Cutaneous Larva Migrans Workup

Updated: Oct 09, 2020
  • Author: David T Robles, MD, PhD, FAAD; Chief Editor: William D James, MD  more...
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Workup

Laboratory Studies

Cutaneous larva migrans (CLM) is diagnosed by history and clinical examination. Some patients demonstrate peripheral eosinophilia on a CBC count and increased immunoglobulin E (IgE) levels on total serum immunoglobulin determinations.

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Procedures

A skin biopsy is not necessary for the diagnosis of cutaneous larva migrans (CLM).  A biopsy must be taken 1-2 cm ahead of the leading edge of a tract or else the larva may be missed.

 

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Imaging Studies

Dermoscopy is an additional tool used to help confirm diagnosis and possibly direct local treatment options. With the use of polarized dermoscopy, one would see an oval structure with a yellow periphery and brown center, representing the body of the larvae. [17]

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Histologic Findings

A biopsy may confirm the presence of tunneling larvae just above the dermoepidermal junction or in the superficial epidermis. The surrounding epidermis reveals spongiosis, intraepidermal vesiculation, with a mixed inflammatory infiltrate and eosinophils.

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