Picture of the Month—Diagnosis | Dermatology | JAMA Pediatrics | JAMA Network
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Special Feature
May 2008

Picture of the Month—Diagnosis

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Arch Pediatr Adolesc Med. 2008;162(5):486. doi:10.1001/archpedi.162.5.486

Cutaneous larva migrans presents as an intensely itchy and slowly moving linear rash on the skin caused by the infestation and migration of animal hookworms within the skin and the cutaneous reaction that results.1-4It frequently occurs following direct skin exposure to the hookworm, often during trips to the beach or from children's sandboxes where contact with the hookworm in sandy soil can occur.

The most common larva associated with cutaneous larva migrans is the dog hookworm Ancylostoma braziliense. Adult worms live and multiply in the animal's intestine. The eggs are then distributed in the soil or sand from the feces of the infected animal. Under warm and moist conditions, the ova hatch into infective larvae and can then penetrate intact skin when in direct contact.1