Multiple papules and nodules on the face and neck caused by the larvae of an unknown nematode: A noncreeping type eruption

Hookworm-related cutaneous larva migrans (HrCLM) is a parasitic skin disease caused by the migration of animal hookworm larvae in the epidermis. Since these larvae cannot penetrate the basal membrane of human skin, they remain confined to the epidermis and are unable to develop and complete their lifecycle. By consequence, HrCLM is a self-limiting disease. However, if not treated promptly, the skin pathology may persist for months. HrCLM is endemic in many resource-poor communities in the developing world. In high-income countries, HrCLM occurs sporadically or in the form of small epidemics. Travelers account for the great majority of cases seen by health-care professionals in high-income countries. Transmission occurs when naked skin comes into contact with contaminated soil. Exposure may also occur indoors. Exceptionally, larvae may be transmitted through fomites. The first clinical sign is a small reddish papule. Thereafter, the characteristic serpiginous, slightly elevated, erythematous track becomes visible. Itching becomes more and more intense. Excoriations induced by scratching facilitate bacterial superinfection of the lesion. The diagnosis is essentially clinical. It is supported by a recent travel history and the possibility of exposure. The drug of choice is ivermectin in a single dose (200 μg per kg bodyweight). Repeated treatments with albendazole (400 mg daily) are a good alternative in countries where ivermectin is not available.

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“…HrCLM folliculitis is difficult to differentiate from papular-nodular lesions caused by other nematode species [43].…”

Section: Diagnosismentioning

confidence: 99%

Mini review: hookworm-related cutaneous larva migrans

Feldmeier

Schuster

2011

Eur J Clin Microbiol Infect Dis

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“… 2 The skin manifestations of cutaneous larva migrans include a linear or serpiginous, pruritic larval track, with folliculitis and migratory subcutaneous nodules. 3 The distinctive clinical appearance, in addition to a history of exposure to contaminated soil or sand, is sufficient for accurate diagnosis. Treatment for this condition involves application of topical thiabendazole or administration of oral albendazole.…”

mentioning

confidence: 99%