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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
http://emedicine.medscape.com/article/1108784-clinical
http://www.cdc.gov/parasites/zoonotichookworm/gen_info/faqs.html
https://cid.oxfordjournals.org/content/30/5/811.full