THE CREEPING TERROR OF CUTANEOUS LARVAE

They’re way more common than you think 

“After parasitic larvae lay their eggs in human skin, a survivor and her dermatologist must stop the infestation before the worms create a breeding ground for the next generation of horrors.” Far from being the logline to a scary movie, this is the nightmare a couple of our patients have been facing recently. 

Both cases of cutaneous larva migrans (CLM), a skin condition caused by the larvae of certain parasitic hookworms — most commonly the Ancylostoma species usually found in dogs and cats — began soon after the patients had visited two popular local beaches. CLM is most common in tropical regions like the Caribbean, since the climate is favourable for breeding. 

We deduced that by doing something completely regular, like walking barefoot in the sand or sitting directly on the beach without a towel, both patients unwittingly came into contact with the parasite, likely left behind by stray animals. (That’s not the worst part!) These hookworms then burrowed under the patients’ skin and laid their eggs, effectively making their bodies a breeding ground. 

Soon, our patients noticed redness and inflammation, complete with the telltale sign of CLM’s raised, winding lesions on their skin. The horror story gets worse: the larvae move beneath the skin, leaving tracks as they go and causing intense itching and swelling. The longer the condition goes undiagnosed, the higher the risk of secondary, bacterial infections taking hold as a result of scratching. 

Just as irritating is that the condition can last for weeks — and while it’s rarely life-threatening, it can cause significant discomfort and potential complications if left untreated. Don’t think the larvae can only enter through cuts, scratches or otherwise broken skin, either — they are perfectly capable of breaking through healthy skin.

Avoiding infection  

Beaches are not the only places that pose a risk of CLM contamination. Anywhere animals are allowed to roam freely, including in playgrounds and public parks — even your own garden — can potentially be favourable breeding grounds for the larvae. One of the worst cases we’ve ever seen was on the torso, caused by a patient doing some work under this house while bare backed.

Here are a few ways to keep yourself safe from this menace: 

• Protect your feet by wearing slippers, sandals or shoes

• Be conscious of where you put your hands

• Pick up your pets' poop before it has time to fester, and dispose of it carefully

• Deworm your pets regularly 

• Avoid sitting directly on the ground, especially in public spaces; use a mat or towel as a barrier

Treatment 

Of course, sometimes these things still happen, despite taking reasonable precautions. That’s where we come in. Depending on the patient and the level of infection, we can prescribe anything from topical anti-parasitic creams (early stage) to oral medications (more advanced), both highly effective at eliminating the hookworms.  

In terms of symptom relief, we usually recommend antihistamines or corticosteroid creams to reduce inflammation and irritation. The trick is coming to see us early. If symptoms do appear, tackling the infection in its preliminary stages can provide swift relief and get you back to normal faster.