Cutaneous larva migrans

Background

Also known as creeping eruption or sandworm disease^[1]
Caused by movement of hookworm (helminth) larvae through epidermis^[2]
- Ancylostoma caninum and Ancylostoma braziliense are most common pathogens
- Typically occurs due to contact with dog/cat feces in soil/sand
- More common in warm/tropical areas
- History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment^[1]

CLM on thigh of child

CLM on leg of 32y/o M

Pruritis serpiginous eruption^[2]
- Pruritis can be severe and intractable^[1], and can lead to impaired sleep and mood disturbance^[3]
- Usually unilateral, but can be bilateral

Papules

Sub Q Swelling and Nodules

Ulcers

Linear and Migratory Lesions

Self-limited condition - larvae die within 2-8 weeks^[2]
- Goal of treatment is to relieve severe pruritus
Albendazole 400mg PO QD x3-5 days OR Ivermectin 12mg PO x1 OR topical thiabendazole TID x15 days
Mebendazole has poor oral bioavailability and does not work for cutaneous larva migrans^[3]

↑ ^1.0 ^1.1 ^1.2 Vano-Galvan S, Gil-Mosquera M, Truchuelo M, Jaén P. Cutaneous larva migrans: a case report. Cases Journal. 2009;2:112. doi:10.1186/1757-1626-2-112.
↑ ^2.0 ^2.1 ^2.2 Prickett KA, Ferringer TC. What's eating you? Cutaneous larva migrans. Cutis. 2015 Mar;95(3):126-8.
↑ ^3.0 ^3.1 Kincaid L, Klowak M, Klowak S, Boggild AK. Management of imported cutaneous larva migrans: A case series and mini-review. Travel Med Infect Dis. 2015 Jul 29.