- Tingling/prickling at the site of exposure within 30 minutes of penetration of larvae, although Archer describes a case of late-onset cutaneous larva migrans (CLM)[6]
- Intense pruritus
- Erythematous, often linear lesions that advance
- Often associated with a history of sunbathing, walking barefoot on the beach, or similar activity in a tropical location
- Predispositions to contracting cutaneous larva migrans include the following:
- Hobbies and occupations that involve contact with warm, moist, sandy soil
- Tropical/subtropical climate travel
- Barefoot beachgoers/sunbathers
- Children in sandboxes
- Carpenter
- Electrician
- Plumber
- Farmer
- Gardener
- Pest exterminator
Physical
- Cutaneous signs of cutaneous larva migrans (CLM) include the following:
- Pruritic, erythematous, edematous papules and/or vesicles
- Serpiginous (snakelike), slightly elevated, erythematous tunnels that are 2- to 3-mm wide and track 3-4 cm from the penetration site
- Nonspecific dermatitis
- Vesicles with serous fluid
- Secondary impetiginization
- Tract advancement of 1-2 cm/d
- Systemic signs include peripheral eosinophilia (Loeffler syndrome), migratory pulmonary infiltrates, and increased immunoglobulin E (IgE) levels, but are rarely seen.
- Lesions are typically distributed on the distal lower extremities, including the dorsa of the feet and the interdigital spaces of the toes, but can also occur in the anogenital region, the buttocks, the hands, and the knees
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