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Cutaneous larva migrans

Updated : February 27, 2024





Background

Cutaneous larva migrans is an infectious illness caused by various species of hookworms. It is also referred to as creeping eruption.   The most prevalent mode of transmission for this disease involves the deposition of eggs in the soil through animal faecal matter, resulting in larva entering humans through the skin after direct contact with animal feces.

Cutaneous larva migrans is distinct from larva currens, which is the cutaneous presentation of Strongyloides stercoralis. The latter exhibits rapid movement within the skin. Other non-larval cutaneous migrations, such as scabies, loiasis, and larval penetration of the dermis, are excluded from CLM.

The progression of the disease is limited by the inability of the organisms to create a collagenase capable of penetrating the basement membrane and reaching the gastrointestinal tract. When treatment is administered, the medications of choice include oral albendazole, ivermectin, and topical thiabendazole.

Epidemiology

In tropical areas such as African, Latin America, southeast Asia, the Caribbean, and southeastern USA, the disease-causing organisms are most prevalent. Typically, the disease is more prevalent during wet seasons. Younger tourists who visit endemic areas are most likely to be affects.

Anatomy

Pathophysiology

Adult hookworms inhabit the intestinal tracts of canines and felines. After being deposited into the soil, eggs that have been shed in faces hatch in 1 day. During the following week, they transform into infectious larvae. The hatched worms respond to elevated temperature and physical vibrations by moving in a serpentine manner.

After contacting the host organism, they secrete a hyaluronidase to penetrate the corneal layer. In spite of digging through the superficial cutaneous layers, they cannot penetrate the basal membrane and enter the lymphatic system, so they can’t complete their lifecycle. Ultimately, hookworms are unable to reproduce, so the sickness remains self-limiting.

Etiology

The creeping migration of larva through infected animal fecal matter to human skin causes Cutaneous larva migrans.

Organisms responsible for this illness include:

Animal vector nematode hookworms:

  • Uncinaria stenocephala
  • Ancylostoma braziliense
  • Ancylostoma caninum

Human hookworms:

  • Ancylostoma duodenal
  • Necator americanus

Genetics

Prognostic Factors

The condition is frequently self-limiting, and remission without treatment is almost always the outcome. Nevertheless, migration might last for many months, and during this period pruritus can be severe, frequently preventing sleep. Although recurrence is possible, it can easily be prevented.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK507706/

Cutaneous larva migrans

Updated : February 27, 2024




Cutaneous larva migrans is an infectious illness caused by various species of hookworms. It is also referred to as creeping eruption.   The most prevalent mode of transmission for this disease involves the deposition of eggs in the soil through animal faecal matter, resulting in larva entering humans through the skin after direct contact with animal feces.

Cutaneous larva migrans is distinct from larva currens, which is the cutaneous presentation of Strongyloides stercoralis. The latter exhibits rapid movement within the skin. Other non-larval cutaneous migrations, such as scabies, loiasis, and larval penetration of the dermis, are excluded from CLM.

The progression of the disease is limited by the inability of the organisms to create a collagenase capable of penetrating the basement membrane and reaching the gastrointestinal tract. When treatment is administered, the medications of choice include oral albendazole, ivermectin, and topical thiabendazole.

In tropical areas such as African, Latin America, southeast Asia, the Caribbean, and southeastern USA, the disease-causing organisms are most prevalent. Typically, the disease is more prevalent during wet seasons. Younger tourists who visit endemic areas are most likely to be affects.

Adult hookworms inhabit the intestinal tracts of canines and felines. After being deposited into the soil, eggs that have been shed in faces hatch in 1 day. During the following week, they transform into infectious larvae. The hatched worms respond to elevated temperature and physical vibrations by moving in a serpentine manner.

After contacting the host organism, they secrete a hyaluronidase to penetrate the corneal layer. In spite of digging through the superficial cutaneous layers, they cannot penetrate the basal membrane and enter the lymphatic system, so they can’t complete their lifecycle. Ultimately, hookworms are unable to reproduce, so the sickness remains self-limiting.

The creeping migration of larva through infected animal fecal matter to human skin causes Cutaneous larva migrans.

Organisms responsible for this illness include:

Animal vector nematode hookworms:

  • Uncinaria stenocephala
  • Ancylostoma braziliense
  • Ancylostoma caninum

Human hookworms:

  • Ancylostoma duodenal
  • Necator americanus

The condition is frequently self-limiting, and remission without treatment is almost always the outcome. Nevertheless, migration might last for many months, and during this period pruritus can be severe, frequently preventing sleep. Although recurrence is possible, it can easily be prevented.

https://www.ncbi.nlm.nih.gov/books/NBK507706/