alternatives: Albendazole 400mg orally for 5 to 7days OR Topical tiabendazole 10-15% TID for 5 to 7days
- Mebendazole has poor oral bioavailability and does not work for cutaneous larva migrans[3]
Disposition
- Discharge
See Also
References
- ↑ 1.0 1.1 1.2 Vano-Galvan S, Gil-Mosquera M, Truchuelo M, Jaén P. Cutaneous larva migrans: a case report. Cases Journal. 2009;2:112. doi:10.1186/1757-1626-2-112.
- ↑ 2.0 2.1 2.2 Prickett KA, Ferringer TC. What's eating you? Cutaneous larva migrans. Cutis. 2015 Mar;95(3):126-8.
- ↑ 3.0 3.1 Kincaid L, Klowak M, Klowak S, Boggild AK. Management of imported cutaneous larva migrans: A case series and mini-review. Travel Med Infect Dis. 2015 Jul 29.
- ↑ Pascual J, Laoteppitaks C. Unique Rash after Beach Vacation. Journal of Emergency Medicine. 2017 June;52(6):878-879. Epub 2017 April 8
- ↑ Pascual J, Laoteppitaks C. Unique Rash after Beach Vacation. Journal of Emergency Medicine. 2017 June;52(6):878-879. Epub 2017 April 8
- ↑ Feldmeier H, Schuster A. Mini-review: Hookwarm-related cutaneous larva migrans. Eur J Clin Microbiol Infect Dis (2012) 31:915-918