Figure 1 Quiz of the Week

A 40-year-old male presents to his family physician with a pruritic, erythematous lesion on his foot after returning from vacation in coastal Brazil a week earlier. He adds that the lesion has migrated since he first noticed it. On examination, a serpiginous, slightly elevated tunnel can be seen on the lateral aspect of his left foot. He is otherwise well, but mentions that the intense pruritus is disturbing his sleep.

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Image credit: @forderit.

Answer: Ivermectin

This patient has cutaneous larva migrans, a cutaneous migratory parasitic infection. It is caused by the larvae of hookworms, most commonly found in sandy areas within subtropical and tropical climates. A single dose of ivermectin is recommended to relieve pruritus and reduce the risk of systemic infection. A short course of albendazole can also be administered as an alternative treatment.

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