Extensive Cutaneous Larva Migrans with Eczematous Reaction on Atypical Localization
Notice bibliographique
Résumé
A 32-year-old man living in midwest Brazil presented with a 15-day history of skin eruption with severe itching after lying on a lawn in an amusement park for a few hours. The patient had no previous history of illness or use of medication. Clinical examination revealed a large (20 × 25 cm) erythematous eczematous plaque on the lower half of his back, with serpiginous tracks in some areas (Figures 1 and and22 ). The clinical characteristics of the lesions and epidemiological history are very suggestive for the diagnosis of cutaneous larva migrans (CLMs) with severe secondary eczematous reaction, on an atypical location. Therefore, considering the diagnosis, a treatment was prescribed with 5% thiabendazole, three times daily for 15 days, and 400 mg of oral albendazole daily for three consecutive days. The response to an antihelminthic drug and rapid resolution of the lesion supported the initial diagnosis of CLM. Figure 1. Large erythematous eczematous plaque on the lower half of patient's back (20 × 25 cm). Figure 2. Serpiginous tracks in some areas of the erythematous eczematous plaque on the lower half of patient's back. CLM is caused by the accidental larval migration of nematodes (most commonly Ancylostoma braziliense) into the epidermis.1–4 This skin infestation, typical of subtropical and tropical regions, is endemic to the Caribbean, Central and South America, and Africa.1–3 With the growing frequency of travel to these areas, the incidence of the disease has also increased elsewhere. Walking barefoot on beach sand is a common feature.2 The larvae penetrate the corneal layer of human epidermis upon contact with soil contaminated with dog or cat feces containing excreted eggs, which in hot, humid environments become filariform larvae.1,4 These larvae migrate within the epidermis, causing an inflammatory reaction with intense itching, eruptions, and a serpiginous aspect that spreads a few centimeters a day.1–4 Lesions are usually few in number, and commonly affected sites include feet, thighs, and buttocks in adults.1,5 Only 7% of lesions occur on the trunk.5 The presence of multiple larvae may produce bizarre patterns.5 Diagnosis is clinical, based on the appearance of the lesions, with an emphasis on patient epidemiology.1,2 Biopsy is not useful.1–3 Differential diagnosis includes scabies, myiasis, tinea corporis, and contact dermatitis.1 Despite the self-limiting nature of the disease, severe itching, risk of secondary infection, and (in some reported cases) progression to Loeffler's syndrome warrant treatment with antihistamines and anthelminthics. First-line treatments are ivermectin and albendazole.1–3 In cases when oral drugs are contraindicated or not sufficient, topical application of 15% thiabendazole solution or ointments should be considered (not available in the United States or Canada).1–3 Treatment is simple, well tolerated, and effective.1–3
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».