Changing paradigms in parasitic infections: common dermatological helminthic infections and cutaneous myiasis
Section snippets
Cutaneous larva migrans
Cutaneous larva migrans (CLM) is the general term applied to an infestation caused by various nematodes that produce characteristic migratory, pruritic, and serpiginous lesions or burrows. CLM has numerous synonyms including “creeping eruption,” “creeping verminous dermatitis,” “sandworm eruption,” “plumber's itch,” and “duck hunter's itch.”
The condition is caused by the larvae of hookworms that are not normal parasites of humans, yet capable of penetrating human skin on exposure.1, 2, 3, 4, 5,
Strongyloidiasis
Larva currens, “running or racing larvae,” is a cutaneous manifestation caused by the intestinal infection or autoinfection with the human nematode, Strongyloides stercoralis, and very rarely S. fulleborn.1, 2, 3 This parasitic nematode is found in feces-contaminated soil, primarily where the ground is moist, subtropical, or tropical. The organism may be free-living and infection occurs through skin penetration by filariform larvae that measure 500 × 16 μm. The migration of the larvae are much
Enterobiasis (pin worms)
The most common helminth infection in the United States and Western Europe, especially among school-age children, is enterobiasis, infection with pinworms. Its distribution is worldwide, and it has no association with any particular socioeconomic level, race, or culture. Synonyms include pinworm or “seatworm infection,” oxyuriasis, and “threadworm.” Over 10 years ago, the estimated prevalence of this condition in the United States was reported to be as high as 42 million, but is probably much
Cercarial dermatitis or “swimmer's itch”
Cercarial dermatitis, commonly known as “swimmer's itch”, is a distinctive papular eruption which occurs when the skin of humans is penetrated by cercariae of nonhuman schistosomes (trematodes).3 Other common names for this condition are “clam digger's dermatitis,” “schistosome dermatitis,” and “sedge pool itch.” The normal hosts of these cercariae are birds, rodents, and other small mammals. There are approximately 20 species of these flukes worldwide that have been implicated in this human
Seabather's eruption
Because seabather's eruption is often confused with swimmer's itch, we mention it here, although it more appropriately should be categorized among stinging marine invertebrates rather than parasitic infections.3 (See Table 2). Seabather's eruption, also known as marine dermatitis and incorrectly termed “sea lice,” is a highly pruritic cutaneous eruption that occurs primarily under swimwear after bathing in the ocean. Most reported cases are from the Southeast coast of Florida, Cuba, Mexico, and
Myiasis
Myiasis is an infestation of the skin of mammals and humans by developing larvae (maggots) of a variety of fly species within the arthropod order of Diptera. The three main clinical types are wound, migratory, and furuncular (or follicular) myiasis. Larvae inhabit skin wounds or burrow into the dermis, causing boil-like lesions. Historically, fly larvae, and more specifically maggots, were central to Francisco Redi's experiment rejecting the theory of spontaneous generation. Maggots have been
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