Cutaneous larva migrans (abbreviated CLM) is a skin disease in humans, caused by the larvae of various nematode parasites of the hookwormfamily (Ancylostomatidae). The parasites live in the intestines of dogs, cats, and wild animals; they should not be confused with other members of the hookworm family for which humans are definitive hosts, namely Ancylostoma duodenale and Necator americanus.
Cutaneous larva migrans
Other names
CLM
Typical "creeping eruption" associated with cutaneous larva migrans
Colloquially called creeping eruption[1][2] due to its presentation, the disease is also somewhat ambiguously known as "ground itch" or (in some parts of the southern United States) "sandworms", as the larvae like to live in sandy soil. Another vernacular name is plumber's itch. The medical term CLM literally means "wandering larvae in the skin".
The infection causes a red, intensely pruritic (itchy) eruption and may look like twirling lesions.[3] The itching can become very painful and if scratched may allow a secondary bacterial infection to develop. Cutaneous larva migrans usually heals spontaneously over weeks to months and has been known to last as long as one year.[3] However the severity of the symptoms usually causes those infected to seek medical treatment before spontaneous resolution occurs. After proper treatment, migration of the larvae within the skin is halted and relief of the associated itching can occur in less than 48 hours (reported for thiabendazole).[1]
This is separate from the similar cutaneous larva currens which is caused by Strongyloides. Larva currens is also a cause of migratory pruritic eruptions but is marked by 1) migratory speed on the order of inches per hour 2) perianal involvement due to autoinfection from stool and 3) a wide band of urticaria.[4]
Causeedit
Hookworm eggs are shed in infected dog (or other animal) feces and are transferred to the ground and to beach sand, where they develop over a period of 1–2 weeks into an infectious larval form (filariform larvae).[5] The filariform larvae can burrow through intact skin which comes into contact with soil or sand that is contaminated with feces. Although they are able to infect the deeper tissues of other animals (through to the lungs and then the intestinal tract), humans are incidental hosts and the larvae are only able to penetrate the epidermis of the skin.[1] They create the typical wormlike burrows which are visible underneath the skin. These parasites apparently lack the collagenase enzymes required to penetrate through the basement membrane deeper into the dermal layers of the skin.[6]
Diagnosisedit
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Topical freezing agents including ethylene chloride or liquid nitrogen,[1] applied locally can freeze and kill the larvae, but this method has a high failure rate because the larvae are usually located away from the site of the visible skin trails. Additionally this is a painful method which can cause blistering and/or ulceration of the skin and is therefore not recommended.[1]
Wearing shoes in areas where these parasites are known to be endemic offers protection from infection.[1] In general avoiding exposure of skin to contaminated soil or sand offers the best protection. In some areas dogs have been prohibited from beaches in an attempt to control human infection.[1]
^ abcdefghijCaumes, E. (1 May 2000). "Treatment of Cutaneous Larva Migrans". Clinical Infectious Diseases. 30 (5): 811–814. doi:10.1086/313787. PMID 10816151.
^ abcAlbanese, G; Caterina Venturi; Giuseppe Galbiati (2001). "Treatment of larva migrans cutanea (creeping eruption): a comparison between albendazole and traditional therapy". International Journal of Dermatology. 40 (1): 67–71. doi:10.1046/j.1365-4362.2001.01103.x. PMID 11277961. S2CID 40314184.
^ARTHUR, ROBERT P. (1 August 1958). "Larva Currens". AMA Archives of Dermatology. 78 (2): 186–90. doi:10.1001/archderm.1958.01560080044007. PMID 13558704.
