Cutaneous larva migrans is a parasitic skin infection caused by hookworm larvae that usually infest cats, dogs and other animals. A case of cutaneous larva migrans acquired from soiled. Cutaneous larva migrans definition cutaneous larvae migrans is a parasitic skin disease caused by a hookworm larvae that usually infests dogs, cats, and other animals. Cutaneous larva migrans usually heals spontaneously within weeks or months. Cutaneous larva migrans is caused by ancylostoma, a hookworm that normally inhabits the intestines of dogs and cats. However, treatment may help control symptoms and help prevent secondary bacterial infections. We describe the case of a mediterranean 32yearold man, recently returned from a trip to a brazilian beach, which presented with a 2week. Introduction larva migrans denotes the prolonged migration of a larvalparasite in the skinor intestinal organs of. When animals defecate on soil or sand the hookworm eggs pass out with the faeces onto. Hookworm ova in dog or cat feces develop into infective larvae when left in warm moist ground or sand. Cutaneous larva migrans clm is a clinical syndrome consisting of an erythematous migrating linear or serpiginous cutaneous track. Occurs in most warm humid tropical and subtropical areas eg eg south usa along the coasts. Larvae cannot complete their normal development into adults.
Cutaneous larva migrans definition of cutaneous larva. Diagnosis of cutaneous larva migrans is currently based on the clinical signs of the creeping eruption. This syndrome is due to subcutaneous larval migration of various animal nematodes such as hookworms hookwormrelated cutaneous larva migrans, gnathostoma spp. It is caused by skin penetration of parasitic larvae due to direct skin contact with contaminated soil.
These parasites live in the intestines of dogs, cats, and wild animals and should not be confused with other members of the hookworm family for which humans are definitive hosts, namely ancylostoma duodenale and necator americanus. Cutaneous larva migrans is a hookworm infection transmitted from warm, moist soil or sand to exposed skin. The skin lesions of cutaneous larva migrans clm commonly manifests as single, linear, irregular, serpiginous raised erythematous track, but. Cutaneous larva migrans occurs worldwide but is most common in tropical environments. People who are exposed to soil and sand are most likely to be infected. Cutaneous larva migrans north dakota department of health. Cutaneous larva migrans skin disorders merck manuals. Cutaneous larva migrans manifests as an erythematous, serpiginous, pruritic, cutaneous eruption caused by accidental percutaneous penetration and subsequent migration of larvae of various nematode parasites. With the strong clinical suspect of cutaneous larva. Feb 26, 2019 cutaneous larva migrans is caused by the epidermal migration of the filariform larvae of various hookworm and occasionally, dog tapeworm, species. However, because more and more people travel in different areas on the globe, the infection is no longer confined to these areas. The duration of hookwormrelated cutaneous larva migrans ranged from 5 to 14 months mean 7. Humans normally become infected with the hookworm larvae by walking barefoot on a beach, or by contact with soil that is contaminated with animal faeces. Cutaneous larva migrans clm is a dermatologic condition known as creeping eruption, and is caused by the migration of animal nematode larvae, most commonly the larvae of the dog and cat hookworm ancylostoma braziliense.
Cutaneous larva migrans article about cutaneous larva. Hookwormrelated cutaneous larva migrans hrclm is an infestation caused by penetration and migration in the epidermis of the larvae of nematodes. The cdc defines clm as a parasitic skin disease caused by a hookworm larvae that usually infects. Case studies in international travelers american family. It is an antiparasitic agent, effective against a variety of end parasites and ectoparasites and is considered in treatment of patients with different forms of scabies, head lice, demodicidosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis. Because cutaneous larva migrans is acquired by direct contact between skin and contaminated. Zoonotic hookworm infections usually result in a skin condition called cutaneous larva migrans, or clm.
Clinically, cutaneous larva migrans clm or creeping eruption, is a raised, erythematous, linear or serpiginous skin eruption, which is often accompanied by intense pruritus. It is caused by hookworm larvae, which are in the feces of infected dogs. The zoonotic hookworm larvae that cause cutaneous larva migrans clm usually do not survive more than 5 6 weeks in the human host. Hookworm ova in dog or cat feces develop into infective larvae when left in warm moist ground or. Cutaneous larva migrans is a syndrome defined clinically and parasitologically by subcutaneous migration of a nonhuman nematodes larva making the infected human a deadend host. Contact with soil which is the contaminated larva of hookworm. Cutaneous larva migrans is caused by the epidermal migration of the filariform larvae of various hookworm and occasionally, dog tapeworm, species. Larva migrans migration of larvae of nematodes in unsuitable hosts. Cutaneous larva migrans is a parasitic skin disease cased by the larvae of various nematode parasites hookworm, which can be found in the feces of dogs and cats.
