Cutaneous larva migrans (creeping eruption).

A 12-year-old male child presented with an itchy red raised linear lesion over the left foot [Figure 1], gradually extending proximally since 8 days. It was initially noticed 2 days after playing barefoot on the beach. Based on the clinical features and history, a diagnosis of cutaneous larva migrans was made.

Figure 1

Tortuous, erythematous, serpiginous thin tract over the dorsa of feet. Non-specific dermatitis at the site of penetration by larva is also seen

Cutaneous larva migrans (creeping eruption) is a common tropical dermatosischaracterized by an erythematous, pruritic and serpiginous eruption with non-specific dermatitis at the site of penetration.[12]

It is caused by cutaneous penetration and subsequent migration of various nematode larvae like Ancylostoma braziliense.[13]

Symptoms usually start in a few hours after penetration. Larvae start migrating at the rate of a few millimeters to a few centimeters per day within one to six days after penetration, forming a tortuous, itchy, skin colored to erythematous and serpiginous tract.[23] It commonly affects the hand and feet.[13] Diagnosis is essentially clinical and histopathology is of little utility as the larvae may have migrated beyond the clinical lesion. No specific serological test is available.[23]

Ivermectin 200 μg/kg single oral dose is the treatment of choice presently.[2]