Panés-Rodríguez A, Piera-Tuneu L, López-Pestaña A, Ormaetxea-Pérez N, Gutiérrez-Támara P, Ibarbia-Oruezabal S, Tuneu-Valls A
Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
Clínica Veterinaria Anoeta, San Sebastián, Guipúzcoa, España.
Actas Dermosifiliogr. 2016 Jun;107(5):407-13. doi: 10.1016/j.ad.2016.01.002. Epub 2016 Mar 2.
Cutaneous larva migrans (LM) infection forms a serpiginous eruption caused by the migration of nematode helminths through the epidermis. The parasites are acquired when the skin comes into contact with soil contaminated by the feces of infected animals. Until now, infections have been believed to be imported from tropical and subtropical regions. Our aim was to study cases of cutaneous LM diagnosed in residents of the Spanish province of Guipúzcoa who had not recently traveled to such regions.
Cross-sectional observational study of LM cases diagnosed in Hospital Universitario Donostia from 2011 to 2015 in patients who had not visited a region where this nematode infection is endemic. Clinical diagnoses were based on characteristic lesions. We studied the following variables: age, sex, site of lesions, date of onset of symptoms, possible source of contagion, pathologic findings, treatment, and clinical course.
We found 4 cases, all in men (mean age, 60 years). Lesions were on the lower extremities in 3 patients and on the trunk in 1 patient. All had been in contact with soil that could have been contaminated by feces and was the most likely source of the parasite. The lesions disappeared after treatment with oral albendazole.
The appearance of cases of autochthonous LM in Europe requires investigation of the culprit species, a review of the epidemiology of this infection, which was once considered imported, and the planning of public health measures to prevent it from becoming endemic.
皮肤幼虫移行症（cutaneous larva migrans，LM）感染是由线虫类蠕虫在表皮内移行引起的匐行疹。当皮肤接触到被感染动物粪便污染的土壤时就会感染这些寄生虫。到目前为止，一直认为感染是从热带和亚热带地区输入的。我们的目的是研究西班牙吉普斯夸省居民中诊断出的皮肤幼虫移行症病例，这些居民近期未前往过此类地区。
对2011年至2015年在多诺斯提亚大学医院诊断出的皮肤幼虫移行症病例进行横断面观察研究，这些患者未去过该线虫感染流行的地区。临床诊断基于特征性病变。我们研究了以下变量：年龄、性别、病变部位、症状出现日期、可能的传染源、病理结果、治疗及临床病程。
我们发现了4例病例，均为男性（平均年龄60岁）。3例患者的病变位于下肢，1例患者的病变位于躯干。所有患者均接触过可能被粪便污染的土壤，这很可能是寄生虫的来源。口服阿苯达唑治疗后病变消失。
欧洲本土皮肤幼虫移行症病例的出现需要调查致病物种，重新审视这种曾被认为是输入性感染的流行病学情况，并规划公共卫生措施以防止其成为地方病。
