Serpiginous Foot Lesions in a Barefoot Child: A Case Report of Pediatric Cutaneous Larva Migrans

Zulfan Zulfan; Nanda Earlia; Vella Vella; Nisa Fitriani Daud

doi:10.60084/ijcr.v4i2.432

Authors

Zulfan Zulfan Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
Nanda Earlia Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
Vella Vella Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
Nisa Fitriani Daud Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia

DOI:

https://doi.org/10.60084/ijcr.v4i2.432

Keywords:

Creeping eruption, Hookworm infection, Serpiginous lesion, Albendazole, Tropical dermatoses

Abstract

Cutaneous larva migrans (CLM) is a common zoonotic parasitic dermatosis in tropical regions, most commonly caused by Ancylostoma braziliense and Ancylostoma caninum. The disease is strongly associated with direct skin contact with soil or sand contaminated by dog or cat feces and is particularly prevalent among children. Clinically, CLM is characterized by intensely pruritic, erythematous, linear or serpiginous tracks that may progressively migrate over time and are often misdiagnosed as other inflammatory or infectious dermatoses. We report a case of a 13-year-old boy who presented with a one-week history of pruritic, erythematous, serpiginous lesions on the dorsum and plantar surface of the left foot. The lesions progressively elongated and were accompanied by pain during ambulation (Visual Analogue Scale 8/10), exceeding the intensity of pruritus. The patient had a history of frequent barefoot exposure to moist soil around his home. Dermatological examination revealed well-demarcated, erythematous serpiginous tracks localized to the left foot. Skin scraping with potassium hydroxide (KOH) preparation showed no fungal elements or larvae. Based on the characteristic clinical features and exposure history, CLM was diagnosed. The patient was treated with oral albendazole 400 mg once daily for three days, along with antihistamines and topical corticosteroids. Significant clinical improvement was observed, with complete resolution of pain (VAS 0/10) and pruritus, with residual post-inflammatory hyperpigmentation at one-week follow-up. This case highlights the importance of recognizing atypical clinical features of CLM, particularly when pain predominates over pruritus, and underscores the critical role of environmental exposure history in establishing early diagnosis. Prompt recognition and appropriate treatment are essential to prevent unnecessary investigations and reduce patient morbidity.

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