Cutaneous larvae migrans (CLM) is a parasitic skin infection historically found in tropical and subtropical areas with large populations of hookworms. Also sometimes spelled as cutaneous larva migrans, this condition is self-limiting in nature, as the hookworms cannot exploit human hosts. Medications are available to speed the end of the infection and make people feel more comfortable, in addition to preventing rare complications.
People contract cutaneous larvae migrans by coming into contact with infected fecal material, usually from cats and dogs. It can be especially common in sandy soils, but other soil types can play host as well. Walking barefoot, digging with the bare hands, or allowing other bare skin to come into direct contract with infected soil can provide a point of entry for the parasites.
The entry wound will become red and swollen, and reddish lines and trails will appear under the layers of the skin, showing the tracks of the parasites as they move through the body. Eventually they will die off, the infection will resolve, and the patient's skin should return to normal. In some patients, cutaneous larvae migrans can lead to complications like heart disease or secondary infections caused by scratching and tearing at the infected area of skin.
Topical antiparasitic drugs are the first line of treatment. Patients wash the area with warm soapy water, pat dry, and apply the medication directly, allowing it to soak in. People can also take oral medications to treat a cutaneous larvae migrans infection. These medications will take longer to work and can have more side effects because it is usually necessary to take a higher dosage. Moisturizing creams can help people manage the itching and discomfort at the site of the infection and it may also be helpful to wear socks or gloves to prevent scratching.
While this condition was once most common in the tropics and subtropics, global travel has carried it to many other regions of the world. People can reduce their risks of contracting cutaneous larvae migrans by wearing shoes and socks, using gloves to garden and touch the soil, and being careful about bare skin when they are in areas where soil contamination is likely. If people start to notice a spreading red raised rash, they should see a doctor for evaluation and treatment. If the rash is the result of a parasitic infection, early treatment can limit complications and help the patient recover as quickly as possible.
