Serpiginous Travels: A Case of Cutaneous Larva Migrans

Cutaneous larva migrans (CLM) is a term used to describe the migrating linear skin lesions caused by the burrowing of parasitic nematode larvae within the epidermis. It may cause significant discomfort and distress to patients despite being a relatively self-limiting condition. We present a case of a 34-year-old female with no significant past medical history who arrived at our institution with a pruritic rash on the left foot. Previous treatment with antivirals and azoles was ineffective. Interestingly, her travel history revealed a recent trip to Barbados which broadened the differential for parasitic infections. The patient was prescribed a course of ivermectin and discharged. She returned to the Infectious Disease clinic three weeks later for follow-up with near resolution of the rash. In our case, we highlight the importance of obtaining a thorough social history when encountering cutaneous lesions as well as key differences in the treatment of hookworm compared to other parasitic infections.