An 11-year-old girl was referred by her general practitioner with a skin lesion on her left foot following return from Jamaica 2 weeks previously. This initially started off as a small pinpoint lesion on the sole of the foot, which had been treated as a verruca with over the counter treatment. Over time an itchy red line started to migrate from the sole of the foot to the dorsum of the foot. She could recall no trauma or insect bites but reports walking barefoot on the sandy beach and resort while on holiday. The diagnosis was uncertain in general practice and so was referred for further assessment.

Cutaneous larva migrans is a hookworm infection usually seen in tropical climates, although with the ease of travel to the tropics its incidence could well be increasing on return to the UK.¹ It is the most commonly acquired tropical dermatosis, but its presentation still remains uncommon in the UK in children. The most common hookworm organism is Ancylostoma braziliense. The natural hosts are cats and dogs. Their eggs are excreted in the animal faeces, and humans are usually infected with the larvae when walking barefoot. Therefore, the tracks seen by the hookworm are usually found on the feet, legs and buttocks. In rare cases the hookworms can mature and reside in the intestines, which cause diarrhoea and malabsorption.² The treatment options include topical thiabendazole 15% three times for 5 days, albendazole 400 mg orally once a day for 7 days or ivermectin (200 mg/kg) as a once only dose, which has advantages in paediatric practice.^{2 3} In this case we used ivermectin to good effect and with no adverse effects to the child.