Cutaneous larva migrans is a parasitic skin infection caused by hookworm larvae that usually infest cats, dogs and other animals. Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that harvest the parasite. It is also known as creeping eruption as once infected, the larvae migrate under the skin’s surface and cause itchy red lines or tracks.
A 60 year old male had come to my clinic with a history of full body itching with redness for the past 3 weeks. He had been to several doctors for his condition and was given only medications for symptomatic relief. However, his symptoms persisted. When probed into the history of the disease, he revealed to me that he had went for swimming in the last 3 weeks. With this history and with the typical skin presentation as shown in the left sided image, a diagnosis of Cutaneous larva migrans was made. He was treated with anti-parasitic drugs and his condition had healed.
As a teacher, I always advise my students to probe into the root cause of a particular disease and treat that cause instead of the symptoms. This is a key clinical skill for medical students to learn. And as patients, it is important to disclose all the relevant history to the doctor even if he or she feels it to be disregarded. A proper clinical history still remains the golden rule for diagnosis.