Efficacy of albendazole ointment on cutaneous larva migrans in 2 young children. The most common cause of cutaneous larva migrans is the ancylostoma. Nov 11, 2014 cutaneous larva migrans is a roundworm usually hookworm infection. Mainly, clm is caused by the larval nematodes, which penetrate into the skin. Cutaneous larva migrans clm is the skin manifestation of hookworm infestation. Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that has been contaminated with animal faeces. The clinical presentation, sero logicalfindings and response to treatment are described. Find highquality cutaneous larva migrans stock photos and editorial news pictures from getty images. Disseminated cutaneous larva migrans in a 7yearold patient larva. Pdf cutaneous larva migrans may be diagnosed by the typical clinical. Cutaneous larva migrans associated with lofflers syndrome in a 6yearold boy. Cutaneous larva migrans clm is a skin condition thats caused by several species of parasite.
It most frequently occurs as a result of human infection with the larvae of the dog or cat hookworms. Cutaneous larva migrans is a type of dermatitis that occurs in people who have traveled to tropical and subtropical geographical areas. In particular, clm is more commonly seen in those who have contact with soil contaminated by cat and dogs hookworm larvae. Cutaneous larva migrans american osteopathic college of. Chronic hookwormrelated cutaneous larva migrans core. Cutaneous larva migrans, also known as creeping eruption or larva migrans, is a term used to describe twisting linear skin lesions caused by the burrowing of larvae. Clm is caused by ancylostoma sp, most commonly dog or cat hookworm ancylostoma braziliense. A case of cutaneous larva migrans acquired from soiled toilet. You may also see it referred to as creeping eruption or larva migrans. The child had played on beaches that were frequented by local dogs. Cutaneous larva migrans due to dog hookworm is also common, leading to a selflimiting dermatosis, usually on the buttocks or lower legs. Cutaneous larva migrans in an unusual site sk malhotra, rakesh t raj, manjeet pal, vippan goyal, shweta sethi dermatology online journal 12 2. Cutaneous larva migrans clm is the most common tropically acquired dermatosis whose earliest description dates back more than 100 years. Cutaneous larva migrans is one of the most common skin diseases reported in travelers returning from.
Symptomatic treatment for frequent severe itching may be helpful. The lesions in his right elbow presented impetiginization. Clinically, cutaneous larva migrans is characterized by an intensely pruritic erythematous migrating tortuous or serpiginous, slightly raised track. Hunters tropical medicine and emerging infectious diseases tenth edition, 2020. The parasites are only capable of penetrating the outer layer of skin, and can only create typical wormlike burrows visible underneath the. Cutaneous cutaneous larva migrans migrans creeping eruption is a cutaneous cutaneous eruption resulting from exposure of the skin to infective filariform filariform larvae of nonhuman hookworms and strongyloides. Cutaneous larva migrans is common in tropical and subtropical areas, particularly areas with sandy soil. Treatment of cutaneous larva migrans clinical infectious. In a series of 25 patients treated with a placebo, 12% healed by the end of the first week and 36% by the end of the fourth week.
Cutaneous larva migrans clm is the most com mon tropically acquired dermatosis. Key words cutaneous larvamigrans, serological findings, creeping eruptions. This entity is also known by various other names such as creeping eruption, sand worm, plumbers itch, duck hunters itch and epidermatitis linearis migrans. Chronic hookwormrelated cutaneous larva migrans international. Cutaneous larva migrans is parasitic infestation caused by animal hookworm larva which attacks the epidermis. In most patients with clm, the signs and symptoms resolve without medical treatment. Humans can pick up the infection by walking barefoot on soil or beaches contaminated with animal feces. Media in category cutaneous larva migrans the following 7 files are in this category, out of 7 total. Various organisms causing clm and their definitive hosts are summarized in table 1.
When people walk or sit on beach sand or soil where infected dogs or cats have defecated, the dog or cat hookworm larva can penetrate the skin of the foot or body and migrate in the top layers of the skin. Cutaneous larva migrans is endemic in tropical and subtropical regions. Cutaneous larva migrans abbreviated clm is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family ancylostomatidae. However, the first author is not aware of reports involving cutaneous larva migrans acquired from urban housing or from toilet floors. The physician recognized the serpiginous pattern of cutaneous larva migrans clm and successfully treated the child with oral ivermectin. An unusual presentation of cutaneous larva migrans. It is most commonly caused by the hookworm that infects dogs and cats. Oct 24, 2014 zoonotic hookworm infections usually result in a skin condition called cutaneous larva migrans, or clm.
