Cutaneos larva migrans in travelers

The symptoms, medical history, and treatment of 98 patients with
cutaneous larva migrans (creeping eruption) who attended a
travel-related-disease clinic during a period of 4 years are
reviewed. This condition is caused by skin-penetrating larvae of
nematodes, mainly of the hookworm Ancylostoma braziliense and other
nematodes of the family Ancylostomidae. Despite the ubiquitous
distribution of these nematodes, in the investigated group only
travelers to tropical and subtropical countries were affected;
28.9% of the patients had symptoms for > 1 month, and for 24.5%
the probable incubation period was > 2 weeks. The efflorescences
typically were on the lower extremities (73.4% of all locations).
The buttocks and anogenital region were affected in 12.6% of all
locations, and the trunk and upper extremities each were affected
in 7.1%. Only a minority of patients presented with eosinophilia or
an elevated serum level of IgE. No other laboratory data appeared
to be related to the disease. Therapy with topical thiabendazole
was successful for 98% of the patients. Systemic antihelmintic
therapy was necessary in two cases because of disseminated,
extensive infection.