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Cutaneous larva migrans - Causes, Symptoms and Treatment

Defination

Cutaneous larva migrans is a parasitic skin infection. It is caused by hookworm larvae . This larva is that usually come from infest cats, dogs and other animals. It is found in southeastern and Gulf States, and in tropical developing countries. Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that have been contaminated with animal faces.

It is also known as creeping eruption as once infected, the larvae migrate under the skin's surface and cause itchy red lines or tracks. The hookworms that cause the condition are small, round blood-sucking worms that infest about 700 million people around the world.

Causes

These parasites are found in dog and cat feces and although they are able to infect the deeper tissues of these animals (through to the lungs and then the intestinal tract), in humans they are only able to penetrate the outer layers of the skin and thus create the typical wormlike burrows visible underneath the skin. The parasites apparently lack the collagenase enzymes required to penetrate through the basement membrane deeper into the skin. Common causes are :-

Ankylostoma braziliense: hookworm of wild and domestic dogs and cats found in central and southern US, Central and South America, and the Caribbean
Ankylostoma caninum: dog hookworm found in Australia
Uncinaria stenocephala: dog hookworm found in Europe
Bunostomum phlebotomum:cattle hookworm.

Symptoms

In minor infestations, there may be no symptoms at all. In more severe cases, a red elevation of the skin (papule) appears within a few hours after the larvae have penetrated the skin. And in few cases :-

Raised, snakelike tracks in the skin that may migrate over time -- in severely infested individuals, there may be several tracks noted.
Occasional blister formation along the migratory path.

Treatment

Humans are an accidental and "dead-end" host so the larvae eventually die. The natural duration of the disease varies which considerably depending on the species of larvae involved. In most cases, lesions will resolve without treatment within 4-8 weeks

Topical or oral thiabendazole (an anti-parasitic agent) may be used in the treatment of this infection. Other agents such as albendazole and ivermectin are also effective. Other agents such as albendazole and ivermectin are also effective.

Antibacterial ointments such as Bactroban may be useful in managing secondary infections that result from the pruritis.