[Cutaneous manifestations of strongyloidosis]

Strongyloidiasis is a parasitic disease, caused by Strongyloides stercoralis, an intestinal nematode, which is mainly endemic in tropical and subtropical regions. It can be sporadically found in the temperate zone, especially in closed communities and among people living under bad social conditions. Gastrointestinal, pulmonary and cutaneous symptoms may arise during the migration of the larvae. The infections are chronic and poor in symptoms among immunocompetent patients. Sometimes the cutaneous manifestation is the only symptom of the disease besides the distinct eosinophilia. Intense itching, erythematosus papule and petechiae develop at the site of the skin infection. Rapidly progressing linear, serpiginous, urticarial streaks are the pathognomic cutaneous manifestations that are called larva currents. The appearance of erythematosus, linear stripes are due to the migrating larvae in the skin. The most common nonspecific symptoms are urticaria, maculopapular exanthema, localized or generalized pruritus and prurigo. The parasite is uniquely able to carry out its whole life cycle inside the human body, so in immunocompromised patients the disease can lead to a hyperinfection syndrome with high mortality, due to the accelerated endogenous autoinfection. Authors present all possible skin manifestations of the strongyloidiasis, based on the case history of three brothers and sisters and that of a female patient suffering from hyperinfection syndrome.