Pediatric Cutaneous Larva Migrans Clinical Presentation

Updated: Nov 18, 2022
  • Author: Theresa M Fiorito, MD, MS, FAAP, CTH®; Chief Editor: Russell W Steele, MD  more...
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Presentation

History

The patient with cutaneous larva migrans (CLM) may recall a stinging sensation upon initial penetration of the larvae.

An erythematous papule or a nonspecific dermatitis can develop hours after penetration and progress millimeters to centimeters per day. Patients may complain of severe itching.

The most common location for penetration is the feet (39%), from walking barefoot in the sand. Cases have been described involving the buttocks and thighs. Presentation on other areas is rare.  

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Physical Examination

The migration of the larvae produces a 2-mm to 4-mm wide, erythematous, linear or serpiginous tracks. The rash is associated with significant pruritis. Vesiculobullous and papular lesions may be observed in association with the linear track. Migration of the larvae through the skin occurs from a week to several months after initial penetration, depending on the type of roundworm.

Untreated lesions resolve after the larvae die (ie, within weeks to months).

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