A Fateful Trip to the Beach
A 33-year-old man came to the dermatology outpatient clinic with a 1-week history of blisters on both feet. The blisters were accompanied by sinuous reddish ductular structures (Figure). The patient had recently returned from a holiday in Brazil, where he had spent time on the beach. This travel history, together with the unambiguous clinical picture, led us to diagnose larva migrans. This disease is commonly found in visitors to the tropics who come into direct contact with sand containing the larvae of various parasites which can migrate through the skin. The larvae reach the sand via the excreta of dogs and cats, so travelers should avoid beaches where these animals can be found. The wearing of shoes with impervious soles helps to prevent infestation. Treatment with albendazole 800 mg/day p.o. for 3 days led to complete recovery. Alternatively, ivermectin could have been given by the same route.
Dr. med. Sebastian Krammer, Prof. Dr. med. Lars E. French, Prof. Dr. med. Michael Flaig
Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Sebastian.Krammer@med.uni-muenchen.de
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by David Roseveare.
Cite this as: Krammer S, French LE, Flaig M: A fateful trip to the beach. Dtsch Arztebl Int 2020; 117: 147.