Hookworm-related cutaneous larva migrans acquired in the UK

Abstract

SUMMARYHookworm-related cutaneous larva migrans (HrCLM) is a skin disease caused by infection with the larvae of animal hookworms. With conditions for infection more favourable in tropical climates, HrCLM in the UK is classically diagnosed in the returning traveller. We present two cases of clinically diagnosed UK-acquired HrCLM from a district general hospital in the south of England. A 68-year-old woman presented with a pruritic serpiginous tract on the right hand. She was a keen gardener and had been handling compost. A 50-year-old man, a long distance runner, presented with a similar lesion on the dorsum of his foot. Both patients were treated with a single dose of albendazole. These cases may represent an emerging infection in the UK. In the absence of a suggestive travel history, early recognition followed by efficient access to therapy is vital for treating HrCLM transmitted in the UK. BACKGROUND

Travelers’ tropical skin diseases: Challenges and interventions

“…CLM is usually the result of skin infection by the larval stages of dog and cat hookworms (in most cases Ancylostoma caninum and braziliense ) but can also be caused by other helminth parasites such as Strongyloides stercoralis (Karthikeyan & Thappa, ). Clinical examination is fundamental to diagnosis and reveals a typical serpiginous erythematous tract (Figure ) known as a “creeping eruption” that represents the path of a single larva through the epidermis (Baple & Clayton, ). Humans are incidentally infected when there is skin contact with contaminated soil or sand containing filariform larvae.…”

“…Humans are incidentally infected when there is skin contact with contaminated soil or sand containing filariform larvae. These develop 5–10 days after the rhabtidiform larvae have hatched from the eggs passed in the feces of their infected definitive host (Baple & Clayton, ). Once the host is contaminated, the parasite is confined to the epidermis and dermis.…”

“…Strongyloides stercoralis (Karthikeyan & Thappa, 2002). Clinical examination is fundamental to diagnosis and reveals a typical serpiginous erythematous tract ( Figure 1) known as a "creeping eruption" that represents the path of a single larva through the epidermis (Baple & Clayton, 2015). Humans are incidentally infected when there is skin contact with contaminated soil or sand containing filariform larvae.…”

“…These develop 5-10 days after the rhabtidiform larvae have hatched from the eggs passed in the feces of their infected definitive host (Baple & Clayton, 2015). Once the host is contaminated, the parasite is confined to the epidermis and dermis.…”

A paediatric case of cutaneous larva migrans acquired in the UK

“…CLM is typically acquired in warmer latitudes and therefore when diagnosed in the UK, it is seen most commonly in travellers returning from the tropics . CLM acquired in the UK is rare.…”