Heukelbach Jörg, Wilcke Thomas, Feldmeier Hermann
Mandacaru Foundation, Fortaleza CE, Brazil.
Int J Dermatol. 2004 Jul;43(7):511-5. doi: 10.1111/j.1365-4632.2004.02152.x.
Cutaneous larva migrans (CLM) is caused by the penetration of larvae of animal hookworms into the skin. Knowledge about this ectoparasitosis is mainly based on the examination of travelers or other expatriates. Population-based studies in an endemic area have never been performed.
A representative population sample of an urban slum in a Brazilian city was examined for the presence of CLM and asked about symptoms associated with the ectoparasitosis.
In total, 3.1% (95% confidence interval, 2.2-4.3%) of the 1185 inhabitants examined presented CLM. Forty-three per cent had more than one larval track (range, 1-17). The prevalence rate in males was 4.2% vs. 2.3% in females. CLM occurred at similar prevalence rates in all age groups. All patients complained of moderate or severe itching. In three cases (8.1%), superinfection was present. Most lesions were located on the trunk, legs, and arms. Not a single lesion was located on the feet.
This population-based study showed that CLM is endemic in this deprived community. The number of lesions and their topographic localization are in contrast with those obtained in previous reports based on the examination of individuals or groups affected in small outbreaks. We conclude that the clinico-epidemiologic pattern of CLM in a deprived community is different from that observed in travelers.
皮肤幼虫移行症（CLM）是由动物钩虫幼虫侵入皮肤引起的。关于这种体外寄生虫病的知识主要基于对旅行者或其他侨民的检查。从未在流行地区进行过基于人群的研究。
对巴西一个城市的城市贫民窟的代表性人群样本进行CLM检查，并询问与这种体外寄生虫病相关的症状。
在接受检查的1185名居民中，共有3.1%（95%置信区间，2.2 - 4.3%）出现CLM。43%的人有不止一条幼虫移行痕迹（范围为1 - 17条）。男性患病率为4.2%，女性为2.3%。CLM在所有年龄组中的患病率相似。所有患者都抱怨有中度或重度瘙痒。3例（8.1%）出现了继发感染。大多数病变位于躯干、腿部和手臂。足部没有一处病变。
这项基于人群的研究表明，CLM在这个贫困社区中呈地方性流行。病变数量及其部位与之前基于对小规模疫情中受影响的个体或群体检查所获得的结果不同。我们得出结论，贫困社区中CLM的临床流行病学模式与旅行者中观察到的不同。
