Cutaneous Larva Migrans Research Articles

Two clinical cases of cutaneous larva migrans among travelers returning from tropical countries

Two clinical cases of cutaneous larva migrans among travelers returning from tropical countries

Disseminated cutaneous larva migrans in a 7-year-old patient

Introduction: Cutaneous larva migrans is a cutaneous infestation caused by zoonotic nematode larvae commonly due to hookworms such as the Ancylostoma braziliense. Case report: Herein we report a case of a 7-year-old child to the Emergency Department complaining of erythematous papular itching lesions on his right elbow, wrist and knee. He had no previous history of contact with sand or animals. The lesions in his right elbow presented impetiginization. Ivermectin 200mcg/kg/day treatment was initiated and oxacillin associated. On the third day of treatment, the patient was discharged with complete resolution of the lesions. Coclusion: The reported case assumes importance because it is a common and benign disease, but due to an unusual presentation was not diagnosed early. The disseminated form commonly may require hospitalization and prolonged treatment as presented

Standardization and application of a modified RFLP-PCR methodology for analysis of polymorphisms linked to treatment resistance in Ancylostoma braziliense

BackgroundSingle nucleotide polymorphisms (SNPs) in codons 167, 198 and 200 of the beta-tubulin isotype 1 gene are associated with benzimidazoles resistance in many helminths. Codon 167 mutation has never been described in hookworms; however, polymorphisms in codons 198 and 200 have been described for Ancylostoma caninum and Necator americanus. These mutations have never been investigated in Ancylostoma braziliense; therefore, it is not known if they are present in this species and whether they are correlated with treatment resistance. The RFLP-PCR technique has been used to analyze these polymorphisms in some nematodes, but depending on the species, these alterations do not create or eliminate any restriction enzyme cleavage site, making it impossible to use this technique. Here, we describe the standardization and application of a modified RFLP-PCR technique for detecting polymorphisms in individual A. braziliense worms recovered from naturally infected dogs in two Brazilian states.ResultsThe molecular techniques used were sensitive, specific, and easy to apply. To our knowledge, we report for the first time the presence of a polymorphism at codon 198 of the beta-tubulin gene of A. braziliense (1/81; 95% CI: 0–3.69%).ConclusionsIt is not known whether the presence of the mutation in codon 198 of the beta-tubulin gene of A. braziliense has importance for this parasite. However, based on studies of other helminths, it is possible that this polymorphism is directly related to the resistance to benzimidazoles. This may be a major concern, since this nematode has considerable relevance as a parasite of canids and felids and as one of the agents of cutaneous larva migrans in humans. Standardized methodologies will be useful for screening for polymorphisms in the beta-tubulin gene of canine hookworms in a broader population. The method could also be adapted for the analysis of other SNPs in other nematode species.

An unusual case of extensive truncal cutaneous larva migrans in a Cameroonian baby: a case report

BackgroundCutaneous larva migrans is a neglected zoonotic helminthic disease which is paradoxically underreported in low-income and middle-income countries from where a majority of the cases emanate. It presents as migratory, raised, erythematous serpentine lesions, responsive to treatment with antihelminthics. It is common in children, but rare in babies. We report an unusual case of cutaneous larva migrans in a Cameroonian baby.Case presentationWe report the case of a 9-month-old Cameroonian baby girl, whose mother had the habit of drying the child’s clothes on the grass in her courtyard. The child was brought to our hospital after she developed itchy, snake-like, slowly progressing lesions on her abdomen and chest. An examination revealed multiple raised serpentine and erythematous skin lesions consistent with cutaneous larva migrans which subsided on antihelminthic and antihistaminic therapy.ConclusionsCutaneous larva migrans is an endemic disease with predilection for poor and vulnerable persons. Preventive efforts such as wearing of slippers, usage of drying lines, and deworming of pets are crucial in preventing the occurrence of this disease and should be encouraged.

Travelers' tropical skin diseases: Challenges and interventions.

Tropical regions receive a significant part of the traveling population. It is very important that health professionals are familiar with the main tropical skin diseases and able to advice patients appropriately. This article reviews the main tropical diseases of travelers, with an emphasis on diagnosis, management, and prevention. Among others, cutaneous larva migrans, myiasis, tungiasis, Chagas disease, Dengue fever, African trypanosomiasis, filariasis, and leishmaniasis are discussed. Increasing awareness among travelers and health care professionals can help reduce morbidity and mortality. Continued research on new drugs and vaccines is needed to reduce the risks of tropical diseases.