We present a case of clm in a 31yearold pregnant woman. Cutaneous larva migrans clm is a skin disease caused by penetration of the skin by canine or feline ancylostoma larvae. Occurs in most warm humid tropical and subtropical areas eg. When bare skin touches the ground, for example, when a person walks barefoot or sunbathes, the hookworm gets into. The creeping verminous dermatitis or cutaneous larva migrans is a parasitosis. Clm is caused by hookworm larvae that usually infect cats, dogs and other animals. Cutaneous larva migrans university college hospital. The feet, hands, buttocks, and genitalia are most commonly affected. A case report of cutaneous larva migrans in a mexican population of. The skin presents an eruption that is accompanied by redness and intense pruritus. Cutaneous larva migrans an overview sciencedirect topics. Sep 10, 2018 cutaneous larva migrans clm is the most common tropically acquired dermatosis whose earliest description dates back more than 100 years. Cutaneous larva migrans can be caused by different parasites. Three probable cases of cutaneous larva migrans are presented.
Oct 11, 2012 the zoonotic hookworm larvae that cause cutaneous larva migrans clm usually do not survive more than 5 6 weeks in the human host. Feb 26, 2019 cutaneous larva migrans is a skin condition in which the larvae of some hookworm species migrate within the skin to produce an intensely pruritic, serpiginous or linear rash. He had no previous history of contact with sand or animals. The eggs of the parasite are in dog and cat feces and develop into larvae when left in warm, moist soil or sand. The most common type of hookworm that causes clm is called ancylostoma braziliense which usually infects dogs. Cutaneous larva migrans is a parasitic skin eruption caused by migration of larvae of various nematodes. Cutaneous larva migrans chapter 4 2020 yellow book.
Even though cutaneous larva migrans clm is selflimited, the intense pruritus and risk for infection mandate treatment. Cutaneous larva migrans clm is a helminthic infection most commonly found in tropical and subtropical geographic areas. Cutaneous larva migransreport of three probable cases. Cutaneous larva migrans pictures, symptoms, diagnosis.
Cutaneous larva migrans is caused by the migration of hookworm larvae in human skin. Today, it is one of the most common helminth hookworm infections acquired from subtropical and tropical regions of the world. Cutaneous larva migrans clm is a dermatitis caused by the invasion and migration of larva of parasites in the skin. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Cutaneous larva migrans kaliaperumal karthikeyan, devinder. Cutaneous larva migrans, or clm, is a parasitic skin infection.
Cutaneous larva migrans is caused by penetration and migration within the epidermis of nematode parasites. The diagnosis is mainly clinical, based on the history of travel to an endemic area and exposure to contaminated soilsand. Western physicians, however, are often not familiar of this condition. Cutaneous larva migransis a widespread and wellrecognized disease in the tropics and is considered the most common dermatological problem affecting westerners after. Description cutaneous larvae migrans also called creeping eruption or ground. Cutaneous larva migrans stock pictures, royaltyfree. Cutaneous larva migrans is a skin condition in which the larvae of some hookworm species migrate within the skin to produce an intensely pruritic, serpiginous or. Cutaneous larva migrans dermatologic disorders merck. Starting from the site of infectionusually the feet, legs, buttocks, or backthe hookworm burrows along a haphazard tract, leaving a winding, threadlike, raised, reddish brown rash. Indeed, we have ventured to emphasize the clinical distinctiveness of this type of larva migrans by giving it a separate name, larva currens. Cutaneous tuberculosis is relatively common, because tuberculosis is still a major problem there. Cutaneous larva migrans is a common tropicallyacquired cutaneous eruption. However, with the ease and increase of foreign travel by many around the world, clm is no longer confined to these areas. Download premium images you cant get anywhere else.
Ivermectin is effective but not approved for this indication. Cutaneous larva migrans dermatologic disorders msd manual. Cutaneous larva migrans clm is a pruritic dermatitis caused by migration of the animal hookworm larvae into the epidermis. Cutaneous larva migrans dermatologic disorders msd. Cutaneous larva migrans clm is a hookworm infection, which manifests as cutaneous eruption. Cutaneous larva migrans is a clinical diagnosis and skin biopsy usually is not obtained because the larvae often are located 1 to 2 cm beyond the visible erythematous border.
Signs of visceral larva migrans will vary depending on the organ infested. Cutaneous larva migrans is one of the most common skin diseases reported in travelers returning from tropical regions. One other disease deserves mention lichen amyloidosis. Cutaneous larva migrans clm was first described as the creeping eruption and diagnosed by a physician in 1874.
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