HOOKWORM-RELATED CUTANEOUS LARVA MIGRANS IN TRAVELER WITH AN UNUSUAL ENTRY SITE

Duangporn  Nacapunchai; Thavatchai  Kamoltham; Paron  Dekumyoy

Duangporn Nacapunchai College of Allied Health Science, Suan Sunandha Rajabhat University, Bangkok10300, Thailand
Thavatchai Kamoltham College of Allied Health Science, Suan Sunandha Rajabhat University, Bangkok10300, Thailand
Paron Dekumyoy Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand

Abstract

Hookworm-related cutaneous larva migrans (HrCLM), or creeping eruption, is an infestation caused by penetration and migration in the skin of animal hookworm larvae. It is self-limited infection but has been reported to persist for as long as 18 months. In this case, a 23-year-old healthy Thai woman who spent vacation for 3 days in Phuket and her activities included sunbathing and covering herself with sand on the beach frequented by many dogs. She developed an eruption on her abdomen a few weeks after her return to Bangkok and was treated by three doctors but the eruption prolonged for 8 months. She had an elevated serpiginous, erythematous and intertwined track localized which initial point at umbilicus, turn right, and migrated up straight then turning right along the left costal margin. A biopsy taken from the leading end of the trail revealed hookworm larva structure and cutaneous larva migran was diagnosed. The patient was treated only with oral albendazole 400 mg twice a day for 7 days. The pruritus stopped within 2 days after treatment and no recurrence was observed after 6 months. This is the first report of an unusual entry site at umbilicus.

Keywords: Cutaneous larva migrans, umbilicus, albendazole, Thailand