Medical Care

Even though cutaneous larva migrans (CLM) is self-limited, the intense pruritus and risk for infection mandate treatment. Prevention is key and involves avoidance of direct skin contact with fecally contaminated soil.

Oral albendazole, oral ivermectin, or topical ivermectin are the usual treatment choices,^{[18, 19, 20]}along with perhaps thiabendazole (not available in the United States).^[21]

In the United States, albendazole at 400 mg/day for 3 days is recommended. Alternatively, ivermectin can be administered as a 12-mg dose and repeated the next day. Some also recommend trying topical treatment with topical ivermectin or topical thiabendazole compounded in a 10% suspension or 15% cream or topical metronidazole cream, all used four times daily. If effective, the topical therapies are expected to resolve the condition in 1 week.

Outside the United States, thiabendazole has been recommended for the treatment of cutaneous larva migrans, as has oral albendazole or ivermectin.^[21]Thiabendazole is not available in the United States.

Consultations

Consultation with a dermatologist may be warranted.

Medication

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Veraldi S, Persico MC, Francia C, Schianchi R. Chronic hookworm-related cutaneous larva migrans. Int J Infect Dis. 2013 Apr. 17 (4):e277-9. [QxMD MEDLINE Link].
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Media Gallery

A patient who was sunbathing nude on a beach in Martinique presented with classic erythematous, serpiginous tracts on the left heel.
Cutaneous larva migrans on the right thumb.
Cutaneous larva migrans on the left thigh.

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Author

David T Robles, MD, PhD, FAAD Director, Dermatology Division, Chaparral Medical Group

David T Robles, MD, PhD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Jacquiline Habashy, DO, MSc Resident Physician, Department of Dermatology, Western University of Health Sciences College of Osteopathic Medicine of the Pacific

Jacquiline Habashy, DO, MSc is a member of the following medical societies: American Osteopathic College of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Daniel Mark Siegel, MD, MS Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate Medical Center

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Association for Physician Leadership, American Society for Dermatologic Surgery, American Society for MOHS Surgery, International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Margaret C Douglass, MD Program Director, Department of Dermatology, Henry Ford Hospital

Disclosure: Nothing to disclose.

Lydia A Juzych, MD Senior Staff, Department of Dermatology, Henry Ford Health Sciences Center

Lydia A Juzych, MD is a member of the following medical societies: Alpha Omega Alpha, Michigan State Medical Society, Michigan Dermatological Society, American Medical Association, American Medical Student Association/Foundation, American Medical Women's Association, Phi Beta Kappa

Disclosure: Nothing to disclose.