Infestations

This review looks at parasitic diseases of the skin. Scabies, caused by the human itch mite (Sarcoptes scabiei), and pediculosis, caused by the bloodsucking louse, are the most prevalent parasitic diseases in temperate regions. For treatment of scabies, ivermectin is suitable for mass drug administration during severe outbreaks, although patients with heavy scabies infestation may exhibit Mazzotti reactions during treatment with oral ivermectin. Another promising scabicide is Tinospora cordifolia lotion. The increase in global travel has also meant a worldwide increase in parasitic disorders endemic to tropical regions; these disorders include cutaneous larva migrans, pyodermas, arthropod-reactive dermatitis, myiasis, tungiasis, urticaria, and cutaneous and mucocutaneous leishmaniasis. Finally, patients with delusional parasitosis will express the belief that parasitical organisms are infesting their skin. Pimozide, an antipsychotic, has been successfully used to treat delusional parasitosis. This module contains 16 highly rendered figures, 2 tables, 15 references, and 5 MCQs.

Global output of research on epidermal parasitic skin diseases from 1967 to 2017

BackgroundEpidermal parasitic skin diseases (EPSD) occur in most countries and cause a considerable health and economic burden, particularly in the tropics and subtropics. The aim of this study was to assess and analyse peer-reviewed literature on EPSD in humans. The results of this study serve as an indicator of the extent the scientific community, health authorities, and international health agencies interact with EPSD as a health problem that is commonly associated with poverty and poor hygiene.MethodsA bibliometric analysis methodology was used. The Scopus database was used to retrieve documents about EPSD for the study period (1967–2017). The study focused on scabies, tungiasis, pediculosis, hookworm-related cutaneous larva migrans (HrCLM), myiasis, and cutaneous strongyloidiasis. Documents that specifically and explicitly discuss EPSD in animals, aquatic organisms, and birds were excluded.ResultsIn total, 4186 documents were retrieved. A fluctuated growth of publications on EPSD in the past five decades was found. The retrieved documents received 43 301 citations, an average of 10.3 citations per article and an h-index of 74. The keywords “scabies” and was the most commonly encountered keyword followed by the keywords “head lice” and “pediculosis”. The most active journal involved in publishing articles on EPSD was the International Journal of Dermatology (164; 3.9%). Researchers from 93 different countries published the retrieved articles. The USA led with 735 (17.6%) documents, followed by the UK (274; 6.5%), and Germany (259; 6.2%). In terms of institutions, the Charité – Universitätsmedizin Berlin in Germany was the most active in this field with 78 (1.9%) publications, followed by the Universidade Federal do Ceará in Brazil with 52 (1.2%) publications.ConclusionsResearch on scabies and pediculosis dominated the field of EPSD research to the expense of tungiasis, HrCLM, myiasis, and cutaneous strongyloidiasis. There was an underrepresentation of literature from the tropics and subtropics despite EPSD being common in these areas. This could possibly be explained by the presence of limited number of non-English journals in the Scopus database. International research collaborations and research networking should be strengthened to help advance and prioritize research on EPSD.

Pulse dye laser (PDL) treatment of cutaneous larva migrans in a pregnant patient

Pulse dye laser (PDL) treatment of cutaneous larva migrans in a pregnant patient

Epidemiology and morbidity of hookworm-related cutaneous larva migrans (HrCLM): Results of a cohort study over a period of six months in a resource-poor community in Manaus, Brazil.

BackgroundHookworm-related cutaneous larva migrans (HrCLM) is a neglected parasitic skin disease, widespread in resource-poor communities in tropical and subtropical countries. Incidence and risk factors have never been investigated in a cohort study.Methodology/Principal findingsTo understand the seasonal epidemiology of HrCLM, an open cohort of 476 children in a resource-poor community in Manaus, Brazil was examined for HrCLM monthly over a period of 6 months. Monthly prevalence and intensity of infection were correlated with the amount of monthly precipitation. Multivariable Cox regression analysis indicated male sex (hazard ratio [HR] 3.29; 95% confidence interval [CI] 1.95–5.56), walking barefoot on sandy ground (HR 2.30; 95% CI 1.03–5.16), poverty (HR 2.13; 95% CI 1.09–4.17) and age between 10 and 14 years (HR 1.87; 95% CI 1.01–3.46) as predictors of HrCLM. Monthly incidence rates ranged between 0.21 and 1.05 cases per person-year with an overall incidence of 0.52 per person-year.Conclusions/SignificanceHrCLM is a frequent parasitic skin disease in this resource-poor community. Every second child theoretically becomes infected during one year. Boys, 10 to 14 years old, belonging to the poorest households of the community, are the most vulnerable population group. Even in the tropical monsoonal climate of Amazonia there is a considerable seasonal variation with monthly incidence and number of lesions peaking in the rainy season.

