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VERIFIED CONTENTAuthor: Klaudia Kierzkowska, graduate of chemistry at the University of Warsaw

Migrating cutaneous larvae syndrome is a rare disease in Poland. It is most common in tropical and subtropical countries, and therefore can be caught on exotic holidays. What is the manifestation of cutaneous larvae migrating syndrome and what is its treatment?

The migrant cutane larvae syndrome(Latin syndroma larvae migrantis cutaneae, larva migrans cutanea) is a complex of skin lesions caused by larvae of various species of hookworms traveling in the subcutaneous tissue. They are small nematodes that are only 9 to 15 mm in diameter and are usually found in dogs and cats. Although the disease is most often diagnosed in the areas of the tropical and subtropical zones, sporadic cases of the disease, which are a "souvenir" from holidays, are also recorded in Poland.

Causes of migrating cutaneous larvae syndrome

Migrating cutaneous larvae are most often caused by two types of nematode larvae - necatorosis larvae (Necator americanus) and ancylostomosis (Ancylostoma duodenale). These tiny parasites have a mouthful with cloves, which they attach to the lining of the small intestine and collect blood.

Nematodes are found mainly in dogs and cats. They hatch from eggs excreted in the animals' faeces, and then undergo the process of maturation in warm and humid conditions.

How is it infected?

Larvae hatch from the eggs excreted with the faeces, in the ground or sand, and after 7 days they become invasive. As a result of contact of human exposed skin with soil contaminated with parasites, infection occurs. The larvae pass through the undamaged epidermis, under which they "wander", digging channels.

Parasites are unable to penetrate the deeper layers of the skin. Ancylostoma larvae, in humans, do not reach puberty and usually die after a few weeks.

Symptoms of migrating cutaneous larvae syndrome

The migrating cutaneous larvae has characteristic symptoms. A local inflammatory reaction appears at the point of penetration of the parasite and along the tortuous tubules formed as a result of the migration of the larvae. On the border of the epidermis and skinwe can observe redness and swelling, which is getting bigger every day.

The larva, moving a few centimeters a day, creates tortuous and slightly convex channels. Inflammation is a symptom of hypersensitivity to parasites and their metabolic products. Skin lesions that are striated in nature are often pruritic. The canal bored by the larva is several centimeters long.

At its end you can see a lump, i.e. the place where the parasite lives. Skin lesions most often appear on the feet, buttocks or abdomen. These places are attacked by the parasite mainly when the infected person lies directly on the sand on the beach.

Over time, blisters may appear at the site of the inflammation. Additionally, you may experience abdominal pain, diarrhea or a feeling of fullness.

Diagnostics of the migrating cutaneous larvae syndrome

Diagnostics is mainly based on the diagnosis of the clinical picture. Although the diagnosis of the disease is not difficult, in some cases a diagnostic skin biopsy is necessary.

A person who has stayed in the areas of endemic occurrence of the disease, should immediately see a doctor if disturbing changes are noticed on their body.

Treatment of migrating cutaneous larvae syndrome

Migratory cutaneous larvae are treated with antiparasitic, antipruritic or antiallergic drugs. The disease is mild, and so far no fatalities have been reported.

Under the influence of drugs or spontaneously within a few weeks, the larvae die. In the case of bacterial superinfection, which is a complication of the disease, antibiotic therapy is necessary.

Although the larvae do not penetrate the dermis, this may happen from time to time. Then the larva matures and locates around the duodenum, which requires hospital treatment.

How to avoid getting sick?

To prevent the disease, when on vacation in a tropical or subtropical zone, avoid skin contact with moist sand or earth if possible.

Children should not sit directly on the sand, but on a towel or a blanket. It is also recommended to wear shoes on beaches where the disease is endemic and to avoid contaminated beaches.

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