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Cutaneous Larva Migrans (CLM) is a distinctive cutaneous condition characterized by lesions that creep or migrate, and are due to the presence of moving parasites in the skin. The parasites are all hookworms of animals, and man is accidentally infected after contact with soil contaminated by faeces of infected dogs and cats. The species most frequently involved are Ankylostoma braziliense and Ankylostoma canium . Though the condition is self limiting, various treatment modalities have been tried viz., cryotherapy, ethyl chloride spray, liquid nitrogen and carbon dioxide snow, topical 10% thiabendazole, systemic thiabendazole, ivermectin and albendazole . We report a case successfully treated with oral albendazole.
A 32 year old male presented with multiple, bizarre, itchy, oozing lesions over left forearm of two weeks duration. He gave history of handling a domestic cat 2 to 3 weeks prior to onset of his symptoms. General physical and systemic examination were normal. Dermatological examination revealed multiple, serpiginous, erythematous, snail track, tortuous raised lesions over extensor aspect of left forearm with eczematization (Fig 1). Investigations revealed eosinophilia. He was diagnosed as a case of CLM and given tab albendazole 400 mg daily for three days. The lesions regressed with in a week but he developed fresh lesion over the same forearm, within a few days. After another course of albendazole 400 mg. twice daily for three days, the lesions disappeared. He remained symptom free during follow up for one month.
Albendazole has been used in the treatment of CLM in dosages varying from 400 to 800 mg. for durations ranging from 1 to 7 days . However, lack of cure and recurrences following treatment have been reported . Our case had partial response to albendazole 400 mg. daily for 3 days. A second course of albendazole in higher dose finally cured the condition. The aim of reporting this case is to enhance the awareness of this condition and stress the need for a high dose schedule for its treatment.