Back to Basics: Itching Rash

Diagnosis: Hookworm-Related Cutaneous Larva Migrans

- Parasitic skin disease caused by the migration of animal hookworm larvae in the epidermis

- Endemic in many resource-poor communities; travelers account for most cases seen in high-income countries

- Transmission occurs when naked skin comes into contact with contaminated stool, ie. "walking on a beach" where there is potentially animal (usually cat or dog) infected feces

- First sign = reddish papule and then becomes the characteristic serpiginous, slightly elevated, erythematous track. Vesiculobullous lesions common.

- Itching becomes more and more intense

- Can get bacterial superinfection from excoriations from scratching

- Clinical diagnosis!

- Treatment of choice = Ivermectin. Can also use albendazole.

- Differential Diagnosis includes scabies, loiasis, myiasis, cercarial dermatitis (schistosomiasis), tinea corporis and contact dermatitis



Feldmeier, H and Schuster. "Mini review: hookworm-related cutaneous larva migrans." Eur J Clin Microbiol Infect Dis (2012) 31:915-918.