Snapshot A 40-year-old man is alarmed by a snake-shaped lesion on his feet. The lesion migrates around 2 cm every day and his feet are extremely itchy. Three weeks ago, he returned from a beach vacation in the Caribbean, where he walked around barefoot in the sand. Introduction Cutaneous migratory infection caused by hookworm larvae login to view 2 more bullets Larvae must penetrate skin login to view 3 more bullets History is important here login to view 4 more bullets Presentation Symptoms login to view 2 more bullets Skin exam login to view 3 more bullets Non-skin findings login to view 2 more bullets Evaluation Diagnosis by clinical history and exam login to view 1 more bullet Laboratory values login to view 2 more bullets Radiograph of chest if Loeffler syndrome is suspected login to view 1 more bullet Differential Diagnosis Allergic contact dermatitis Atopic dermatitis Scabies Treatment Medical treatment login to view 3 more bullets Prevention, and Complications Prevention login to view 1 more bullet Complications login to view 4 more bullets Prognosis If untreated, larvae die on own in 2 - 8 weeks If treated, resolution occurs 2 - 3 days after therapy begins