Cutaneous larva migrans (CLM) is a skin infection caused by worm larvae. This infection is characterized by reddish bumps on the skin that twist like snakes.
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 in direct contact with soil or sand contaminated with hookworm larvae. For example, when walking barefoot or lying on the ground or sand without wearing shoes.
Causes and Risk Factors for Cutaneous Larvae Migrans
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 .
These worm larvae 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 often come into 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 rash caused by the crawling hookworm are characteristic serpentine, 2–3 mm wide and extending 3–4 cm from the point of entry of the larvae. Some of the areas of the body most often infected with these worms are the hands, feet, buttocks and genital area.
When to see a 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 from occurring .
Because hookworm larvae often live in pets' bodies, 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. In order to confirm the diagnosis, the doctor will ask about the symptoms and whether the patient has a job or activity that is often in contact with sand or soil without using protection or footwear.
Next, the doctor will do a physical examination of the rash on the patient's skin. After that, the doctor can carry out a supporting examination to determine the cause.
The type of supporting examination 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 amounts of Ancylostoma worm larvae
Prevention of Cutaneous Larvae Migrans
To reduce the risk of being infected with CLM, you can take the following steps:
- Wash your hands frequently
- Maintain personal and environmental hygiene
- Always use footwear when walking
- Always use a mat when sunbathing on the beach sand
- Get your pet checked regularly by the vet