What’s Eating You? Cutaneous Larva Migrans
Cutis. 2015 March;95(3):126-128
March 9, 2015|Cutis
Author and Disclosure Information
This article provides a focused update and clinical review on cutaneous larva migrans (CLM), including atypical clinical presentations and newer management recommendations. The results and recommendations are subject to modification based on future studies.
Practice Points
- Classic cutaneous larva migrans (CLM) presents with a unilateral, serpiginous, pruritic eruption on the hands, feet, or buttocks following direct contact with sand or soil that is contaminated with Ancylostoma braziliense or Ancylostoma caninum.
- Atypical presentations of CLM include bilateral distribution; folliculitis and urticarial plaques; prolonged cases lasting up to 1 year; and Löffler syndrome characterized by migratory pulmonary infiltrates and peripheral eosinophilia.
- Cutaneous larva migrans is self-limited, but treatment often is necessary due to intense pruritus. Treatment options include a single oral dose of albendazole or ivermectin, topical thiabendazole, and prolonged courses of oral albendazole in cases complicated by Löffler syndrome.
Conclusion
Cutaneous larva migrans is a self-limited and pruritic skin eruption that is acquired after direct inoculation with sand or soil that is contaminated with feces containing A braziliense or A caninum. Although the classic presentation is readily identifiable, there are a variety of atypical presentations that may go undiagnosed. Symptomatic relief usually can be achieved with short courses of oral or topical antihelminth medications.
