Cutaneous larva migrans

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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
    • History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment[1]
CLM on thigh of child
CLM on leg of 32y/o M

Clinical Features

  • Pruritis serpiginous eruption[2]
    • Pruritis can be severe and intractable[1], and can lead to impaired sleep and mood disturbance[3]
    • Usually unilateral, but can be bilateral
    • Linear, moving lesions

Differential Diagnosis

Travel Related Skin Conditions

Papules

Sub Q Swelling and Nodules

Ulcers

Linear and Migratory Lesions

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
  • Albendazole 400mg PO QD x3-5 days OR Ivermectin 12mg PO x1 OR topical thiabendazole TID x15 days
  • Mebendazole has poor oral bioavailability and does not work for cutaneous larva migrans[3]

Disposition

  • Discharge

See Also

References

  1. 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. 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. 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.

Authors

Michael Holtz