Cutaneous Larva migrans: 3 cases at the forehead

Abstract

Cutaneous Larva migrans, known as creeping dermatitis, is a parasitic disease caused by an hookworm larvae in a dead end in moist soil. It is a very common condition in tropical countries, especially among children playing in sand and among travelers. The body contact with soil contaminated with larvae in certain religious practices may expose individuals to contamination. We report three cases of CML at the forehead in three Muslim religious practitioners. Contamination was made by contact with dirty soil in unfenced mosques during overwintering. The presence of stray cats was confirmed by the 3 patients. Treatment with albendazole resulted in complete healing. RÉSUMÉLa Larva Migrans Cutanée (LMC) connue sous le nom de larbisch ou creeping disease est une maladie parasitaire due à une larve d'ankylostome en impasse dans le sol humide. C'est une affection très fréquente dans les pays tropicaux notamment chez les enfants jouant dans le sable et chez les voyageurs. Le contact du corps avec le sol souillé de larves dans certaines pratiques religieuses, peut exposer les individus à la contamination. Nous rapportons 3 cas de LMC à localisation au front chez 3 pratiquants de religion musulmane. La contamination a été faite par contact avec le sol souillé par les excréments d'animaux dans des mosquées non clôturées pendant l'hivernage. La présence de chats errants a été confirmée par les 3 patients. Le traitement par l'albendazole a entrainé la guérison totale.

Hookworm – Related cutaneous larva migrans: Case report

“…However, for multiple lesions or massive infestation, the treatment of choice being ivermectin, orally at a single dose of 200mg/kg [6], However, in countries that do not have ivermectin, such as Morocco, the prescription of repeated doses of albendazole constitutes a good therapeutic alternative. The recommended dose being 400mg/d for an average of three to seven days, with a good response in 92% to 100% of cases [4,5]. This was the case for our patient who showed an improvement in these symptoms within 48 hours following the administration of the first dose of albendazole (200mg/d).…”

“…In our patient the diagnosis was made solely on the basis of the pathognomonic clinical picture. Pharmacological management in local infection includes topical 10% thiabendazole solution 2-3 times daily for 5-10 days [4,5]. However, for multiple lesions or massive infestation, the treatment of choice being ivermectin, orally at a single dose of 200mg/kg [6], However, in countries that do not have ivermectin, such as Morocco, the prescription of repeated doses of albendazole constitutes a good therapeutic alternative.…”

“…In addition to pharmacological treatment, Prevention is just as simple and makes it possible to reduce the risk of infestation by cutaneous Larva migrans based on systematic washing of the hands after contact with the ground and before the meal and to avoid geophagy, eviction of dogs in public parks and avoid wearing socks in sandy areas, This was explained by the accumulation of sand at the level of the socks, which would contribute to prolonged contact with the parasite and therefore increase the chances of its penetration [4,5].…”