A creeping eruption

January 31, 2018

Figure 1 Quiz of the Week

A 40-year-old male presents to his family physician with a pruritic, erythematous lesion on his foot after returning from vacation in coastal Brazil a week earlier. He adds that the lesion has migrated since he first noticed it. On examination, a serpiginous, slightly elevated tunnel can be seen on the lateral aspect of his left foot. He is otherwise well, but mentions that the intense pruritus is disturbing his sleep.

Which of the following treatments is the next best step?

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Answer: Ivermectin

This patient has cutaneous larva migrans, a cutaneous migratory parasitic infection. It is caused by the larvae of hookworms, most commonly found in sandy areas within subtropical and tropical climates. A single dose of ivermectin is recommended to relieve pruritus and reduce the risk of systemic infection. A short course of albendazole can also be administered as an alternative treatment.

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