Dermoscopy of cutaneous larva migrans

A 45-year-old Indian woman presented with intensely itchy linear red rash on the abdomen of five days duration. Dermatological examination revealed a well-defined elevated erythematous serpentine to bizarre tract of 2-3 mm width and 12 cm in length on an erythematous background. There were crusted erosions and scaling proximally and multiple pustules in a linear fashion on the distal end located on the right lumbar region [Figure 1]. Dermoscopy (Illuco IDS 1100, ×10 polarised) of centre of the lesion showed well-defined segmented yellowish-white linear structure which may correspond to larval body with a pinkish erythematous background and brown dots with peripheral white scales that correspond to empty larval tract [Figure 2a]. Dermoscopy of distal half of the lesion showed multiple segmented yellowish linear areas which correspond to pustules along the larval tract probably due to intense inflammatory reaction to the larva [Figure 2b]. This might be a peculiar finding which has not been described previously in the literature. Although the diagnosis of cutaneous larva migrans is clinical in most of the cases, dermoscopy can prove to be a useful adjunct in confirming the active or residual stage of the infestation.

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Figure 1:

Well-defined elevated erythematous serpentine to bizarre tract of 2–3 mm width and 12 cm in length on an erythematous background with crusted erosions and scaling proximally (yellow arrows) and multiple pustules arranged in a linear fashion on distal end (red arrow) located on the right side of abdomen. Marked blue oval area shows larval body

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Figure 2:

(a) Well-defined segmented yellowish-white linear structure which may correspond to larval body (blue oval) with a pinkish erythematous background and brown dots with peripheral white scales (yellow arrow) that correspond to empty larval tract (Illuco IDS 1100, ×10 polarised). (b) Multiple segmented yellowish linear areas which correspond to pustules along the larval tract (red arrow) (Illuco IDS 1100, ×10 polarised)

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