Treatment of cutaneous larva migrans with a single session of carbon dioxide laser: a study of ten cases in the Philippines.

BACKGROUND: Cutaneous larva migrans (CLM) has a detrimental effect on patients' emotional and physical quality of life. Due to local unavailability of gold standard oral treatments for CLM, carbon dioxide laser was attempted. We present a case series where a single session of carbon dioxide laser treatment was associated with cessation of signs and symptoms of CLM. AIMS: The aim of this study was to assess the efficacy of a single session of carbon dioxide laser in the treatment of CLM. MATERIALS AND METHODS: Ten cases (eight patients) with CLM were treated with one session of carbon dioxide laser treatment and followed up daily for the first week with photographic documentation and then weekly for the next 3 weeks to complete a 4 week follow-up period. RESULTS: The first cases in our series, who received one to two passes of fractional CO2 laser, experienced further larval migration for 2-3 days, after which no more progression was noted. For the next seven cases, we increased the number of CO2 laser passes to 3-4, and noted no further larval migration. At the end of the 4-week follow-up period, all CO2 laser-treated areas were completely healed, leaving postinflammatory hyperpigmentation of the serpiginous track. CONCLUSION: The results of this case series indicate the efficacy of a single session of CO2 laser in treating CLM. Further studies are required to identify the minimum number of passes required to effectively control CLM.

Nd:YAG photodestruction of a presumed corneal Toxocara canis larva.

PURPOSE: To describe the technique of Nd:YAG photodestruction of a presumed Toxocara canis corneal larval migrans and to report the unique clinical combination of a corneal nematode and diffuse unilateral subacute neuroretinitis (DUSN). METHODS: Clinical case report. RESULTS: A 63-year-old white male presented with idiopathic neuroretinitis treated empirically with systemic anti inflammatory therapy. Subsequently, he developed keratouveitis with an obvious corneal larva. Serology was positive for T. canis. Laser destruction of the larva combined with topical steroid and oral albendazole therapy led to initial resolution, followed by 1 episode of recurrent keratouveitis without identified ocular surface or intraocular larvae. This was cleared with topical steroids. A second empiric course of oral albendazole was also administered. The patient has shown no ocular recurrences or evidence of systemic involvement 1 year after the second course of treatment. CONCLUSIONS: Corneal larvae can be safely and successfully destroyed by Nd:YAG photodestruction. T. canis may be one of several nematodes responsible for DUSN. A careful examination of the anterior segment is essential in the management of patients with DUSN.

[Cutaneous larva migrans--an unusual case]. / Larwa wedrujaca skórna--niecodzienny przypadek.

Cutaneous larva migrans is the result of human skin infestation by nematode larvae, which penetrate through the epidermis. The case of 21-year-old woman with serpiginous, erythematosus, and linear stripes was reported. The skin lesions lasted for five months. The diagnosis of cutaneous larva migrans was established based on the typical clinical picture of infestation. Thus, it is important for infestation to be recognized clinically, so that effective treatment may be instituted. Various therapeutic modalities, including cryotherapy, topical and systemic chemotherapy, can be used in the treatment of cutaneous larva migrans. It was demonstrated, that cryosurgery is a fast and effective method in the therapy of cutaneous larva migrans infestation.

[Gadfly larva in the anterior chamber (author's transl)]. / Dasselfliegenlarve in der vorderen Augenkammer.

The larva of a gadfly (hypoderma bovis) was surgically removed from the left anterior chamber of a little girl. The corneal dystrophy and the irritation of the iris disappeared very soon after the operation and only slight defects of the iris remained, which were probably due to the operation. Similar cases in the literature and the problems of infection are discussed.