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