Dog overpopulation and diagnosis of intestinal parasites on Santa Cruz Island, Galapagos 2016

Dog overpopulation and diseases are hazards to native island species and humans on the Galapagos. The main objective of the study reported here was to estimate the observed human:dog ratio on Santa Cruz Island, Galapagos in September 2016. In addition, dog demographic data were used to model the expected annual dog population growth in the next 10 years. A secondary objective was to measure the burden of dogs infected with intestinal parasites. The observed human:dog ratio was 964:202 (or 4.77:1), which extrapolates to 3290 dogs; an increase of 31% in the dog population on Santa Cruz from 2014 to 2016. Study results show that current spay-neuter efforts (about 300 dogs per year; 60% females, 40% males) are not enough to keep the population stable (i.e., current baseline of 3290 dogs). The frequency of dogs infected with Ancylostoma spp., an intestinal parasite in dogs that can cause cutaneous larval migrans in humans, was 18/44 or 41% (95% CI = 27%, 55%). These results provide the most complete assessment of the dog overpopulation on the Galapagos to date.

Contamination by parasites of zoonotic importance in fecal samples from Florianópolis Beaches, Santa Catarina State, Brazil

Helminths and protozoa are examples of endoparasites that, during their biological cycles, can alternate between free-life stages and parasitic stages in the environment. Pets, such as dogs and cats, live together with men and play an important role in the society; however, these animals may carry a large number of parasites which, besides showing direct pathogenicity to the host, represent risks to the human health, as is the case of parasitic zoonoses. Public areas like parks, gardens, squares and beaches may offer risks to human users since these environments may contain feces deposited by parasitized dogs. The present study verified the occurrence of helminth eggs and/or protozoan cysts or oocysts in fecal samples collected from sand strips at the beaches Armação do Pântano do Sul, Campeche and Morro das Pedras, in the south of Florianópolis Island, Santa Catarina State (SC), during the summer period. Pet feces were collected in the 2016/2017 summer season, from December 2016 to February 2017. In the Laboratory of Animal Parasitology (CCA-UFSC), fecal samples were processed based on Willis-Mollay flotation technique and Hoffman sedimentation technique. Samples from all three analyzed beaches were positive for the presence of parasites and fecal material was found along the seashore, sites where people walk freely and barefoot. Of 104 fecal samples collected, 45 (43.27%) were positive for one or more parasites. The greatest prevalence was found in Campeche Beach, which had 72.22% positive samples. Ancylostomids were most prevalent, indicating that cutaneous larva migrans is likely to occur in humans. Other parasites such as Trichuris vulpis, Toxocara spp. and Giardia spp. were also detected in coproparasitological analyses. Based on the results, it was concluded that contamination of the beaches in Florianópolis Island, SC, constitutes a public health problem due to the possibility of zoonosis transmission. These results reinforce the importance of establishing health programs for parasite control and educational programs for elucidating the risks of transmission of these zoonoses to the population, as an attempt to reduce environmental contamination risks at beaches of seaside resorts.

Larva Migrans Cutânea: apresentação típica de dois casos clínicos

Introduction: Cutaneous Larva Migrans is a dermatosis caused by nemantode parasites, mainely Ancylostoma brasiliensis and Ancylostoma caninus. It is an endemic disease in tropical countries but a rare diagnosis in the rest of the world. Case Report: We report the case of a ten-year-old child emigrated from Angola. The physical examination showed scarring injuries from previous incisions made as a form of treatment as well as a serpiginous lesion on the dorsum of the left foot, compatible with cutaneous Larva Migrans. The patient was started on albendazole and complete resolution of symptoms was obtained after one week. About that time, the patient’s brother, who had the same symptoms on both feet, was submitted to the same treatment, also with resolution of symptoms. Discussion: The authors wish to enphasize the relevance of this case due to the migration from countries with high prevalence of cutaneous Larva Migrans.

Cutaneous larva migrans at unusual sites‒A case series

Cutaneous larva migrans at unusual sites‒A case series

Retrospective study of epidermal parasitic skin diseases amongst out- patients of skin diseases hospital, Maiduguri, Borno State, Nigeria

