Topical Thiabendazole Research Articles

Cutaneous larva migrans, a neglected tropical disease of skin, with severe secondary eczematization at an unusual location.

Cutaneous larva migrans (CLM), commonly referred to as creeping eruption, is an infectious condition caused by various types of hookworms. It primarily affects the superficial layers of the skin owing to the absence of hyaluronidases and proteases. Typically, the distal lower extremities are the most commonly affected areas. The presence of distinctive lesions characterized by erythematous, winding, or serpentine tracks, slightly elevated from the skin surface, is indicative of the condition. Diagnosis primarily relies on clinical observation. Dermoscopy reveals multiple segmented yellowish-linear regions corresponding to pustules along the larval path. Treatment typically involves the use of topical and oral ivermectin, oral albendazole, and topical thiabendazole cream.

Bullous cutaneous larva migrans: an atypical case of creeping eruption

Cutaneous larva migrans is a hookworm-related infestation caused by zoonotic nematode larvae such as the Ancylostoma braziliense. Herein a case of a 2-year-old child complaining initially of painfull blisters on her left foot is report. The correct diagnosis was delayed and only confirmed when serpiginous, erythematous tracks and bullae were developed. Patient was treated with fexofenadine oral, topical thiabendazole and a cream with ketoconazole, betamethasone dipropionate and neomycin sulfate. The reported case assumes importance because of the atypical presentation of the disease as a case of bullous cutaneous larva migrans.

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

Cutaneous larva migrans (CLM), a zoonotic helminthiasis imported to Canada by travelers to the tropics, causes morbidity due to severe, intractable pruritus. Treatment in Canada is only available through the Special Access Program (SAP) of Health Canada, thus, many patients are prescribed ineffective courses of non-targeted therapy. We analyzed patients with CLM referred to our specialized Tropical Disease Unit (TDU) having failed non-targeted therapy prior to referral, and characterized demographic and travel related correlates of CLM. Patients with CLM evaluated between June 2012 and December 2014 were identified through our SAP application log, and charts were reviewed for demographic, clinical, and travel-related data following IRB approval. 25 patients with CLM were identified: 12 women, and 13 men. Median age was 35 years (range 4-58 years). Patients had primarily acquired their CLM in the Caribbean (80%), with Jamaica being the most well represented source destination (N = 10, 40%). Reported symptoms included intense, function-limiting pruritus (N = 25, 100%) and loss of sleep (N = 3, 12%). Twelve patients (48%) with CLM had received at least 1 course of non-targeted therapy prior to referral. Non-targeted therapies included topical steroids (N = 7), cryotherapy (N = 3), oral antibiotics (N = 2), and oral mebendazole (N = 11). Median duration of symptoms was 34 days (range 5-226 days). Of 25 patients with CLM, 23 (92%) were prescribed a single 3-day course of albendazole and responded appropriately, and 2 (8%) required a second 3-day course of albendazole. Although CLM is non-communicable and of little public health relevance in Canada, it causes significant morbidity. A substantial proportion of patients with CLM referred to our specialized TDU had a prolonged course of illness and were prescribed ineffective and non-targeted therapies. Oral albendazole or ivermectin, or topical thiabendazole, are the drugs of choice for CLM, and should be prescribed as first-line therapy.

Outbreak of cutaneous larva migrans in a group of travellers

We describe an outbreak of cutaneous larva migrans (CLM) in a group of 140 holidaymakers to a resort in Barbados and the index case. methods A two-page questionnaire was mailed to holidaymakers and 90% responded. results 25.4% of respondents developed a rash consistent with CLM. Risk factors for developing the illness were younger age and less frequent use of protective footwear while walking to the beach. Patients had difficulty in obtaining a correct diagnosis during their initial medical consultation and in obtaining medication from pharmacies. Efficacious treatments were oral and topical thiabendazole. conclusions CLM can occur in a large proportion of people exposed to contaminated soil or sand. Protective footwear is effective in reducing infection. Thiabendazole is an efficacious treatment.

Persistent Cutaneous Larva Migrans Due to Ancylostoma Species

Cutaneous larva migrans is considered to be a self-limited parasitic infection of about 2 to 8 weeks' duration, though it has been reported to persist for as long as 55 weeks. In this case, a healthy 47-year-old white man had multiple serpiginous lesions typical of cutaneous larva migrans for 18 months. A biopsy taken 2 months before presentation showed a parasite consistent with Ancylostoma species deep in a hair follicle. The patient initially responded to topical thiabendazole, but relapse occurred when therapy was discontinued. Oral thiabendazole cured the problem after 22 months of infestation. Cutaneous larva migrans may sometimes be long-standing, here almost 2 years, even in a healthy patient. Organisms may reside deep in the hair follicles. Topical thiabendazole may not penetrate to this depth, necessitating oral thiabendazole therapy.

