• 1.

    Karthikeyan K, Thappa D, 2002. Cutaneous larva migrans. Indian J Dermatol Venereol Leprol 68: 252258.

  • 2.

    Eksomtramage T, Aiempanakit K, 2018. Bullous and pustular cutaneous larva migrans: two case reports and a literature review. IDCases 12: 130132.

    • Search Google Scholar
    • Export Citation
  • 3.

    Veraldi S, Çuka E, Pontini P, Vaira F, 2017. Bullous cutaneous larva migrans: case series and review of atypical clinical presentations. G Ital Dermatol Venereol 152: 516519.

    • Search Google Scholar
    • Export Citation
  • 4.

    Veraldi S, Arancio L, 2006. Giant bullous cutaneous larva migrans. Clin Exp Dermatol 31: 613614.

  • 5.

    Morrone A, Franco G, Fazio R, Valenzano M, Calcaterra R, 2011. Bullous cutaneous larva migrans. Acta Dermatovenerol Croat 19: 120121.

Past two years Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 7442 7442 91
PDF Downloads 204 204 28
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Bullous Cutaneous Larva Migrans of the Palm

View More View Less
  • 1 Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

A 24-year-old woman presented with 1-month history of intensely pruritic creeping eruption over her right palm. Examination revealed a slightly raised, thread-like, curvilinear tract with a 2 cm × 2 cm bulla over the left palm (Figure 1). There was a history of playing in the beach sand 1 month before the onset of eruption. Systemic examination did not reveal any abnormality. Her baseline hematological and biochemical investigations were within normal limits. Stool analysis was negative for parasites. On the basis of the history and clinical picture, a diagnosis of bullous cutaneous larva migrans (CLM) was made. The patient was treated with a single dose of oral ivermectin 12 mg and 3 days albendazole 400 mg daily for 3 days, along with oral antihistamines. The lesions showed resolution in 10 days (Figure 2).

Figure 1.
Figure 1.

Slightly raised, thread-like, curvilinear tract with a 2 cm × 2 cm bulla over the left palm. This figure appears in color at www.ajtmh.org.

Citation: The American Journal of Tropical Medicine and Hygiene 106, 5; 10.4269/ajtmh.21-1299

Figure 2.
Figure 2.

Resolution of bulla and tracts after the treatment. This figure appears in color at www.ajtmh.org.

Citation: The American Journal of Tropical Medicine and Hygiene 106, 5; 10.4269/ajtmh.21-1299

Cutaneous larva migrans is a skin infestation caused secondary to invasion and migration of nematodal larval parasites. This entity is common among tropical and subtropical countries.1 The bullous form of CLM is one of the atypical and rare forms with few case reports in literature.2,3 These types of atypical clinical presentations of CLM are currently witnessed more than in the past. The exact pathogenesis of bulla development is not known.3 Some authors hypothesized that it might be due to 1) release of lytic enzymes (hyaluronidases and metalloproteases) by the larva, 2) delayed hypersensitivity reaction to unknown antigens released by the larva, and 3) allergic or irritant contact dermatitis to topically applied medicaments.4 The cytological examinations of the bulla often reveal lymphocytes, neutrophils, and eosinophils.3 Avoiding contact with contaminated soil is the most appropriate preventative measure.1 Oral agents such as albendazole, thiabendazole and ivermectin represent the first line of treatment of bullous CLM.5

REFERENCES

  • 1.

    Karthikeyan K, Thappa D, 2002. Cutaneous larva migrans. Indian J Dermatol Venereol Leprol 68: 252258.

  • 2.

    Eksomtramage T, Aiempanakit K, 2018. Bullous and pustular cutaneous larva migrans: two case reports and a literature review. IDCases 12: 130132.

    • Search Google Scholar
    • Export Citation
  • 3.

    Veraldi S, Çuka E, Pontini P, Vaira F, 2017. Bullous cutaneous larva migrans: case series and review of atypical clinical presentations. G Ital Dermatol Venereol 152: 516519.

    • Search Google Scholar
    • Export Citation
  • 4.

    Veraldi S, Arancio L, 2006. Giant bullous cutaneous larva migrans. Clin Exp Dermatol 31: 613614.

  • 5.

    Morrone A, Franco G, Fazio R, Valenzano M, Calcaterra R, 2011. Bullous cutaneous larva migrans. Acta Dermatovenerol Croat 19: 120121.

Author Notes

Address correspondence to Palaniappan Vijayasankar, Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry 605107, India. E-mail: vijayasankarpalaniappan@gmail.com

Authors’ addresses: Palaniappan Vijayasankar, Ragavi Subramaniam, and Kaliaperumal Karthikeyan, Sri Manakula Vinayagar Medical College and Hospital, E-mails: vijayasankarpalaniappan@gmail.com, ragavi.b12@gmail.com, and karthikderm@gmail.com.

Save