5 responses to “Practice Tip: Cutaneous larva migrans”

  1. Nice approach and fact about importance of history of travel.
    Good overview of available medications and the best treatment options.

  2. Thanks for the information on risky beach sand exposures, and on treatments.

  3. Excellent update in a nutshell

  4. I have seen this infection in my office on a number of occasions and am glad to hear that Ivermectin is now available in Canada. Excellent update on risk factors, diagnosis and management for Canadian primary care physicians given the frequency of vacation travel of our population to highly endemic areas!

  5. Very good.
    I have a patient who travels quite a bit to warmer climes, has chronic respiratory issues (and is on prednisone quite often), along. with chronic anemia -remote Roux en y – family history of death due to colorectal cancer at age 57. This rash is new and she described it as starting with little blisters on her lower back. They have gone.The current, large serpentine rash is on her upper back. No recent travel but the rash is alarming. I am looking into DDX shingles. I actually did a house call as staff said she wasn’t feeling well enough to come to her appointment. I am her psychiatrist in a shared care team. She expressed she felt dismissed by her GP. Seeing her labs before the house call I was very surprised. Her Hb is 87 g/L which is low even for her. Pathologist remarked on slight microcytosis.
    She is of course concerned about the family hx cancer; B12 normal without supplement. ESR normal. No iron infusion suggested and she has never had any.
    She has a small, older terrier type dog that looked well. She hasn’t had him dewormed for years.
    Considering the chronically low Hb that seems resistant, chronic cough, and this rather alarming rash I wonder if it is hookworm. I know it can cause severe anemia in dogs and rarely goes to the lungs.
    But, alas, I am not a “real Dr” being a psychiatrist. So for my part am lending an ear, referring to an Internist who specializes in bariatric medicine, and running this idea to her GP, who reportedly ran from the room when he saw the rash and later told her he is planning a punch biopsy.
    The rash was impressive. I wonder if the prednisone she is on is suppressing any itching. I would have expected it in either migrans or shingles.

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