Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 16 2021

Cutaneous Larva Migrans

  • 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
      • most commonly Ancylostoma braziliense (hookworm of dogs and cats)
      • others: Necator, Strongyloides
    • Larvae must penetrate skin
      • can migrate under skin
      • creeping eruption
      • transmitted via animal feces
    • History is important here
      • in tropical or subtropical regions
      • typically 3 weeks after beach vacation involving sand
      • children who play in sandboxes can be affected
      • carpenters and plumbers who work under houses can be affected
  • Presentation
    • Symptoms
      • very itchy
      • migrates 2 cm daily
    • Skin exam
      • erythematous, elevated, serpiginous red-to-purple lesions
      • commonly on feet and ankles
      • can also affect buttocks, genitals, hands
    • Non-skin findings
      • Loeffler syndrome
        • eosinophils accumulate in lungs in response to parasitic infection
  • Evaluation
    • Diagnosis by clinical history and exam
      • skin biopsy typically not needed
    • Laboratory values
      • eosinophilia
      • increased IgE levels
    • Radiograph of chest if Loeffler syndrome is suspected
      • patchy infiltrates
  • Differential Diagnosis
    • Allergic contact dermatitis
    • Atopic dermatitis
    • Scabies
  • Treatment
    • Medical treatment
      • thiabendazole (topical) – first-line treatment
      • albendazole (oral)
      • ivermectin (oral)
  • Prevention, and Complications
    • Prevention
      • avoid direct skin contact with fecally contaminated soil or sand
    • Complications
      • secondary infection causing cellulitis
      • eczematous inflammation
      • allergic reaction
      • Loeffler syndrome (rare)
  • Prognosis
    • If untreated, larvae die on own in 2 - 8 weeks
    • If treated, resolution occurs 2 - 3 days after therapy begins
1 of 0
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options