Cutaneous larva migrans

Minte2ol, soluble in ethanol cutaneous larva migrans. ... 

Cutaneous larva migrans (creeping eruption) Ancylostoma braziliense and others Thiabendazole, Albendazole, or Ivermectin-... 

Several benzimidazoles are in use for the treatment of helminthic infections. Three of these, mebendazole, thiabendazole and albendazole, are described in this section. They have a broad range of activity against many nematode and cestode parasites, including cutaneous larva migrans, trichinosis, disseminated strongyloidiasis, and visceral larva migrans. A fourth, triclabendazole, is considered as the drug of choice for Easciola hepatica therapy. 

Unlabeled Uses Cutaneous larva migrans, filariasis, pediculosis, scabies, VJucfiereria bancrofti... 

The answer is c. (Hardman, p 1688.) Thiabendazole has been shown to be effective against Strongyloides, cutaneous larva migrans, and Trichuris. Adverse effects consist of nausea, vertigo, headache, and weakness. Treatment usually involves oral administration for several days. It has been found to be ineffective in Ascaris, N. americanus, E. vermicularis, and T. saginata. 

Thiabendazole is an alternative to ivermectin or albendazole for the treatment of strongyloidiasis and cutaneous larva migrans. 

The standard dosage, 25 mg/kg (maximum 1.5 g) twice daily, should be given after meals. Tablets should be chewed. For strongyloides infection, treatment is for 2 days. Cure rates are reportedly 93%. A course can be repeated in 1 week if indicated. In patients with hyperinfection syndrome, the standard dose is continued twice daily for 5-7 days. For cutaneous larva migrans, thiabendazole cream can be applied topically, or the oral drug can be given for 2 days (although albendazole is less toxic and therefore preferred). 

Green AD, Mason C, Spragg PM. Outbreak of cutaneous larva migrans among British mUitary personnel in Behze. J Travel Med 2001 8(5) 267-9. 

Gourgiotou K, Nicolaidou E, Panagiotopoulos A, Hatziolou JE, Katsambast AD. Treatment of widespread cutaneous larva migrans with thiabendazole. J Eur Acad Dermatol Venereol 2001 15(6) 578-80. 

In 80 children aged 6 months to 14 years a single dose of ivermectin 200 micrograms/kg was compared with topical benzyl benzoate for the treatment of pediatric scabies in a randomized, controlled trial (17). Ivermectin cured 24 of 43 patients and topical benzyl benzoate cured 19 of 37 patients at 3 weeks after treatment. There were no serious adverse effects with either treatment, although benzyl benzoate was more likely to produce local skin reactions. These results are in line with those of another study, in which 18 children aged 14 months to 17 years with either scabies (n — 11) or cutaneous larva migrans (n — 7) were... 

Thiabendazole has broad-.spectmm anthelmintic activity. It is used to (real enterobiasis, strongyloidiasis (threadworm infection), a.scariasis, uncinariasis (hookworm infection), and trichuriasis (whipworm infection). It has also been u.sed to relieve symptoms associated with cutaneous larva migrans (creeping eruption) and the inva.sive phase of trichinosis. In addition to its use in human medicine, thiabendazole is widely used in veterinary practice to control intestinal helminths in iive.stock. 

Creeping eruption or larva migrans in man is caused by the presence of the larvae of dog and cat hookworms, Ancylostoma caninum and A. braziliense in the skin. Some other nematodes like Uncimria stenocephala (European dog hookworm) and Gnathostoma spitiigerum also produce somewhat similar cutaneous lesions. The creeping eruption is prevalent in different regions of the warm climates, especially in the Americas, Africa and Asia. It is estimated that nearly 10 million people around the world suffer from this disease [24]. 

P. J. Hotez, S. Narasimhan, J. Haggerty, L. Milstone, V. Bhopale, G. A. Schad, and F. F. Richards. Hyaluronidase from infective Ancylostoma hookworm larvae and its possible function as a virulence factor in tissue invasion and in cutaneous larva migrans. Infect. Immun. 60 1018 (1992). 

One ppm of thiabendazole prevents Ascaris eggs from maturing. In therapeutic topical concentrations, it is used to prevent the development of dog and cat hookworm larvae that have invaded human skin, causing cutaneous larva migrans. In laboratory animals, thiabendazole has antipyretic, analgesic, and antiinflammatory properties, as well as anthelmintic properties. These properties are probably also exhibited in humans and may account for the symptomatic improvement in persons with early systemic trichinosis. 

CUTANEOUS LARVA MIGRANS (creeping eruption, dog and cat hookworm)... 

Thiabendazole, an anthelmintic (22 mg/kg t.i.d. after meals), is indicated for the treatment of strongyloidiasis (threadworm infection), cutaneous larva migrans (creeping eruption), and visceral larva migrans. 

As a single dose, albendazole is superior to mebendazole at removing adult hookworms from the GI tract. Oral albendazole is the drug of choice for treating cutaneous larva migrans or creeping eruption, due most often to skin migration by larvae of the dog hookworm. 

Ivermectin also is effective against microfilaria but not adult worms of W. bancrofti, B. malayi, L. loa, and M. ozzardi. It exhibits excellent efficacy against A. lumbricoides, S. sterco-ralis, and cutaneous larva migrans. 

Taken as a single 200- ig/kg oral dose, ivermectin is a first-line drug for treatment of cutaneous larva migrans. Similar doses also are safe and highly effective against human head lice and scabies, even in HIV-infected individuals. 

Tissue nematodes responsive to drug therapy include ancyclostoma species, which cause cutaneous larva migrans, seen primarily in the southern USA. Species of dracunculus, onchocerca, toxo-cara, and Wuchereria bancrufti (the cause of filariasis) are all responsive to drug treatment. The number of persons worldwide estimated to be infected by tissue nematodes exceeds 0.5 billion. 

Clinical use Thiabendazole is a drug of choice for visceral forms of larva migrans and is an effective drug for treatment of strongyloidiasis, cutaneous larva migrans, and threadworm infections. Thiabendazole is rapidly absorbed from the gut and is metabolized by liver enzymes. The drug has anti-inflammatory and immunorestorative actions in the host. 

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