A case of cutaneous larva migrans from Turkey

Cutaneous larva migrans (CLM) is an infestation that occurs with the penetration and migration of larvae of animal (especially cat and dog) hookworms into the epidermis. The disease occurs as a result of contact with the faeces of infected animals. It is observed as itchy erythematous migrating and serpiginous slightly raised eruptions [1]. CLM is seen endemically in some regions. These are Central and South America, Mexico, Caribbean, Africa, Southeast Asia, Mediterranean regions, the south-eastern parts of the United States, and some other tropical areas. It is the most common skin disease seen after traveling to tropical and subtropical regions [1–3]. However, when we look at the literature, cases have been reported in non-endemic regions like our country [4]. A small number of CLM cases have been reported in our country. While 4 of them were autochthonous, 4 of them had a history of traveling to the endemic region [2, 3, 5–7]. Although facilitating the transportation between countries makes it easier to see the disease, global warming and its effects make it easier to see some parasitic diseases in non-endemic regions as a result of changes of both climate and environment.
A 45-year-old male patient presented to our outpatient clinic with an itchy lesion that started on the thigh for 2 weeks and spread from the hips to the trunk over time. The patient was an office worker, but stated that he was dealing with garden work on the weekend. The patient had no recent travel history abroad. He had no other known diseases. He did not benefit from the topical steroid treatment he used for 2 weeks.
On dermatological examination, there was a lesion of about 10 cm in length on an erythematous floor that spread to the back on the right side of the trunk (fig. 1). In laboratory tests, eosinophilia was noteworthy. In the skin biopsy examination, chronic inflammation with perivascular and eosinophils was evident (fig. 2). With these signs and symptoms, a diagnosis of CLM was made. As treatment, 800 mg albendazole was given for 3 days. After the treatment, the patient’s complaints disappeared completely (fig. 3). The patient was followed up for complications that may develop in the late period.
Although many different larvae can cause CLM, the most common factors are Ancylostoma braziliense and Ancylostoma caninum. Humans are accidental hosts. Filariform larvae penetrate the skin as a result of direct contact with contaminated soil or sand [8]. Then...


View full text...