Abstract
Cutaneous larva migrans (CLM) is one of the helminthic infections which is caused by penetration of the skin by canine or feline ancylostoma larvae and is characterized by the lesions with pruriginous, and serpiginous cutaneous eruption. The main species of CLM is ancylostoma braziliensis. It is mostly seen in tropical and subtropical regions. Most of the cases that are seen in developed countries are the patients who travel to these endemic regions. Even though the lesions are usually seen in foot, atypical localization (genital region, scalp, cornea and trunk) can be rarely encountered. A twenty-six-year-old male patient was admitted to our outpatient clinic with serpiginous erythematous cutaneous eruption in his abdomen and pruritus, which increased especially at night-time. There was a history of the patient about accommodating in a hostel during Thailand trip two months ago. There was no skin contact of any substance in our patient. Permethrin and sulphur treatments for scabies in this patient were received no response in another health center. The patient was forwarded to our clinic in order for the investigation of etiology after the result of infectious origin in his skin biopsy. In physical examination of the patient, there was a serpiginous erytematous cutaneous eruption raised from the skin in his abdomen. Additionally, there were erythematous papules on his buttock and lice in his hair. Another physical sign of the patient and laboratory tests were normal. The patient was diagnosed with CLM and pediculosis capitis. Cryotherapy was used and oral albendazole (Five days in dose of 400 mg/day) was given for the treatment of CLM. Permethrin was given for the treatment of pediculosis capitis. Pediculosis capitis was recovered completely 3 weeks later during a follow up period, the skin lesions of CLM were healed with postinflammatory pigmentation. In case there is a history of a patient about travelling to tropical countries in the cases of scabies treatment, a diagnosis of CLM should be kept in mind due to atypical involvement.
Keywords
References
- 1. Heukelbach J, Feldmeier H. Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans. Lancet Infect Dis. 2008;8:302–9.
- 2. Bouchaud O, Houzé S, Schiemann R et al. Cutaneous larva migrans in travelers: a prospective study, with assessment of therapy with ivermectin. Clin Infect Dis. 2000;31: 493–8.
- 3. Yavuzer K, Ak M, Karadag AS. A case report of cutaneous larva migrans. Eurasian J Med. 2010;42(1):40–1.
- 4. Çalışkan E, Uslu E, Turan H, Başkan E, Kılıç N. Cutaneous larva migrans: report of three cases from the Western Black Sea Region, Turkey. Mikrobiyol Bul. 2016;50(1):165-9.
- 5. Meotti CD, Plates G, Nogueira LL, et al. Cutaneous larva migrans on the scalp: atypical presentation of a common disease. An Bras Dermatol. 2014; 89(2): 332-3.
- 6. Benardon S, Ramoni S, Boneschi V, Cusini M, Veraldi S. Multifocal perigenital cutaneous larva migrans. G Ital Dermatol Venereol. 2014; 149(4): 477-9.
- 7. Karthikeyan K, Thappa DM. Cutaneous larva migrans. Indian J Dermatol Venereol Leprol. 2002;68(5):252–8.
- 8. Velho PENF, Faria AV, Cintra ML, Souza EM, Moraes AM. Larva migrans: a case report and review. Rev Inst Med Trop Sao Paulo. 2003;45:167–71.
- 9. Tianyi FL, Agbor VN, Kadia BM, Dimala CA. An unusual case of extensive truncal cutaneous larva migrans in a Cameroonian baby: a case report. J Med Case Rep. 2018;12(1):270.
- 10. Kudrewicz K, Crittenden KN, Himes A. A case of cutaneous larva migrans presenting in a pregnant patient. Dermatol Online J. 2014 Oct 15;20(10).
