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| Cutaneous Larva Migrans, Causes, Diagnosis, Treatment, Prevention, Complications |
Cutaneous larva migrans (CLM) is a skin infection caused by worm larvae. This infection is characterized by red bumps on the skin that twist like a snake.
The type of worm that causes cutaneous larva migrans is hookworm. These worms live and lay eggs in the intestines of animals, such as cats, dogs, sheep, and horses. Worm eggs will come out with animal waste, then hatch and develop into larvae in the soil or sand.
Worm larvae can enter the human body when the skin comes into direct contact with soil or sand contaminated with hookworm larvae. For example, when walking barefoot or lying on the ground or sand without wearing a mat.
Causes and Risk Factors of Cutaneous Larva Migrants
CLM is caused by the Ancylostoma worm, which is a type of hookworm that lives in the intestines of animals, such as cats, dogs, sheep, and horses. These worms lay eggs in the intestines of these animals and come out with feces. The eggs then hatch into larvae that live in damp and sandy soil.
Two species of Ancylostoma worms that often cause cutaneous larva migrans are Ancylostoma braziliense and Ancylostoma caninum.
The larvae of this worm can enter the human body when a person sits, lies down, or walks barefoot on contaminated soil or sand. Therefore, CLM is more at risk for people who are in frequent contact with soil or sand, such as:
- Children playing on the ground or sand
- Pest exterminator, especially in rice fields
- Farmers, gardeners and construction workers
Symptoms and Signs of Cutaneous Larva Migrans
CLM often causes symptoms of an itching or stabbing sensation for 30 minutes when the worm larvae enter the skin. Larvae can stay for several months or spread slowly and form reddish bumps.
The bumps and rashes caused by the spread of hookworms are snake-like, 2–3 mm wide and 3–4 cm long from where the larvae first entered. Some areas of the body that are most often infected with this worm are the hands, feet, buttocks, and genital area.
When to go to the doctor
Check with your doctor if you experience the above symptoms, especially if you have previously done activities that put your skin in direct contact with soil or sand. Early treatment will prevent secondary skin infections.
Since hookworm larvae often live in pets, check your pet regularly to the vet, to prevent transmission of this worm infection.
Diagnosis of Cutaneous Larva Migrants
Symptoms and complaints caused by CLM can be similar to other skin disorders or disorders. To confirm the diagnosis, the doctor will ask about the symptoms and whether the patient has a job or activity that often comes in contact with sand or soil without wearing protective clothing or footwear.
Next, the doctor will perform a physical examination of the rash on the patient's skin. After that, the doctor can perform additional tests to determine the cause.
The type of investigation that can be done is optical coherence tomography (OCT), which uses light waves. This examination aims to identify the type of parasite in the skin.
Treatment of Cutaneous Larva Migrants
CLM resolves on its own in 1 to 2 months. However, your doctor will prescribe an anti-worm medication, such as albendazole or ivermectin, to treat the infection. Doctors can also prescribe antihistamines or corticosteroid ointments to relieve itching.
If the condition of the patient with cutaneous larva migrans is severe enough, cryotherapy or frozen therapy using liquid nitrogen can be performed, to stop the parasite's growth gradually.
Complications of Cutaneous Larva Migrants
Although it can heal on its own, a number of complications can occur as a result of untreated CLM, including:
- Secondary skin infection
- Loffler's disease, namely the accumulation of infiltrates and eosinophils in the lungs due to infection with large numbers of Ancylostoma worm larvae
Prevention of Cutaneous Larva Migrants
To reduce the risk of being infected with CLM, you can take the following steps:
- Wash your hands regularly
- Keeping yourself and the environment clean
- Always use footwear when walking
- Always use a mat when sunbathing on the beach sand
- Regularly check your pet to the vet
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