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Cutaneous larva migrans is the skin manifestation of hookworm infestation. People of all ages, and race can be affected if they have been exposed to the larvae. It is most commonly found in tropical or subtropical geographic locations and is relatively common. The main risk factor for this disease is contact with damp, sandy soil contaminated with infected cat and dog feces. The larvae may migrate at rates of a few millimeters to a few centimeters per day. People who are exposed to soil and sand are most likely to be infected. The feet, hands, buttocks, and genitalia are most commonly affected. These lesions may itch, sting and eventually cause pain. They can move up to 2cm per day. Small blisters may also develop. Because the lesions are often scratched, secondary bacterial infection may develop and complicate the picture. In the United States the infection is most common along the southeastern coast and most often caused by the cat and dog hookworm. The disease is self-limited and rarely causes systemic problems. People without intestinal symptoms do not need treatment, since the worms will eventually die or be excreted. Thiabendazole or albendazole are used to treat the infestation. Mild infections can be treated by applying one of the drugs to the skin along the tracks and the normal skin surrounding the area. Thiabendazole also can be given internally, but taken this way it can cause side effects including dizziness, nausea, and vomiting. Albenza tablets, Mintezol chewable tablets and stromectol tablets may also be given for the treatment of Cutaneous larva migrans.
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