Cutaneous Larva Migrans in Travelers: Synopsis of Histories, Symptoms, and Treatment of 98 Patients

The symptoms, medical history, and treatment of 98 patients with cutaneous larva migrans (creeping eruption) who attended a travel-related-disease clinic during a period of 4 years are reviewed. This condition is caused by skin-penetrating larvae of nematodes, mainly of the hookworm Ancylostoma braziliense and other nematodes of the family Ancylostomidae. Despite the ubiquitous distribution of these nematodes, in the investigated group only travelers to tropical and subtropical countries were affected; 28.9% of the patients had symptoms for > 1 month, and for 24.5% the probable incubation period was > 2 weeks. The efflorescences typically were on the lower extremities (73.4% of all locations). The buttocks and anogenital region were affected in 12.6% of all locations, and the trunk and upper extremities each were affected in 7.1%. Only a minority of patients presented with eosinophilia or an elevated serum level of IgE. No other laboratory data appeared to be related to the disease. Therapy with topical thiabendazole was successful for 98% of the patients. Systemic antihelmintic therapy was necessary in two cases because of disseminated, extensive infection.

Creeping eruption. A review of clinical presentation and management of 60 cases presenting to a tropical disease unit

Cutaneous larva migrans is an infection with a larval nematode, most frequently by dog or cat hookworms. It has a characteristic presentation that is easily recognizable. We reviewed the charts of 60 patients with cutaneous larva migrans who presented to the Tropical Disease Unit, Toronto (Ontario) Hospital, during a 6-year period. Ninety-five percent of the patients were Canadians who had recently returned from the tropics or subtropics, notably the Caribbean. Almost all patients had a linear or serpiginous, very pruritic larval track. Topical thiabendazole was efficacious in 52 (98%) of 53 patients treated. Albendazole cured six (88%) of seven patients treated. Because of adverse effects, oral thiabendazole and liquid nitrogen were not utilized. We conclude that topical thiabendazole and oral albendazole are very effective and safe modalities for the treatment of cutaneous larva migrans.

Other Roundworms: Trichuris, Hookworm, and Strongyloides

Trichuriasis may be asymptomatic or, in heavy infection, lead to profuse, bloody diarrhea and rectal prolapse. Diagnosis is made by finding the distinctive barrel shaped eggs in the stool or in the heavily infested patient, by anoscopy and identification of worms attached to reddened and ulcerated rectal mucosa. Mebendazole is the drug of choice in treatment. Capillariasis, a parasitic infection encountered mainly in the Philippine Islands, is of interest in that the eggs may be confused with the eggs of trichuris. Hookworm disease is generally asymptomatic, but in heavy infection, leads to iron deficiency and hypochromic, microcytic anemia. Diagnosis is made by finding the characteristic hookworm eggs on a examination of a direct fecal film. Accidental invasion of humans by dog and cat hookworm leads to cutaneous larva migrans, also known as "creeping eruption." Human hookworm is treated most effectively with mebendazole, while the rash produced by creeping eruption responds to topical thiabendazole. Strongyloides is fairly common in rural areas of the southeastern United States and may be seen in the urban setting among inmates of mental institutions, prisons, and in immigrants who formerly resided in endemic tropical regions. Because of its remarkable capacity for dissemination of larvae throughout the body, this parasite is now recognized as a serious problem for the patient who is immunocompromised. Diagnosis is made by finding larvae in the stool or by the Enterotest. All infected patients should be treated with thiabendazole. I consider the issue on Drugs For Parasitic Infections, published annually or biannually by The Medical Letter on Drugs and Therapeutics, to be the single best source of information on the treatment of parasitic diseases for primary care physicians.

Larva Migrans Complicated by Loeffler's Syndrome

A husband and wife contracted larva migrans while vacationing on the Gulf of Mexico. Subsequently, migratory pulmonary infiltrates and peripheral eosinophilia (Loeffler's syndrome) developed in both patients. Their cutaneous lesions were treated with topical thiabendazole and resolved within two weeks. The pulmonary complication was treated symptomatically and resolved during the next eight weeks.

Treatment of Creeping Eruption With Topical Thiabendazole

Fifteen patients with creeping eruption were treated topically with an aqueous, commercially available 10% thiabendazole suspension. Symptomatic relief of pruritus was noted within three days and 160 of 164 tracts cleared in one week.

Treatment of creeping eruption with topical thiabendazole

Treatment of creeping eruption with topical thiabendazole

Topical Thiabendazole for Creeping Eruption

A double-blind study was done to evaluate a solution of topical thiabendazole for the treatment of creeping eruption. Thiabendazole in dimethylsulfoxide applied topically favorably alters the natural course of creeping eruption and is as effective as the drug administered orally. The vehicle, dimethylsulfoxide, has no effect on the course when compared to placebo tablet therapy.

Topical thiabendazole for creeping eruption

A double-blind study was done to evaluate a solution of topical thiabendazole for the treatment of creeping eruption. Thiabendazole in dimethylsulfoxide applied topically favorably alters the natural course of creeping eruption and is as effective as the drug administered orally. The vehicle, dimethylsulfoxide, has no effect on the course when compared to placebo tablet therapy.