Corresponding author:
Takahiro Matsuo, MD
Department of Infectious Diseases, St. Luke’s International Hospital,
Tokyo, Japan
9-1, Akashi-cho, Chuo-ku, Tokyo, Japan. Tel: +81-3-3541-5151; Fax:
+81-3-3544-0649
E-mail: tmatsuo@luke.ac.jp
A previously healthy 24-year-old American man, a returning traveler
from Tanzania presented to our hospital with deteriorating pruritic
meandering erythema on bilateral soles for 10 days (Picture 1A, 1B). He
had an episode of walking barefoot on the beach during the trip. On
exams, he was noted to have elevated, serpiginous, and reddish-brown
tracks on his bilateral foot (2-3 mm in width and 5 cm in length), which
were consistent with cutaneous larva migrans. We performed incisional
biopsy and started oral ivermectin 0.2 mg/kg/day for 2 days. The
patient’s condition improved without any complication. Three-month
later, we confirmed the resolution of these tracks.
Hookworm-related cutaneous larva migrans (HrCLM) is caused by
penetration and migration in the epidermis of the larva of nematodes.
The most common parasite species are Ancylostoma brasiliense,
Ancylostoma caninum, and Necator americanus [1]. Although
HrCLM resolves spontaneously after a few weeks to months, with
ivermectin or albendazole complete remission is observed within 1 week
[2]. Some patients may have persistent discomfort, secondary
bacterial infection and Loeffler’s syndrome, which is pulmonary
infiltration with peripheral eosinophilia. We should consider HrCLM in
patients with these skin lesions from endemic areas.