[Hookworm-related folliculitis in a woman performing skin bleaching in Benin]. / Folliculite ankylostomienne compliquant une dépigmentation cutanée volontaire au Bénin.

Hookworm-related cutaneous larva migrans is caused by the subcutaneous migration of hookworm larvae. The characteristic sign is a serpiginous cutaneous track. Folliculitis is an uncommon clinical manifestation. We report a case of hookworm-related folliculitis in a woman performing skin bleaching. A 33-year-old woman presented with a widespread cutaneous eruption made of erythematous and itchy follicular papulo-nodules, with erythematous serpiginous tracks, about 5-10cm long and numerous streaks of scratching, located on the limbs, buttocks and trunk. The cutaneous lesions occurred two days after contact with the floor of a warehouse contamined by faeces of cats. The lesions have been evolving for a week and have been treated with antibiotics without success. Clinical examination found cutaneous atrophy, purple stretch marks and hyperpigmentation of dorsal parts of fingers joints. The patient reported having been using bleaching cosmetics containing topical steroids and hydroquinone for twelve years. She was cured within 4 weeks with oral albendazole 400mg per day during 7 consecutive days.

La folliculite ankylostomienne est une forme folliculaire de larva migrans cutanée ankylostomienne rarement observée. Nous en rapportons un cas chez une patiente de 33 ans, se dépigmentant depuis 12 ans. Elle a consulté pour une éruption évoluant depuis une semaine, diffuse, très prurigineuse, apparue deux jours après le contact avec le sol d'un entrepôt souillé par des déjections de chats. L'examen physique retrouvait de nombreuses lésions de folliculites, érythémateuses coexistant avec des cordons serpigineux de dermatite rampante sur les zones d'extension des membres, le dos, les fesses et l'abdomen, typiques de folliculite ankylostomienne. Un traitement à base d'albendazole 400 mg par jour pendant 7 jours a permis d'obtenir la guérison.

[Cutaneous larva migrans in Turkey: an imported case report]. / Türkiye'de kütanöz larva migrans: bir importe olgu sunumu.

Cutaneous larva migrans (CLM) is a parasitic infection most commonly found in tropical and subtropical areas. However, with the ease and increase of foreign travel to many countries around the world, the infection is not limited to these areas. CLM is an erythematous, serpiginous infection with skin eruption caused by percutaneous penetration of the larvae to the skin. In this report, a case diagnosed as imported CLM after an Amazon trip and treated with albendazole was presented. A 36 year-old male patient admitted to infectious diseases clinic with intense itching, erythematous, raised, streaklike serpiginious eruptionand some redness at bilateral foot especially at the right foot for about one week. The patient was living in Turkey, and travelled to Brazil for an Amazon trip three months ago and the lesions began immediately after this occasion. CLM was diagnosed with the typical lesions in the patient and oral albendazole treatment 2 x 400 mg/day for 3 consecutive days was carried out with oral amoxicillin/clavulanat 3 x 1 g/day for the secondary bacterial infection. The patient responded very well to oral albendazole treatment with a result of a rapid improvementof pruritus in days and no side effect was observed during the treatment period.After discharge, during his controlit was seenthat the lesions were regressed with leaving hyperpigmentation. In cases with cutaneous larva migrans, diagnosis is often made by the presence of pruritic typical lesions and tunnels, travel story to endemic regions, the story of barefoot contact with sand and soil in these regions, and the sun tanning story on the beach. The lesions are often seen in the lower extremities, especially in the dorsal and plantar surface of the foot. Laboratory findings are not specific. Temporary peripheral eosinophilia can be seen and biopsy can be done to confirm the diagnosis but usually no parasite is seen in the histopathological examination. Contact dermatitis, bacterial and fungal skin infections and other parasitic diseases should be considered in differential diagnosis. For the treatment ivermectin 1 x 200 mg/kg single dose or albendazole 400 mg/day for three days is recommended. As a result, cutaneous larva migrans should be kept in mind especially in patients with a history of travel to endemic areas and a history of bare feet contact with sandy beaches and soil in this region and with itchy, red and serpiginous skin lesions.

Hookworm infection.

Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species. Adult worms feed on the blood of a host and can cause iron deficiency anaemia, especially in high-risk populations (children and women of childbearing age). Almost 500 million people in developing tropical countries are infected, and simulation models estimate that hookworm infection is responsible for >4 million disability-adjusted life years lost annually. Humans mount an immune response to hookworms, but it is mostly unsuccessful at removing adult worms from the bowel. Accordingly, the host switches to an immune-tolerant state that enables hookworms to reside in the gut for many years. Although anthelmintic drugs are available and widely used, their efficacy varies and the drugs do not prevent reinfection. Thus, other control strategies aimed at improving water quality, sanitation and hygiene are needed. In addition, efforts are underway to develop a human hookworm vaccine through public-private partnerships. However, hookworms could also be a resource; as hookworms have the capability to regulate the host's inflammation, researchers are experimentally infecting patients to treat some inflammatory diseases as an approach to discover new anti-inflammatory molecules. This area of endeavour might well yield new biotherapeutics for autoimmune and allergic diseases.

Asymptomatic eosinophilia due to gnathostomiasis.

The diagnosis of gnathostomiasis typically includes a triad of eosinophilia, migratory skin lesions, and exposure risk. The cutaneous manifestations are protean yet often involve intermittent migratory swellings and creeping skin eruptions with abscesses or nodules, which vary in onset and duration. We report the first case of gnathostomiasis presenting as fever and eosinophilia without cutaneous migratory and internal organ involvement.

Larva migrans: una revisión / Larva migrans: a review

El síndrome de la larva migrans abarca las parasitosis causadas por los nematodos de los géneros Uncinaria, Ancylostoma, Necator y Gnathostoma. Se ha descrito más comúnmente en lugares con climas calurosos. Se estima que 1.200 millones de personas alrededor del mundo han adquirido la infección en algún momento. La larva migrans cutánea causada por Ancylostoma caninum y A. Vrasiliense se caracteriza por trayectos eritematosos, ligeramente elevados, lineales o serpiginosos en patrones irregulares. El diagnóstico es eminentemente clínico. Es útil la biometría hemática y herramientas auxiliares como la entodermoscopia, la microscopia confocal y la biología molecular. El tratamiento más efectivo son los antiparasitarios por vía oral en especial la ivermectina.

Larva migrans syndrome includes parasitic diseases caused by nematodes of gender Uncinaria, Ancylostoma, Necator and Gnathostoma. It has been reported in tropical countries with an estimated incidence of 1.2 billon infected people around the world.Cutaneous larva migrans due to Ancylostoma caninum and A. brasiliense is characterized by erythematous linear or serpiginous sinuous tracts. Diagnosis is always done by its typical clinical features, and it can also be useful the hemathologic counts, dermoscopy, confocal microscopy and molecular biology. The most effective treatments are oral antiparasitic drugs especially ivermectin.

Cutaneous larva migrans induced by swallowing live pond loaches.

Freshwater fish, specifically loaches, are potential hosts of Gnathostoma species. Consumption of uncooked freshwater loaches may result in cutaneous larva migrans. We report the case of a 70-year-old Taiwanese man who presented with a serpiginous skin rash on his abdomen. He had eaten live loaches intermittently (sometimes daily) for 5 months before his presentation. On histopathological examination, a transected parasite body and a headbulb were found in the mid-dermis. The parasite was confirmed as belonging to the genus Gnathostoma, most likely Gnathostoma doloresi. The patient recovered uneventfully without treatment, and had no symptoms at his 12-month follow-up visit.

Cutaneous larva migrans: a neglected disease and possible association with the use of long socks.

Cutaneous larva migrans is a common parasitic skin disease that can be easily prevented by wearing 'protective' footwear. However, this has been under-emphasized in terms of what constitutes the protective footwear. Even though the disease resolves spontaneously, the significant duration of the disease along with severity of pruritus make treatment unavoidable. Here, we present a very long-standing creeping eruption, which puzzled many attending clinicians handling the case, and the possibility of long socks as a causal effect on the development of cutaneous larva migrans infection.

