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Cutaneous larva migrans is the skin manifestation of hookworm infestation.

Cutaneous larva migrans (CLM) is caused by Ancylostoma sp, most commonly dog or cat hookworm Ancylostoma braziliense. Hookworm ova in dog or cat feces develop into infective larvae when left in warm moist ground or sand; transmission occurs when skin directly contacts contaminated soil or sand and larvae penetrate unprotected skin, usually of the feet, legs, buttocks, or back. CLM occurs worldwide but most commonly in tropical environments.

CLM causes intense pruritus; signs are erythema and papules at the site of entry, with a winding, threadlike subcutaneous trail of reddish-brown inflammation. Diagnosis is by history and clinical appearance.

Topical thiabendazole Some Trade Names
MINTEZOL
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15% liquid or cream (compounded) bid to tid for 5 days is extremely effective. Oral thiabendazole Some Trade Names
MINTEZOL
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is not well tolerated and not usually used. Albendazole Some Trade Names
ALBENZA
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(400 mg po once/day for 7 days) and ivermectin Some Trade Names
STROMECTOL
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can cure the infestation and are well tolerated.

CLM may be complicated by a self-limiting pulmonary reaction called Löffler's syndrome (patchy pulmonary infiltrates and peripheral blood eosinophilia).

Last full review/revision September 2008 by James G.H. Dinulos, MD

Content last modified September 2008