Cutaneous larva
migrans is caused by migration of larval nematodes through the
epidermis. Visit:
Visceral larva
migrans
The migrating worms provoke severe inflammation, which
appears as serpinginous urticarial trails.
DermAtlas
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The names applied to this
condition are as varied as the organisms that cause it and include
creeping eruptions, sandworm, plumber’s itch, duck hunter’s itch, and
epidermis linearis migrans.
The common larval nematodes are
Strongyloides stercoralis
, Ancylostoma brasiliensis , A. caninum ,
Uncinaria stenocephala , Bunostomum
phlebotomum, Necator americanus and Gnathostoma spinigerum.
Hookworm Infection
In a
condition known as larva currens (creeping eruption), the agent is
Strongyloides stercoralis. This disorder was first reported
in prisoners of war held by the Japanese during Word War II.
Unlike cutaneous larva migrans, linear urticarial trails in the area of the
anus are the only lesions.
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Dogs and cats
infected with
hookworm are the major source of the disease.
Outbreaks
of cutaneous larva migrans occur at subtropical and tropical beaches. Plumbers who crawl under houses and animal caretakers are also
frequently infected.
The diagnosis is based on history and clinical
appearance.
Microscopic features: -
Small cavities in the
epidermis (correspond to the track of the larva) ; Parasite is rarely
seen in the section ; Diffuse spongiotic dermatitis ; Intraepidermal
vesicles containing some eosinophils ; Usually no inflammatory
reaction around larva ; Mixed inflammatory reaction behind the
migrating larva with a superficial dermal infiltrate of numerous
eosinophils, neutrophils, lymphocytes and plasma cells ; Eosinophilic
folliculitis may be present.
Thiabendazole is the treatment of choice and is effective
in either topical or oral preparations.
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