Overview
Cutaneous larva migrans (CLM) is a parasitic skin condition caused by the penetration of third-stage larvae of various nematodes, typically hookworms, leading to serpiginous, intensely itchy skin lesions 12.Diagnosis
Clinical presentation of serpiginous, erythematous, and intensely pruritic skin lesions 1.
History of exposure to contaminated soil or beaches, often associated with travel to tropical regions 12.
No specific laboratory tests; diagnosis is primarily clinical 3.Management
First-line treatment: Topical corticosteroids (e.g., betamethasone) to reduce inflammation and pruritus 3.
Antibiotic therapy: Ivermectin orally (200 mcg/kg once or twice) is highly effective 3.
Other options: Albendazole orally (400 mg twice daily for 3 days) can be considered 3.Special Populations
Pregnancy: Ivermectin is generally avoided; topical treatments and albendazole should be used cautiously under close monitoring 3.
Pediatrics: Dosage adjustments are necessary; ivermectin dosing should be weight-based and carefully titrated 3.
Elderly: Similar treatment approaches as adults, but renal function and concomitant medications should be considered 3.
Comorbidities: No specific contraindications noted, but treatment should be individualized based on patient's overall health status 3.Key Recommendations
Diagnose CLM based on clinical presentation and travel history (Evidence: Moderate 12).
Initiate treatment with ivermectin 200 mcg/kg once or twice daily for 2-3 days (Evidence: Strong 3).
Consider topical corticosteroids for symptomatic relief (Evidence: Moderate 3).References
1 Korzeniewski K. A cluster of cutaneous larva migrans in travellers returning from Zanzibar. Journal of travel medicine 2022. link
2 Can İ, Yürekli A. Effect of global warming on dermatology practice: The increase in cases of cutaneous larva migrans in the eastern Black Sea region of Turkey. Journal of cosmetic dermatology 2022. link
3 Sunderkötter C, von Stebut E, Schöfer H, Mempel M, Reinel D, Wolf G et al.. S1 guideline diagnosis and therapy of cutaneous larva migrans (creeping disease). Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2014. link