A ten year retrospective study (1997-2006) was undertaken to determine the prevalence of Epidermal Parasitic Skin Diseases (EPSD) among out-patients from the skin diseases hospital in Maiduguri, Borno state. Out of 10,000 out-patients examined during the study period, 3527(35.27%) where infected with EPSD. Of this number, 2819(79.9%) were infected with scabies and 708 (20.1%) with Cutaneous Larva Migrans (CLM). Retroprevalence among age revealed 1912(67.83%) for the young and 907 (32.17%) for adults infected with scabies and 418(59.04%) and 290 (40.96%) for adults infected with CLM. Similarly, sex wise prevalence reveals that the males had 2031 (72.05%) and 501 (70.76%) for scabies and CLM scabies (p<0.05), while females had 788 (27.95%) and 207 (29.24%) respectively for scabies and CLM (p<0.05). Based on cumulative monthly distribution, it was most prevalent between May and September for both scabies and CLM out- patients. Adequate attention should be accorded to the risk factors such as lack of adequate sanitation, poor hygiene and overcrowding which when eliminated or reduced will reduce the burden of the disease. Keywords : Epidermal, Parasitic, Skin diseases, Scabies, CLM,

Cutaneous larva migrans in a gardener

Cutaneous larva migrans is parasitic infestation caused by animal hookworm larva which attacks the epidermis. Contact with soil which is the contaminated larva of hookworm. Cat and dog are the most popular hosts which exceed the egg of hookworm. Ancylostoma caninum and braziliensi are the most common. Diagnosis of CLM is the feature of theserpiginous eruption, lesion erythematous in and itching approximately a week after contact with contaminated soil. In this case report, we describe a case of CLM in a gardener.

Impact of climate change on dermatological conditions related to flooding: update from the International Society of Dermatology Climate Change Committee.

Climate change contributes to the increase in severity and frequency of flooding, which is the most frequent and deadly disaster worldwide. Flood-related damage can be very severe and include health effects. Among those health impacts, dermatological diseases are one of the most frequently encountered. Both infectious and noninfectious dermatological conditions are increasing after flooding. We searched PubMed using the search term climate change OR global warming OR rainfall OR flooding OR skin. Articles published in the English-language literature were included. We also searched the International Society of Dermatology website library on climate change for additional articles. There is an increased risk of trauma during the course of a natural disaster. The majority of post-tsunami wound infections were polymicrobial, but gram-negative bacteria were the leading causes. Infectious diseases with dermatological manifestations, such as impetigo, leptospirosis, measles, dengue fever, tinea corporis, malaria, and leishmaniasis, are important causes of morbidity among flood-afflicted individuals. Insect bites and stings, and parasite infestations such as scabies and cutaneous larva migrans are also frequently observed. Inflammatory conditions including irritant contact dermatitis are among the leading dermatological conditions. Dermatological conditions such as alopecia areata, vitiligo, psoriasis, and urticaria can be induced or exacerbated by psychological conditions post disaster. Prevention is essential in the management of skin diseases because of flooding. Avoiding exposure to contaminated environments, wearing protective devices, rapid provision of clean water and sanitation facilities, prompt vector controls, and education about disease risk and prevention are important.

Cutaneous larva migrans with pulmonary involvement

Cutaneous larva migrans with pulmonary involvement

Neglected tropical skin diseases in a Nigerian tertiary hospital

Background: Neglected tropical diseases (NTD) are a subset of chronic infectious diseases commonly found among the less privileged in developing countries. The World Health Organization (WHO) seeks to reduce and eventually eradicate these chronic disabling diseases which propagate poverty and under-development. The cutaneous manifestation of NTD is the major cause of morbidity and stigmatization. Thus the dermatologist has a key role to play in the abovementioned WHO goal. This study aims to identify skin NTD in a dermatologicpractice in Nigeria and to mention some challenges to effective control of some.Materials and Methods: This is a descriptive retrospective study in which the records of all patients presenting with skin NTD were extracted from the general dermatology out-patient records and analyzed.Results: Two thousand seven hundred and fifty (2750) records of patients in the dermatology out-patient clinic were assessed, out of which 154 had skin NTD, accounting for 5.6% of the total population. The vast majority were males (63.6%), with a male to female ratio of 1.8:1; and a mean age of 28.4 ± 17.4. Six NTDwere identified, and the predominant type was scabies (66.9%), which was more common in males and students. Onchodermatitis (14.3%) on the other hand had a female preponderance.Conclusion: Neglected tropical skin diseases (NTSD) are common in the urban dermatology clinic. The most prevalent (scabies) is a highly contagious disease, whose diagnosis remains sub-optimal among healthcare practitioners. Dermatologists are best positioned to ensure early diagnosis of a good number of NTD and stem their progression before the morbidity, disfigurement, stigmatization, and attendant short, andlong-term complications develop.Keyword: Neglected Tropical Skin Diseases, Nigeria, Scabies, Leprosy, Cutaneous Leishmaniasis, Lymphatic filariasis, Cutaneous larva migrans

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

sCutaneous 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.

Cutaneous Larva Migrans in an Infant.

Cutaneous Larva Migrans in an Infant.