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images in clinical medicine

Cutaneous Larva Migrans

A B

Chia Chun Ang, M.D.

Changi General Hospital Singapore angchiachun@gmail.com

42-year-old man presented with a 1-week history of intensely pruritic eruption on the dorsum of his right foot. He had gone for a barefoot RETAKE 1st Ang AUTHOR ICM stroll on the beach a few days before the onset of the rash. The lesion pro2nd REG F FIGURE fig1 a_b gressed daily, despite the application of antibacterial lotion to the eruption. The 3rd CASE TITLE Revised physical serpiginous, erythematous raised tracts with bulla EMail examination revealed Line 4-C SIZE Enon formation, findings clinically diagnostic of cutaneous larva migrans ARTIST: mleahy that H/T are H/T FILL Combo (Panel A). Cutaneous larva migrans is 39p6 caused by the migration of hookworm larvae AUTHOR, PLEASE NOTE: in human skin. It is most commonly caused by the hookworm that infects dogs and Figure has been redrawn and type has been reset. cats. The parasites eggs are passed from animal feces into warm, moist soil or sand, Please check carefully. where the larvae hatch. Transmission occurs when skin comes in direct contact 36204 ISSUE: 1-28-10 withJOB: contaminated soil or sand. In humans, the larvae are unable to penetrate the basement membrane to invade the dermis, so disease remains limited to the epidermis. Cutaneous larva migrans is self-limited, though effective anthelmintic treatment (with thiabendazole, albendazole, mebendazole, or ivermectin) can diminish symptoms and shorten the duration of disease. Proper footwear is the key to preventing this condition. Two weeks after a course of albendazole, the patients lesions showed signs of healing, with areas of desquamation and hyperpigmentation (Panel B).
Copyright 2010 Massachusetts Medical Society.

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n engl j med 362;4 nejm.org january 28, 2010

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