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Cutaneous larva migrans abbreviated CLM is a skin disease in humans caused by the larvae of various nematode parasites of the hookworm family Ancylostomatidae The parasites live in the intestines of dogs cats and wild animals they should not be confused with other members of the hookworm family for which humans are definitive hosts namely Ancylostoma duodenale and Necator americanus Cutaneous larva migransOther namesCLMTypical creeping eruption associated with cutaneous larva migransSpecialtyInfectious diseases Colloquially called creeping eruption 1 2 due to its presentation the disease is also somewhat ambiguously known as ground itch or in some parts of the southern United States sandworms as the larvae like to live in sandy soil Another vernacular name is plumber s itch The medical term CLM literally means wandering larvae in the skin Contents 1 Symptoms and signs 2 Cause 3 Diagnosis 4 Treatment 5 See also 6 References 7 External linksSymptoms and signs editThe infection causes a red intensely pruritic itchy eruption and may look like twirling lesions 3 The itching can become very painful and if scratched may allow a secondary bacterial infection to develop Cutaneous larva migrans usually heals spontaneously over weeks to months and has been known to last as long as one year 3 However the severity of the symptoms usually causes those infected to seek medical treatment before spontaneous resolution occurs After proper treatment migration of the larvae within the skin is halted and relief of the associated itching can occur in less than 48 hours reported for thiabendazole 1 This is separate from the similar cutaneous larva currens which is caused by Strongyloides Larva currens is also a cause of migratory pruritic eruptions but is marked by 1 migratory speed on the order of inches per hour 2 perianal involvement due to autoinfection from stool and 3 a wide band of urticaria 4 nbsp nbsp Cause editHookworm eggs are shed in infected dog or other animal feces and are transferred to the ground and to beach sand where they develop over a period of 1 2 weeks into an infectious larval form filariform larvae 5 The filariform larvae can burrow through intact skin which comes into contact with soil or sand that is contaminated with feces Although they are able to infect the deeper tissues of other animals through to the lungs and then the intestinal tract humans are incidental hosts and the larvae are only able to penetrate the epidermis of the skin 1 They create the typical wormlike burrows which are visible underneath the skin These parasites apparently lack the collagenase enzymes required to penetrate through the basement membrane deeper into the dermal layers of the skin 6 Diagnosis editThis section is empty You can help by adding to it January 2023 Treatment editCLM can be treated in a number of different ways Systemic oral agents include albendazole 1 2 trade name Albenza 7 and ivermectin 1 trade name Stromectol 8 Another agent which can be applied either topically or taken by mouth is thiabendazole 1 2 trade name Mintezol 9 an anti helminthic Topical freezing agents including ethylene chloride or liquid nitrogen 1 applied locally can freeze and kill the larvae but this method has a high failure rate because the larvae are usually located away from the site of the visible skin trails Additionally this is a painful method which can cause blistering and or ulceration of the skin and is therefore not recommended 1 To relieve some of the itch Benadryl or anti itch creams such as hydrocortisone or calamine lotion can help Wearing shoes in areas where these parasites are known to be endemic offers protection from infection 1 In general avoiding exposure of skin to contaminated soil or sand offers the best protection In some areas dogs have been prohibited from beaches in an attempt to control human infection 1 See also editDermatology Intestinal parasite Visceral larva migrans List of migrating cutaneous conditionsReferences edit a b c d e f g h i j Caumes E 1 May 2000 Treatment of Cutaneous Larva Migrans Clinical Infectious Diseases 30 5 811 814 doi 10 1086 313787 PMID 10816151 a b c Albanese G Caterina Venturi Giuseppe Galbiati 2001 Treatment of larva migrans cutanea creeping eruption a comparison between albendazole and traditional therapy International Journal of Dermatology 40 1 67 71 doi 10 1046 j 1365 4362 2001 01103 x PMID 11277961 S2CID 40314184 a b Chaudhry AZ Lonworth DL 1989 Cutaneous manifestations of intestinal helminthic infections Dermatol Clin 7 2 275 90 doi 10 1016 S0733 8635 18 30599 0 PMID 2670373 ARTHUR ROBERT P 1 August 1958 Larva Currens AMA Archives of Dermatology 78 2 186 90 doi 10 1001 archderm 1958 01560080044007 PMID 13558704 CDC Parasites Retrieved 25 April 2013 Maxfield L Crane J S 2021 Cutaneous Larva Migrans StatPearls StatPearls PMID 29939528 Drugs com Albenza Drugs com Retrieved 25 April 2013 Drugs com Stromectol Drugs com Retrieved 25 April 2013 Drugs com Mintezol Drugs com Retrieved 25 April 2013 External links editDermAtlas 1921851750 Retrieved from https en wikipedia org w index php title Cutaneous larva migrans amp oldid 1194111126, wikipedia, wiki, book, books, library,
