Dermatology - Cutanose Larvae Migrans

Dermatology - Cutanose Larvae Migrans
The cutaneous infestation caused by hookworm larvae that pierce human skin is known as cutaneous larva migrans. Humans are abnormal, hopeless hosts that pick up the parasite from animal excrement-contaminated environments. Human skin is penetrated by larvae, which can move up to several millimeters every day.

Serpiginous lesions are thin, linear, elevated, tunnel-like lesions that are 2-3 mm broad, contain serous fluid, and can be one or more, depending on how many larvae are piercing them. Larvae are restricted to an area several centimeters in diameter, and they travel a few to many millimeters per day. Most frequently, the feet, lower legs, and buttocks get infested. A unique type of larva migrans known as larva currens (cutaneous strongyloidiasis) is characterized by severe pruritus, papulovesicles, urticaria, and papules at the site of larval penetration.

Clinical diagnosis is made. The differential diagnosis consists of phytoallergic contact dermatitis, migratory lesions from other parasites, stings from jellyfish, and epidermal dermatophytosis.

Avoid attempting to remove the parasite as it has already moved further down the skin by the time the lesion becomes noticeable. Albendazole, ivermectin, and thiabendazole are examples of topical agents. Oral thiabendazole (50 mg/kg per day in two doses for 2-4 days), oral ivermectin (6 mg twice day), or oral albendazole (400 mg/day for 3 days) are examples of systemic medications.