By Gary M. White, MD
Cutaneous larva migrans (also known as creeping eruption) is a characteristic eruption that is caused by penetration and migration in the skin of nematode larvae. In the US, Acnylostoma caninum or A. braziliensis (dog or cat hookworm) is common.
An inflamed, red, linear, worm-shaped lesion is seen. The foot is a common location.
Ivermectin 200 micrograms/kg as a single oral dose is the treatment of choice and may be given to both adults and children. In one study of 59 patients from Europe, 95% cleared with one dose of 200 ug/kg ivermectin. Topical thiobendazole (the oral suspension or a 10-15% cream) applied QID is effective within days.
Albendazole 400 mg as a single dose has also worked well. Excision the advancing tip may also be done, but the parasite may be missed. In many cases, the disease is self-limited as the parasite will die because the human is not an appropriate host.
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