Localización atípica de larva migrans cutánea: presentación de un caso / Atypical location of cutaneous larva migrans: presentation of a case

Remitida por el médico de la familia se estudió una paciente de 17 años que acudió a la Consulta de Dermatología del Policlínico Flores Betancourt del municipio de Artemisa, la misma refirió síntomas que sugirieron, la entidad nosológica de Larva Migrans Cutánea con localización atípica. Para un diagnóstico más eficaz se le ordenaron exámenes complementarios de laboratorio y se obtuvo un conteo de eosinófilos elevado y heces negativas. Se le administró tratamiento tópico y sistémico con Tiabendazol. Esta zoonosis en ocasiones no se diagnostica correctamente en nuestro medio por la similitud con otras patologías por lo que se necesita de métodos preventivos para disminuir la morbilidad de esta entidad en la población de riesgo (AU)

It was studied a 17-year-old female patient that was sent by family doctors to the Dermatology Consultation of Flores Betancourt Polyclinic in the municipality of Artemisa, who referred symptoms that suggested the nosological entity of cutaneous larva migrans with atypical location. For a more effective diagnosis she was ordered complementary laboratory examinations and it was obtained a high count of eosinophils and negative faeces. She was administered topical and systemic Thiabendazole treatment. This zoonosis is not ocassionally correctly diagnosed in our environment due to the similarity to other pathologies so that preventive methods are needed to decrease morbidity from this entity in the population at risk(AU)

A case of cutaneous larva migrans acquired from soiled toilet floors in urban Kuala Lumpur.

Despite being a common skin dermatosis in the tropics, physicians in the tropics may miss the diagnosis of cutaneous larva migrans for other pruritic skin manifestation. This is especially in those who live in urban housing with no history of travel. Cutaneous larva migrans, an intensely pruritic skin pathology is mainly contracted by people with history of beach holiday or contact with moist soft sand which had been contaminated with dog or cat faeces. This article reports a patient who presented with intensely itchy papular spots over the dorsum of his foot after walking barefooted in an urban toilet soiled with cat faeces. The patient had initially seen an urban general practitioner who diagnosed the papular skin lesion as an allergic reaction, and prescribed antihistamines. The patient subsequently developed creeping skin lesions and was seen by the author who prescribed albendazole 400 mg twice daily for three days. The patient reported reduction in itching after two days of albendazole treatment and a follow up at ten days revealed a healed infection.

An itchy holiday.

A 33-year-old Dutch woman developed itchy skin lesions during a beach holiday in Thailand. She was treated for various diagnoses, without success. Finally she was successfully treated for a clinically suspected hookwormrelated folliculitis. A brief overview of hookworm-related folliculitis is given.

Baylisascariasis.

The raccoon roundworm, Baylisascaris procyonis, is the most common and widespread cause of clinical larva migrans in animals. In addition, it is increasingly recognized as a cause of devastating or fatal neural larva migrans in infants and young children and ocular larva migrans in adults. Humans become infected by accidentally ingesting infective B. procyonis eggs from raccoon latrines or articles contaminated with their feces. Two features distinguish B. procyonis from other helminthes that cause larva migrans: (i) its aggressive somatic migration and invasion of the central nervous system and (ii) the continued growth of larvae to a large size within the central nervous system. Typically, B. procyonis neural larva migrans presents as acute fulminant eosinophilic meningoencephalitis. Once invasion of the central nervous system has occurred, the prognosis is grave with or without treatment. To date, despite anthelmintic treatment of cases of B. procyonis neural larva migrans, there are no documented neurologically intact survivors. Epidemiologic study of human cases of neural larva migrans demonstrate that contact with raccoon feces or an environment contaminated by infective eggs and geophagia or pica are the most important risk factors for infection. In many regions of the United States, increasingly large populations of raccoons, with high rates of B. procyonis infection, live in close proximity to humans. Although documented cases of human baylisascariasis remain relatively uncommon, widespread contamination of the domestic environment by infected raccoons suggests that the risk of exposure and human infection is probably substantial. In the absence of early diagnosis or effective treatment, prevention of infection is the most important public health measure.

Cutaneous larva migrans: the creeping eruption.

Cutaneous larva migrans (CLM) is the most common tropically acquired dermatosis. It is caused by hookworm larvae, which are in the feces of infected dogs and cats. The condition occurs mainly in the Caribbean and New World, and anyone walking barefoot or sitting on a contaminated beach is at risk. Ancylostoma braziliense and Ancylostoma caninum are the most common hookworms responsible for CLM. The lesions, called creeping eruptions, are characteristically erythematous, raised and vesicular, linear or serpentine, and intensely pruritic. The conditions respond to oral and/or topical application of thiabendazole. Humans become an accidental dead-end host because the traveling parasite perishes, and its cutaneous manifestations usually resolve uneventfully within months.