Management of imported cutaneous larva migrans: A case series and mini-review

Present and future: infectious tropical travel rashes and the impact of climate change

In this article, we discuss pertinent cutaneous findings with which patients may present after travel to tropical destinations. We address arthropod-borne infectious diseases such as cutaneous leishmaniasis, Chagas disease, cutaneous larva migrans, and myiasis. We discuss other relevant diseases with cutaneous signs such as monkey pox and severe acute respiratory syndrome coronavirus 2. We provide clinicians with information regarding the background, diagnosis, treatment, and prevention of these tropical rashes. In addition, we address the impact that climate change will have on the temporal and geographic incidence of these rashes. Viral, fungal, and vector-borne diseases have seen a geographic expansion into more northern latitudes. Among these are tick-borne Lyme disease, aquatic snail-related seabather's eruption, and atopic dermatitis. As these diseases spread, we believe that the updated information within this article is significant to the practicing physician in today's warming world.

A Unique Case of Cutaneous Larva Migrans Acquired Within the Province of Quebec and Successfully Treated With Topical Ivermectin

Cutaneous larva migrans (CLM) is a zoonotic helminthiasis frequently imported to Canada by travellers to beach destinations in the tropics. The preferred treatment is oral ivermectin. We present a case of CLM acquired within the province of Quebec, a first in our provincial health records. Our case also puts forward the use of topical ivermectin as a possibly effective CLM treatment approach as our patient was successfully treated with 1 month of an ivermectin 1% cream applied locally twice daily.

Bullous and pustular cutaneous larva migrans: two case reports and a literature review

Cutaneous larva migrans (CLM) is a common skin infestation in tropical countries. The classic presentation is a serpiginous, migratory track on the feet. Local and systemic reactions, as well as secondary bacterial infections, are rarely reported. The authors report two cases of CLM with a blister and pustular response on uncommon body locations. The patients were treated with anthelmintic therapy, and a topical corticosteroid was used to relieve their severe reactions. This report aims to describe an infrequent presentation of a common disease and review treatment plans.

Epidemiological profile of cutaneous larva migrans in travelers returning to France between 2003 and 2015

BACKGROUND

Cutaneous larva migrans (CLM) is caused by the penetration and migration of canine or feline hookworm larvae into the skin, and frequently affects travelers from high-income countries returning from tropical and sub-tropical areas. Unfortunately, this pathology is neglected due to poor understanding among both physicians and travelers. This study describes the profile of cases reported in Marseille, France.

PATIENTS AND METHODS

A retrospective study was performed in two specialized hospitals between 2003 and 2015. Data on socio-demographics, clinical aspects and treatment were collected. Diagnosis was based on travel history and symptoms.

RESULTS

Forty-three patients with a diagnosis of CLM were recorded in this study. They were aged between 14 and 70 and 51% were male. They were infected while visiting the Americas (37%), Africa (33%), Asia (28%) and (in the case of one patient) Portugal. The mean timescale for diagnosis was 41 days. Track lesions associated with pruritus in the lower limbs were the most common symptoms. Nine had a history of super-infection. Sixteen patients received treatment prior to referral including six who were administered antiparasitic drugs. A one-day treatment with ivermectin, administered at our facility, resulted, in most instances, in a favorable outcome.

CONCLUSION

This study reports 43 cases of CLM acquired mainly in Africa, Asia and the Americas but also, for the first time, CLM acquired during travel to Portugal. The data show the need for increased awareness of CLM prevention and treatment in order to optimize pre-travel advice and case management. Travelers need to understand how CLM is transmitted and the need to avoid contact with soil and sand contaminated by dogs and cats. In particular, footwear and sun chairs should be used on beaches.

Treatment of cutaneous larva migrans with a single session of carbon dioxide laser: a study of ten cases in the Philippines

BACKGROUND

Cutaneous larva migrans (CLM) has a detrimental effect on patients' emotional and physical quality of life. Due to local unavailability of gold standard oral treatments for CLM, carbon dioxide laser was attempted. We present a case series where a single session of carbon dioxide laser treatment was associated with cessation of signs and symptoms of CLM.

AIMS

The aim of this study was to assess the efficacy of a single session of carbon dioxide laser in the treatment of CLM.

MATERIALS AND METHODS

Ten cases (eight patients) with CLM were treated with one session of carbon dioxide laser treatment and followed up daily for the first week with photographic documentation and then weekly for the next 3 weeks to complete a 4 week follow-up period.

RESULTS

The first cases in our series, who received one to two passes of fractional CO₂ laser, experienced further larval migration for 2-3 days, after which no more progression was noted. For the next seven cases, we increased the number of CO₂ laser passes to 3-4, and noted no further larval migration. At the end of the 4-week follow-up period, all CO₂ laser-treated areas were completely healed, leaving postinflammatory hyperpigmentation of the serpiginous track.

CONCLUSION

The results of this case series indicate the efficacy of a single session of CO₂ laser in treating CLM. Further studies are required to identify the minimum number of passes required to effectively control CLM.