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August 1990

Lesions on the Feet of a Scuba Diver

Author Affiliations

The Skin and Cancer Hospital, Temple University School of Medicine, Philadelphia, Pa

Arch Dermatol. 1990;126(8):1093-1094. doi:10.1001/archderm.1990.01670320117024

REPORT OF A CASE  A 22-year-old man presented with a 3-week history of pruritic lesions on his feet acquired while on a scubadiving vacation in Jamaica. In spite of being cautioned, he walked barefoot through puddles after a rain. Three to four days after returning home, he noted erythematous papules on both feet that progressed to an irregular linear lesion. He initially went to a college infirmary where he was treated with topical lindane without improvement. Physical examination revealed an erythematous firm serpiginous and excoriated rash on the dorsum and plantar surface of the left foot and plantar surface of the right foot (Figs 1 and 2). An excisional biopsy specimen of the lesion on the plantar aspect of the left foot is shown (Figs 3 through 5).What is your diagnosis?

DIAGNOSIS:  Cutaneous larva migrans.

HISTOPATHOLOGIC FINDINGS  The histologic features included a subcorneal bulla and intraepidermal vesicles containing

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