1Postgraduate, Department of Dermatology, Venereology and Leprosy, Meenakshi Medical College, Hospital and Research Institute, Kanchipuram, MAHER University, Chennai
2Professor and HOD, Department of Dermatology, Venereology and Leprosy, Meenakshi Medical College, Hospital and Research Institute, Kanchipuram, MAHER University, Chennai
3Asssistant, Department of Dermatology, Venereology and Leprosy, Meenakshi Medical College, Hospital and Research Institute, Kanchipuram, MAHER University, Chennai
*Correspondence: Dr. C Harriton, E-mail: doctor.harriton@gmail.com
Title: Diverse Clinical Presentations Of Cutaneous Larva Migrans: More Than A Serpiginous Rash
Background: Cutaneous larva migrans (CLM) is a parasitic skin infestation caused by the migration of animal hookworm larvae within the epidermis, usually acquired through contact with contaminated soil or sand. The classical presentation is an intensely pruritic serpiginous track, most commonly involving the feet or buttocks. However, atypical anatomical sites and unusual morphological variants may lead to diagnostic confusion with other dermatoses.
Aim And Objectives: To describe the diverse clinical presentations of cutaneous larva migrans and highlight the importance of recognising atypical anatomical sites, morphological variants, and occupational risk factors in endemic settings.
Methods and materials: A case series of ten patients presenting with clinically diagnosed cutaneous larva migrans was evaluated. Patients ranged in age from 10 to 52 years and had varied occupational and environmental exposures. Clinical assessment included lesion morphology, anatomical distribution, exposure history, differential diagnoses considered, and response to treatment.
Results: Among the ten cases, most patients were young adult males with outdoor occupations, including farming, construction work, and street vending. Unusual anatomical sites included the elbow, forearm, finger, waistline, lateral thigh, abdomen, and thigh. Morphological variants observed included papular, nodular, ulcerative, pigmented, tinea-like, and multifocal serpiginous lesions. One patient presented with a generalized papular eruption suggestive of an id (hypersensitivity) reaction, while another showed simultaneous involvement of two anatomical sites (abdomen and thigh). Treatment varied based on lesion extent and included cryotherapy in two patients, topical therapy in three patients (10% thiabendazole cream, topical ivermectin 1% cream, and compounded topical thiabendazole), oral ivermectin in three patients, and oral albendazole in two patients.
Conclusion: Cutaneous larva migrans can present with a broad spectrum of clinical manifestations beyond the classical serpiginous track. Atypical anatomical sites, unusual morphological variants, and multifocal involvement may mimic other dermatoses and delay diagnosis. Awareness of exposure history, careful morphological examination, and timely treatment are essential for early recognition and effective management in endemic regions.
Keywords: Cutaneous larva migrans, Atypical clinical presentation, Serpiginous skin eruption
How to cite this article: Harriton C, Kumaravel S, Nirmala R. Diverse clinical presentations of cutaneous larva migrans: more than a serpiginous rash. Int J Drug Deliv Technol. 2026;16(16s): 522-526. DOI: 10.25258/ijddt.16.16s.56
Source of support: Nil.
Conflict of interest: None