An 11-month-old infant presented with a 12-day history of serpiginous lesion over the left buttock [Figure 1a]. Apart from mild anemia and eosinophilia, rest of the investigations including stools were normal. Two doses of oral ivermectin (200 μg/kg, 1.5 mg), one week apart, completely cleared the lesion [Figure 1b and c].
Figure 1
(a) Serpentine flesh-colored lesion over the left buttock (pre-treatment). (b) Partial clearance of the lesion after 1 week following treatment. (c) Complete resolution of the lesion after 2 weeks of treatment
(a) Serpentine flesh-colored lesion over the left buttock (pre-treatment). (b) Partial clearance of the lesion after 1 week following treatment. (c) Complete resolution of the lesion after 2 weeks of treatmentCutaneous larva migrans (CLM), also known as “creeping eruption” or “epidermatitis linearis migrans,” is a common infestation in tropics and subtropics, most commonly caused by larva of Ancylostoma brasiliense.[1]The larvae enter into the human skin through minor abrasions or even intact skin through hair follicles. Most common sites of involvement are the dorsum of feet and buttocks. The characteristic lesions are intensely itchy, raised and skin-colored to erythematous, and in linear, bizarre, or serpentine pattern.[1] Dermoscopy can be a helpful aid in the clinical diagnosis, but it may fail to detect the larvae in a majority of patients.[2] It was not done in our case.CLM is rare in infancy,[3] and cases can also be seen in nonendemic regions.[4] Hence, familiarity with the condition is important for correct diagnosis and management.Ivermectin has been used successfully to treat scabies in infants,[5] and it may be a useful option to treat CLM,[1] as seen in our case.
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