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.

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.

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]

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.

Treatment & Management

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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.