Elsevier

Clinics in Dermatology

Volume 21, Issue 5, September–October 2003, Pages 407-416
Clinics in Dermatology

Changing paradigms in parasitic infections: common dermatological helminthic infections and cutaneous myiasis

https://doi.org/10.1016/j.clindermatol.2003.08.004Get rights and content

Abstract

Parasitic diseases caused by helminths, or worms, account for billions of human infections worldwide. Although most human pathogens caused by these organisms are infrequent in the United States, skin manifestations of parasitic diseases are being seen much more frequently in dermatologists' offices due to the increase in immigration and travel. Helminths are notable for their complicated lifecycles often including consecutive developmental phases, in separate hosts or in a free-living state. These parasitic organisms are usually macroscopic, multicellular organisms, and do not breed within their mammalian hosts. Notably, many helminthic diseases present with dermatologic signs and symptoms including skin nodules, cysts, migratory skin lesions, and pruritus. In this section, we discuss cutaneous myiasis as well as the four most common nematode dermatologic conditions seen in the United States.

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

References (66)

  • N. Shorter et al.

    Furuncular cuterebrid myiasis

    J Pediatr Surg

    (1997)
  • Lucchina LC, Wilson ME. Cysticercosis and other helminthic infections. In: Freeberg IM, Eisen AZ, Wolff K, et al.,...
  • D.H. Stein

    Fungal, protozoan, and helminth infections

  • D.C. Kalter et al.

    Parasitic diseases

  • C.M. Nunes et al.

    Presence of larva migrans in sand boxes of public elementary schools

    Revista de Saude Publica

    (2000)
  • L.T. MacDougall et al.

    Dirofilaria repens manifestating as a breast nodule

    Am J Clin Pathol

    (1992)
  • H.D. Davies et al.

    Creeping eruption

    Arch Dermatol

    (1993)
  • P.E. Beattie et al.

    Cutaneous larva migrans in the west coast of Scotland

    Clin Exp Dermatol

    (2002)
  • E. Caumes et al.

    Cutaneous larva migrans with folliculitisreport of seven cases and review of the literature

    Br J Dermatol

    (2002)
  • G. Yosipovitch et al.

    Widespread and unusual presentations of cutaneous larva migrans acquired in tropical sandy beach resorts

    J Eur Acad Dermatol Venereol

    (2002)
  • M.A. Roest et al.

    Cutaneous larva migrans contracted in Englanda reminder

    Clin Exp Dermatol

    (2001)
  • S. Veraldi et al.

    Epiluminescence microscopy in cutaneous larva migrans

    Acta Derm Venereol (Stockh)

    (2000)
  • E. Van den Enden et al.

    Treatment of cutaneous larva migrans

    NEJM

    (1998)
  • E. Caumes

    Treatment of cutaneous larva migrans

    Clin Infect Dis

    (2000)
  • M.M. Saez de Ocariz et al.

    Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin

    Clin Exp Dermatol

    (2002)
  • C.G. Burkhart et al.

    Ivermectin for cutaneous larvae migrans

    Cutis

    (1998)
  • G. Albanese et al.

    Treatment of larva migrans cutanea (creeping eruption)a comparison between albendazole and traditional therapy

    Int J Dermatol

    (2001)
  • G. Kang et al.

    Prevalence of intestinal parasites in rural Southern Indians

    Trop Med Int Health

    (1998)
  • P. Gilbert

    Skin problems and parasites in childrenparasitic worms

    Profess Care Mother Child

    (1998)
  • C. Nithikathkul et al.

    The prevalence of enterobiaisis in children attending mobile health clinic of Huachiew Chalermprakiet University

    SE Asian J Trop Med Pub Heal

    (2001)
  • P. Herrstrom et al.

    Allergic disease and infestation of Enterobius vermicularis in Swedish children 4–10 years of age

    J Invest Allergol Clin Immunol

    (2001)
  • M. Lacroix et al.

    Occurrence of Enterobius vermicularis in children hospitalized at a central hospital

    Ugeskrift Laeger

    (2000)
  • P. Herrstrom et al.

    Enterobius vermicularis and finger sucking in young Swedish children

    Scand J Prim Heal Care

    (1997)
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