Cutaneuos Larva Migrans – causes and Treatment

Introduction

Cutaneous larva migrans (CLM) is a parasitic skin infection caused by the larvae of animal hookworms, predominantly the Ancylostoma braziliense and Ancylostoma caninum species. This condition commonly affects individuals who have been in contact with contaminated soil or sand in tropical and subtropical regions.

Causes

CLM is primarily caused by the larvae of animal hookworms, including Ancylostoma braziliense and Ancylostoma caninum species. These larvae thrive in warm, moist environments such as sandy beaches, playgrounds, and soil contaminated with animal feces. When human skin comes into contact with these larvae-infested environments, the larvae can penetrate the skin, leading to infection.

Mechanism of cutaneous larva migrans

Upon penetrating the skin, hookworm larvae migrate through the epidermis, causing characteristic serpiginous tracks. The larvae do not mature into adult worms in humans but instead wander beneath the skin, causing inflammation and itching. As they move, they leave a trail of allergic reaction and tissue destruction, resulting in the characteristic winding rash seen in CLM.

Symptoms

The primary symptom of CLM is the appearance of red, itchy, raised tracks on the skin, typically in areas exposed to contaminated soil or sand. These tracks can be linear or serpiginous and may advance several centimeters per day. Itching is often severe and may worsen at night, leading to sleep disturbances. Secondary bacterial infections may occur due to scratching.

Risk Factors

Individuals at higher risk of developing CLM include those who frequent beaches, sandboxes, or other areas with contaminated soil. Activities such as walking barefoot or sitting directly on the ground increase the risk of skin exposure to hookworm larvae, particularly Ancylostoma braziliense and Ancylostoma caninum species. Travel to tropical or subtropical regions where CLM is endemic also elevates the risk.

Treatment of cutaneous larva migrans

Treatment for CLM aims to relieve symptoms and eradicate the parasitic infection. Topical therapies such as albendazole or ivermectin may be prescribed to kill the larvae and alleviate itching. Antihistamines and corticosteroids can help reduce itching and inflammation. In severe cases or when secondary bacterial infections occur, oral antibiotics may be necessary. Preventive measures, such as wearing shoes on beaches and avoiding direct skin contact with contaminated soil, are essential to reduce the risk of CLM.

Conclusion

Cutaneous larva migrans, caused primarily by Ancylostoma braziliense and Ancylostoma caninum species, is a parasitic skin infection prevalent in tropical and subtropical regions. Understanding the causes, mechanism, symptoms, risk factors, and treatment options for CLM is crucial for effective management and prevention of this condition. By taking preventive measures and seeking prompt medical attention, individuals can minimize the impact of CLM on their health and well-being.

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