Cutaneous larva migrans (CLM) is an acquired dermatosis
Seen in patients returning from the tropics
Often seen in patient with a history of sunbathing or in barefoot beachgoers
Caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae), with Ancylostoma braziliense the most frequently found in humans.
Clinical manifestations:
Linear, serpentine erythematous lesions
Intense pruritus
Will often heal spontaneously over weeks or months without treatment
Treatment:
Thiabendazole (applied topically)
Oral alternatives include other anti-parasitic medications such as albendazole, ivermectin
Oral thiabendazole as a single dose can be used, but is less effective than albendazole or ivermectin
Consider antibiotics if there is secondary bacterial infections
Freezing the leading edge has been previously used, but is considered ineffective and painful.
Bottom Line:
Consider CLM the next time a patient complains of a linear, erythematous itchy rash after returning from their all-inclusive stay in a Caribbean resort
