UMEM Educational Pearls

Category: Infectious Disease

Title: Cutaneous Larva Migrans- What is it?

Keywords: Rash, Cutaneous larva migrans, nematode, tropics (PubMed Search)

Posted: 3/16/2016 by Jon Mark Hirshon, MD, MPH
Click here to contact Jon Mark Hirshon, MD, MPH

Cutaneous larva migrans (CLM) is an acquired dermatosis

  • Seen in patients returning from the tropics
    • Often seen in patient with a history of sunbathing or in barefoot beachgoers
  • Caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae), with Ancylostoma braziliense the most frequently found in humans.

 

Clinical manifestations:

  • Linear, serpentine erythematous lesions
  • Intense pruritus
  • Will often heal spontaneously over weeks or months without treatment

 

Treatment:

  • Thiabendazole (applied topically)
    • Oral alternatives include other anti-parasitic medications such as albendazole, ivermectin
    • Oral thiabendazole as a single dose can be used, but is less effective than albendazole or ivermectin
  • Consider antibiotics if there is secondary bacterial infections
  • Freezing the leading edge has been previously used, but is considered ineffective and painful.

 

Bottom Line:

  • Consider CLM the next time a patient complains of a linear, erythematous itchy rash after returning from their all-inclusive stay in a Caribbean resort

References


Attachments

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