IOP Conference Series: Earth and Environmental Science

PAPER • OPEN ACCESS Related content

- Trophic interaction of fish larvae,
Cutaneous larva migrans in a gardener phytoplankton, and zooplankton in Pari
Island lagoon
R Puspasari, A Damar, M M Kamal et al.
To cite this article: I Agustiningtyas 2018 IOP Conf. Ser.: Earth Environ. Sci. 125 012075
- Using Barnacle-Specific Primers to
Quantify Larva Attachment on Nano-Filled
Coatings during the Early Stages of
Marine Biofouling
Zhengyu Yan, Changlu Guo, Zhizhou
View the article online for updates and enhancements. Zhang et al.

- Identification normal external and internal

bacteria and fungi in larvae and pupae
Papilio polyetes
Y Sanjaya, Suhara and M Nurjhani

This content was downloaded from IP address 180.248.121.190 on 27/10/2019 at 06:53

ICTROMI IOP Publishing
IOP Conf. Series: Earth and Environmental Science1234567890
125 (2018) 012075 doi:10.1088/1755-1315/125/1/012075

Cutaneous larva migrans in a gardener

I Agustiningtyas*

Department of Parasitology and Microbiology, Medical Faculty of Universitas Islam

Indonesia
*
Corresponding author: irenaagustiningtyas@uii.ac.id

Abstract. Cutaneous larva migrans is parasitic infestation caused by animal hookworm larva
which attacks the epidermis. Contact with soil which is the contaminated larva of hookworm.
Cat and dog are the most popular hosts which exceed the egg of hookworm. Ancylostoma
caninum and braziliensi are the most common. Diagnosis of CLM is the feature of
theserpiginous eruption, lesion erythematous in and itching approximately a week after contact
with contaminated soil. In this case report, we describe a case of CLM in a gardener.

1. Introduction
Cutaneous larva migrans was the infection caused by invasion and migration of hookworm larvae,
Ancylostoma caninum and Ancylostoma braziliensis in the skin.[1] Host definitive of the Ancylostoma
sp. were cat and dog.[2] Ancylostoma sp. shed their eggs by feces and contaminated the soil.[3] The
transmission of larvae was penetrating the skin, even though no lesion or microtrauma. The larvae will
not penetrate the derm. The other name of cutaneous larva migrans was creeping eruption because it
made the tunnel of the epidermis. The larvae have a degradative enzyme that can penetrate to the skin,
which the part of epidermis was lack of collagenous.[4]
Diagnosis of cutaneous larva migrans was made by the signs and symptoms.[5] From the
anamnesis, the history of contact with soil is needed.[6] The existence of pet in the environment was a
key as a risk factor for larvae transmission.[7] The use of footwear was necessary to explore.[1] The
signs of cutaneous larva migrans were itching and the visible of erythema tunnel, serpiginous, was
called creeping eruption.[1,8]

2. Findings
In April 2017, a 45-year-old man was presented with an itchy serpiginous eruption, erythematous in
the right and left palmar (Figure 1). He reported farming and clearing the grass in the front yard of the
house where cat feces were present. One week ago, he describes his hand felt itchy, and he gives an
antibiotic topical, and salicylic acid on the lesion, but no improvement. Physical examination showed
an erythematous serpiginous eruption on the right and left palmar. A clinical diagnosis of cutaneous
larva migrans was made from the history and the clinical manifestations. Albendazole, antihelminthic
was given orally 200 mg/day for three days. The signs of the cutaneous larva migraine an
improvement after treated orally.

Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution
of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Published under licence by IOP Publishing Ltd 1
ICTROMI IOP Publishing
IOP Conf. Series: Earth and Environmental Science1234567890
125 (2018) 012075 doi:10.1088/1755-1315/125/1/012075

Figure 1. In the palmar of right and left hand: erythematous serpiginous eruption.
The use of topical cream salicylic acid.

3. Discussion
The gardener was infected by larvae of Ancylostoma sp. because did not use the glove when planting
activity. The neighborhood has many cats who defecate in the sand of his plant pots. In April, there
were rainy seasons. The eggs of Ancylostoma sp. will hatch in the supportive environment, like in this
month. For the first time, the gardener feels an itch, and in the palmar of the right and left hand, there
were papul erythematous. He applied a topicalantibiotic cream, but no improvement. After one week
later, the lesion shows serpiginous, creeping eruption. The physicians give him a prescription
antihistamine and albendazole. Albendazole was taken orally one tablet 200 mg per day for three days.
The itch was relieved after oneweek treated.

4. Conclusion
The cat was the host definitive of Ancylostoma sp. The cat shed the eggs of Ancylostoma sp. in feces.
Cutaneous larva migrans was caused by larvae of the Ancylostoma sp., which hatch in the supportive
environment. The use of glove or footwear was necessary to avoidance from the larvae because the
transmission was by invasion and penetrating larvae in the skin.

References
[1] Ma D L, Vano-Galvan S and Baden LR 2016 Creeping eruption — cutaneous larva migrans N.
Engl. J. Med. 374(14) e16 [Accessed: Oct 15, 2017] Available from:
http://www.nejm.org/doi/pdf/10.1056/NEJMicm1509325
[2] CDC 2014 Zoonotic hookworm [Accessed: Oct 15, 2017] Available from:
https://www.cdc.gov/parasites/zoonotichookworm/biology.html
[3] Tekely E, Szostakiewicz B, Wawrzycki B, Kądziela-Wypyska G, Juszkiewicz-Borowiec M,
Pietrzak A, et al. 2013 Cutaneous larva migrans syndrome: a case report Postep. Derm.
Alergol. 2(2) 119–21
[4] Purdy K S, Langley R G, Langley R G, Purdy K S, Webb A N, Walsh N, et al. 2011 Cutaneous
larva migrans Lancet 377 1948 [Accessed: Oct 15, 2017] Available from:
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)61149-X.pdf
[5] Purdy K S, Langley R G, Langley R G, Purdy K S, Webb A N, Walsh N, et al. 2011 Clinical
picture cutaneous larva migrans Lancet 377 1948

2
ICTROMI IOP Publishing
IOP Conf. Series: Earth and Environmental Science1234567890
125 (2018) 012075 doi:10.1088/1755-1315/125/1/012075

[6] Heukelbach J, Feldmeier H, Kirkpatrick R, Odendaal J, Calitz E and Caumes E 2008

Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans
Lancet Infect. Dis. 8(5) 302–9 [Accessed: Jun 18, 2017] Available from:
http://www.ncbi.nlm.nih.gov/pubmed/18471775
[7] Montgomery S P Cutaneous larva migrans
[8] Gutte R and Khopkar U 2011 Cutaneous larva migrans (creeping eruption) Indian Dermatol.
Online J. 2(1) 48 [Accessed: Oct 15, 2017] Available from:
http://www.ncbi.nlm.nih.gov/pubmed/23130223