Cutaneous larva migrans in Adult
Clinically, there may be one or more intensely pruritic serpiginous tracts localized primarily to the ankles and feet; however, other areas of the body that have contacted infected soil may be involved. Itching begins within hours to days of exposure. Larval migration begins approximately 4 days after entry and progresses at a rate of around 1 or 2 cm a day. The tracts are often edematous, erythematous, and may have associated vesicles and bullae. Most patients present with more than one tract. Since the human is a "dead-end" host, the larva typically spontaneously resolve, although lesions may persist for up to a month.
The disease is most commonly found in warm climates, with high incidence observed in the southeastern United States, Central and South America, Africa, and the Caribbean.
Although very rare, larvae can migrate beyond the skin, causing systemic disease characterized by pulmonary infiltrates and peripheral eosinophilia, termed Loeffler syndrome.
Related topic: (Human) Hookworm infection
B76.9 – Hookworm disease, unspecified
19362000 – Cutaneous larva migrans
240854000 – Ancylostomal cutaneous larva migrans
Differential Diagnosis & Pitfalls
- Larva currens
- Swimmer's itch (cercarial dermatitis)
- Larval forms of marine coelenterates
- Portuguese man-of-war and jellyfish stings
- Erythema annulare centrifugum
- Erythema chronicum migrans
- Figurate erythemas
- Contact dermatitis
- Tinea pedis
- Foreign body