Treatment of cutaneous larva migrans

Cutaneous larva migrans caused by the larvae of animal hookworms is the mos t frequent skin disease among travelers returning from tropical countries. Complications (impetigo and allergic reactions), together with the intense pruritus and the significant duration of the disease, make treatment mandat ory. Freezing the leading edge of the skin track rarely works. Topical trea tment of the affected area with 10%-15% thiabendazole solution or ointment has limited value for multiple lesions and hookworm folliculitis, and requi res applications 3 times a day for at least 15 days. Oral thiabendazole is poorly effective when given as a single dose (cure rate, 68%-84%) and is le ss well tolerated than either albendazole or ivermectin. Treatment with a s ingle 400-mg oral dose of albendazole gives cure rates of 46%-100%; a singl e 12-mg oral dose of ivermectin gives cure rates of 81%-100%.