Cutaneous larva migrans

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Cutaneous larva migrans
Classification and external resources
Larva Migrans Cutanea.jpg
Typical "creeping eruption" associated with cutaneous larva migrans
ICD-10B76.9
ICD-9126.9
DiseasesDB3263
MedlinePlus001454
eMedicinederm/91 ped/1278
MeSHD007815
 
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Cutaneous larva migrans
Classification and external resources
Larva Migrans Cutanea.jpg
Typical "creeping eruption" associated with cutaneous larva migrans
ICD-10B76.9
ICD-9126.9
DiseasesDB3263
MedlinePlus001454
eMedicinederm/91 ped/1278
MeSHD007815

Cutaneous larva migrans (abbreviated CLM) is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). The most common species causing this disease in the Americas is Ancylostoma braziliense. 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.

Colloquially called creeping eruption[1][2] due to its presentation, the disease is also somewhat ambiguously known as "ground itch" or (in some parts of the Southern USA) "sandworms", as the larvae like to live in sandy soil. Another vernacular name is plumber's itch. The medical term CLM literally means "wandering larvae in the skin".

Cause[edit]

Hookworm eggs are shed in infected dog (or other animal) feces to the ground, where they then develop over a period of 1–2 weeks into the infectious larval form (filariform larvae).[3] The filariform larvae can burrow through intact skin that comes into contact with soil or sand that is contaminated with feces. Although they are able to infect the deeper tissues of animals (through to the lungs and then the intestinal tract), humans are incidental hosts and the larvae are only able to penetrate the upper dermis of the skin[1] and thus create the typical wormlike burrows visible underneath the skin. These parasites apparently lack the collagenase enzymes required to penetrate through the basement membrane deeper into the skin.

Symptoms[edit]

The infection causes a red, intensely pruritic (itchy) eruption. The itching can become very painful and if scratched may allow a secondary bacterial infection to develop. Cutaneous larva migrans usually heals spontaneously over weeks to months and has been known to last as long as one year.[4] However, the severity of the symptoms usually causes those infected to seek medical treatment before spontaneous resolution occurs. Following proper treatment, migration of the larvae within the skin is halted and relief of the associated itching can occur in less than 48 hours (reported for thiabendazole).[1]

This is separate from the similar cutaneous larva currens which is caused by strongyloides. Larva currens is also a cause of migratory pruritic eruptions but is marked by 1) incredible speed on the order of inches per hour 2) perianal involvement due to autoinfection from stool and 3) a wide band of urticaria.[5]

Treatment and Prevention[edit]

CLM can be treated in a number of different ways:

See also[edit]

Additional images[edit]

External links[edit]

References[edit]

  1. ^ a b c d e f g h i j Caumes, E. (1 May 2000). "Treatment of Cutaneous Larva Migrans". Clinical Infectious Diseases 30 (5): 811–814. doi:10.1086/313787. 
  2. ^ a b c Albanese, G; Caterina Venturi, and Giuseppe Galbiati (2001). "Treatment of larva migrans cutanea (creeping eruption): a comparison between albendazole and traditional therapy". International Journal of Dermatology 40: 67–71. 
  3. ^ a b CDC. "Parasites". Retrieved 25 April 2013. 
  4. ^ Chaudhry, AZ; Lonworth DL (1989). "Cutaneous manifestations of intestinal helminthic infections.". Dermatol Clin 7: 275–90. 
  5. ^ ARTHUR, ROBERT P. (1 August 1958). "Larva Currens". A.M.A. Archives of Dermatology 78 (2): 186–90. doi:10.1001/archderm.1958.01560080044007. PMID 13558704. 
  6. ^ Drugs.com. "Albenza". Drugs.com. Retrieved 25 April 2013. 
  7. ^ Drugs.com. "Stromectol". Drugs.com. Retrieved 25 April 2013. 
  8. ^ Drugs.com. "Mintezol". Drugs.com. Retrieved 25 April 2013.