dermatologic disorders
Cutaneous Larva Migrans
Introduction
Cutaneous larva migrans is the skin manifestation of hookworm infestation. Diagnosis is clinical. Treatment is oral or topical antihelminthic therapy. Cutaneous larva migrans is caused byAncylostomaspecies, most commonly dog or cat hookwormAncylostoma braziliense. Hookworm ova in dog or cat feces develop into infective larvae when left in warm moist ground or sand. Transmission occurs when skin directly contacts contaminated soil or sand and larvae penetrate unprotected skin, usually of the feet, legs, buttocks, or back. Cutaneous larva migrans occurs worldwide but most commonly in tropical environments. Emergence of this condition in previously naive countries is thought to be due to climate change ( General references ). This photo shows a rash on a foot caused by the burrowing larvae of animal hookworms. The movement of the larvae beneath the skin causes distinct patterns of red wheals accompanied by intense pruritus. © Springer Science+Business Media This photo shows a a superficial raised serpiginous tract on the dorsal aspect of the foot. Image courtesy of Karen McKoy, MD. Cutaneous larva migrans causes intense pruritus. Signs are erythema and papules at the site of entry, followed by a winding, threadlike subcutaneous trail of reddish brown inflammation. Patients may also develop papules and vesicles resembling Folliculitis , called hookworm folliculitis. Cutaneous larva migrans may be complicated by a self-limiting pulmonary reaction called Löffler Syndrome (patchy pulmonary infiltrates and peripheral blood eosinophilia) ( Diagnosis of cutaneous larva migrans is by history and clinical appearance. 