History and findings: Cutaneous larva migrans (CLM) is a zoonotic hookworm infection. Since survival and mobility of the worm larvae depend on external temperature, CLM is most frequently acquired in subtropical or tropical areas. Two women, aged 39 and 60 years, respectively, presented themselves in the outpatient department with pruriginous skin lesions, first noted several days before. Neither had been abroad, but both had been walking around a dredged lake in North Rhine-Westphalia some days before. The characteristic serpiginous skin lesions were identified as larva migrans cutanea ("creeping eruption"; sandworm). It is caused by the larvae of a zoonotic hookworm infection.
Treatment and course: The lesions regressed after a single dose of ivermectin 0.2 mg/kg body weight.
Conclusion: CLM occurs most frequently in warm regions. It may sometimes also occur autochtchoneusly in Germany, especially in sandy soil, during the summer months. This must be taken into account when patients with pruriginous skin lesions are seen. Therapy with ivermectin is efficacious and safe.
Georg Thieme Verlag KG Stuttgart. New York.