November 8, 2014
Notes: Kisacik, Bunyamin
Onat, Ahmet Mesut
Rheumatol Int. 2013 Feb;33(2):315-8. doi: 10.1007/s00296-012-2413-5. Epub 2012 Mar 24.
Author Address: Department of Internal Medicine Division of Rheumatology, Gaziantep University Faculty of Medicine, 27100 Sahinbey, Gaziantep, Turkey. email@example.com
Reference Type: Journal Article
Record Number: 4274Author: Kitchen, M., Wilhelm, M., Moser-Oberthaler, S., Hopfl, R., Ratzinger, G., Nguyen, V. A. and Schmuth, M.
Title: [Pitfalls in diagnosis and treatment of cutaneous larva migrans: three unusual cases from a dermatology clinic]
Journal: Wien Klin Wochenschr
Volume: 126 Suppl 1
Short Title: [Pitfalls in diagnosis and treatment of cutaneous larva migrans: three unusual cases from a dermatology clinic]
Alternate Journal: Wiener klinische Wochenschrift
ISSN: 1613-7671 (Electronic)
Original Publication: Das kutane Larva migrans Syndrom: Schwierigkeiten bei Diagnose und Behandlung anhand von drei Fallbeispielen.
Accession Number: 24249319
Abstract: Cutaneous larva migrans (CLM, creeping eruption) is a skin disease commonly seen in travelers returning from the tropics. The lesions are caused by intradermal migration of animal hookworm larvae which cannot mature in humans. While the typical serpiginous skin lesions are easily diagnosed and treated with albendazole or ivermectin, unusual presentations can be misdiagnosed and cause prolonged morbidity. We present 3 cases of CLM, which were difficult to diagnose and/or treat.Case 1 is a 34-year old Caucasian male who presented with itchy papular lesions on the soles of both feet and was initially treated for plantar psoriasis.Case 2 is a 54-year old Caucasian male who suffered from extensive follicular larva migrans on the buttocks for several months and was only cured after repeated courses of albendazole and ivermectin.Case 3 is a 29-year old Caucasian male with pruritic inflammatory papules on the trunk. Despite extensive diagnostic procedures including skin biopsies and tissue cultures the correct diagnosis was only made later during the course of the illness. After treatment for CLM with albendazole (800 mg/d for 3 days) and after resolution of perifocal edema and inflammation the typical serpiginous tracks became more obvious. They responded rapidly to anthelminthic treatment.These cases highlight the importance of careful history taking and work-up in individuals presenting with atypical skin lesions. In case of exposure to CLM empiric anthelminthic treatment might be considered.