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Chronic hookworm-related cutaneous larva migrans.

Stefano Veraldi¹, Maria Chiara Persico, Claudia Francia

¹Department of Medical and Surgical Physiopathology and Transplantation, University of Milan, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. stefano.veraldi@unimi.it

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases

|December 11, 2012

Summary

This study describes the chronic form of hookworm-related cutaneous larva migrans, a persistent skin condition lasting over five months. This persistent presentation, often without itching, highlights a distinct clinical manifestation of the parasitic infection.

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Area of Science:

Dermatology
Infectious Diseases
Parasitology

Background:

Hookworm-related cutaneous larva migrans (CLm) is typically an acute, self-limiting condition.
A persistent or chronic form of CLm, characterized by prolonged duration and absence of pruritus, has been less frequently described.

Purpose of the Study:

To present and characterize the 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans (CLm).
To document the clinical presentation, duration, and histopathological findings of untreated, persistent CLm.

Main Methods:

Retrospective case series of 13 patients diagnosed with clinically typical CLm lasting over 5 months.
Patients were identified between 1998 and 2011, with no prior treatment due to the absence of pruritus.
Clinical data, geographical acquisition of infestation, lesion location, and histopathological findings were analyzed.

Main Results:

Thirteen patients (10 males, 3 females; aged 23-55) presented with CLm lasting 5-14 months (mean 7.8 months).
Infestations were acquired in various tropical and subtropical regions, with lesions predominantly on the feet.
Histopathology revealed dermal edema and inflammatory infiltrates (lymphocytes, eosinophils) without detectable larvae.

Conclusions:

The findings support the existence of a 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans.
This form presents differently from typical CLm, particularly with its prolonged duration and lack of pruritus.
Further research into the pathogenetic mechanisms of persistent CLm is warranted.