Abstract
Kutanöz larva migrans (KLM) köpek veya kedi kancalı kurdu larvalarının deriye girerek epidermis içinde ilerlemesi ile ortaya çıkan, kaşıntılı, serpiginöz kutanöz lezyonla karakterize helmintik enfeksiyonlardan biridir. KLM’nin en sık sebebi ancylostoma braziliensisdir. Tropikal ve subtropikal coğrafi bölgelerde yaygın olarak görülmektedir. Gelişmiş ülkelerde görülen vakaların çoğu, bu endemik bölgelere seyahat etmiş kişilerdir. Lezyonlar genellikle ayakta yerleşmekle birlikte nadiren atipik lokalizasyonlar (genital bölge, kafa derisi, kornea ve gövde) da karşımıza çıkabilmektedir. 26 yaş erkek hasta hastanemiz deri ve zührevi hastalıklar polikliniğine göbek etrafında kızarıklık ve geceleri artan kaşıntı şikâyetiyle başvurdu. Hastanın 2 ay önce Tayland seyahati sırasında hostelde konaklama öyküsü vardı. Deriye temas eden madde öyküsü yoktu. Dış merkezde skabiyeze yönelik verilen permetrin ve kükürt tedavilerine yanıt alınamamıştı. Alınan deri biyopsisinde enfeksiyöz etyoloji yönünde sonuç çıkması sonrası etiyoloji araştırılması açısından merkezimize yönlendirilmişti. Hastanın fizik muayenesinde göbek sağ tarafında deriden kabarık, serpiginöz, eritemli lezyon mevcuttu. Ayrıca saçlarda sirkeler ve kalçada eritemli papüller vardı. Diğer fizik muayene bulguları ve kan tetkikleri normaldi. Hastaya kutanöz larva migrans ve pedikülozis kapitis tanıları konuldu. KLM için kriyoterapi uygulandı 400mg/gün oral albendazol (5 gün, 400 mg/gün) verildi. Pedikülozis için topikal permetrin tedavisi başlandı. 3 hafta sonra kontrol muayenesinde saçlı derideki pedikülozisin iyileştiği ve KLM'ye ait cilt lezyonlarının postinflamatuar hiperpigmentasyonla iyileştiği gözlendi. Skabiyez tedavisine dirençli olgularda tropikal ülkelere seyahat öyküsü de varsa, atipik tutulumu da olması sebebiyle KLM tanısı da akla getirilmelidir.
Keywords
References
- 1. Heukelbach J, Feldmeier H. Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans. Lancet Infect Dis. 2008;8:302–9.
- 2. Bouchaud O, Houzé S, Schiemann R et al. Cutaneous larva migrans in travelers: a prospective study, with assessment of therapy with ivermectin. Clin Infect Dis. 2000;31: 493–8.
- 3. Yavuzer K, Ak M, Karadag AS. A case report of cutaneous larva migrans. Eurasian J Med. 2010;42(1):40–1.
- 4. Çalışkan E, Uslu E, Turan H, Başkan E, Kılıç N. Cutaneous larva migrans: report of three cases from the Western Black Sea Region, Turkey. Mikrobiyol Bul. 2016;50(1):165-9.
- 5. Meotti CD, Plates G, Nogueira LL, et al. Cutaneous larva migrans on the scalp: atypical presentation of a common disease. An Bras Dermatol. 2014; 89(2): 332-3.
- 6. Benardon S, Ramoni S, Boneschi V, Cusini M, Veraldi S. Multifocal perigenital cutaneous larva migrans. G Ital Dermatol Venereol. 2014; 149(4): 477-9.
- 7. Karthikeyan K, Thappa DM. Cutaneous larva migrans. Indian J Dermatol Venereol Leprol. 2002;68(5):252–8.
- 8. Velho PENF, Faria AV, Cintra ML, Souza EM, Moraes AM. Larva migrans: a case report and review. Rev Inst Med Trop Sao Paulo. 2003;45:167–71.
- 9. Tianyi FL, Agbor VN, Kadia BM, Dimala CA. An unusual case of extensive truncal cutaneous larva migrans in a Cameroonian baby: a case report. J Med Case Rep. 2018;12(1):270.
- 10. Kudrewicz K, Crittenden KN, Himes A. A case of cutaneous larva migrans presenting in a pregnant patient. Dermatol Online J. 2014 Oct 15;20(10).
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Case Report |
| Authors | |
| Publication Date | April 28, 2020 |
| Submission Date | March 7, 2019 |
| Published in Issue | Year 2020 Volume: 7 Issue: 1 |
