Follicular cutaneous larva migrans: a report of three cases and review of the literature

Background Hookworm-related cutaneous larva migrans (CLM) is characterized clinically by erythematous and slightly raised tracks, located especially on the feet. These tracks may be single or multiple, linear or serpiginous, more or less ramified and intertwined. The length is variable (up to many cm); the width ranges from 1mm to 4mm. Tracks are often accompanied by severe pruritus. Methods Three adult Caucasian patients recently returned from trips to Malaysia and Thailand, presented with follicular CLM. The disease was characterized clinically by follicular, erythematous, small papules that were sometimes topped with vesicles or pustules, located on the buttocks. Pruritus was severe. Results Histopathological examinations revealed a perifollicular infiltrate predominantly consisting of lymphocytes and eosinophils. All patients were successfully treated with oral albendazole (400mg/day for sevendays). In the first patient, two courses were necessary. Conclusions Dermatologists should be aware of the existence of this rare and atypical, although emerging, clinical presentation of hookworm-related CLM.