Dermoscopy of Cutaneous Larva Migrans

A man in his 20s presented with itchy skin lesions over the right side of his trunk for 1-week duration. Cutaneous examination revealed multiple skin-coloured linear bizarre tracts and papules over the right side of the trunk extending to the arm and axilla [Figure 1a and b]. The rest of the mucocutaneous examination was non-contributory. A diagnosis of cutaneous larva migrans was made. The patient was initiated on tablet albendazole 400 mg along with tablet ivermectin for 3 days following which he had improvement in skin lesions [Figure 1c]. Dermoscopy examination revealed brownish linear serpiginous tracts suggestive of cutaneous larva migrans [Figure 2]. The brownish linear serpiginous tracts suggest a larval body and brownish dots represent an empty larval tract in the image [Figure 2]. Larva migrans is usually a diagnosis made clinically, however, dermoscopy can aid as an adjunct to the diagnosis.

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Figure 1:

(a) Multiple skin-coloured linear bizarre tracts and papules over the right side of the trunk extending to the arm and axilla. (b) Close-up image showing serpiginous tracts of larva migrans. (c) Improvement in skin lesions noted on follow-up after 3 weeks.

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Figure 2:

Dermoscopy image (DermLite, × 10, polarised mode) revealed brownish linear serpiginous tracts (larval body) with brownish dots (empty larval tract) suggestive of cutaneous larva migrans.

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