Question
Cutaneous larva migrans
Answer
Cutaneous larva migrans (CLM), or “creeping eruption,” is a self-limiting parasitic skin infestation caused by migration of animal hookworm larvae through the human epidermis — most commonly Ancylostoma braziliense — humans being an accidental, dead-end host.
Transmission: infective filariform larvae hatched from eggs in dog/cat faeces on soil/sand penetrate exposed human skin (typically bare feet).
Clinical features: since larvae cannot penetrate the dermis/enter the bloodstream in this aberrant host, they remain confined to the epidermis, migrating slowly, producing a characteristic serpiginous, intensely pruritic, raised, erythematous track that advances visibly over days.
Natural course: self-limiting, resolving spontaneously over weeks to a few months as larvae die without maturing.
Diagnosis: primarily clinical, based on the characteristic serpiginous track and relevant soil/sand exposure history.
Treatment: oral albendazole or ivermectin; topical thiabendazole is an alternative for localized lesions.