O. Bouchaud et al., Cutaneous larva migrans in travelers: A prospective study, with assessmentof therapy with ivermectin, CLIN INF D, 31(2), 2000, pp. 493-498
The purpose of this prospective study was to update epidemiological data on
cutaneous larva migrans (CLM) and to assess the: therapeutic efficacy of i
vermectin. We performed the study between June 1994 and December 1998 at ou
r travel clinic. Ivermectin (a single dose of 200 g/kg) was offered to all
the patients with CLM, and its efficacy and tolerability were assessed by a
questionnaire. Sixty-fouls patients were enrolled. All were European and h
ad stayed in tropical areas. After the patients had returned from their des
tinations, 55% had lesions occur within a mean of 16 days (range, 1-120 day
s; >1 month in 7 patients). The initial diagnosis was wrong in 55% of patie
nts. The mean number of lesions was 3 (range, 1-15), and the main sites wer
e the feet (48%) and buttocks (23%). The cure rate after a single dose of i
vermectin was 77%. In 14 patients, 1 or 2 supplementary doses were necessar
y, and the overall cure rate was 97%. The median time required for pruritus
and lesions to disappear was 3 and 7 days, respectively. No systemic adver
se effects were reported. Physicians' knowledge of CLM, which can have a lo
ng incubation period, is poor. Single-dose ivermectin therapy appears to be
effective and well tolerated, even if several treatments are sometimes nec
essary.