Introduction

Cutaneous Larva Migrans (CLM), also known as creeping eruption, is a dermatosis caused by skin penetration by larval hookworms. The parasites inducing the problems are often acquired by skin contact with environmental from sources of larvae from the soil. Ancylostoma braziliense is the most species that causes cutaneous larva migran. Cutaneous Larva Migrans (CLM) is prevalent in tropical and subtropical areas, where the climate is hot and humid. CLM is endemic in regions near the equator; one of them is in Indonesia, such as Celebes and Borneo. Climate, poverty, inadequate water supplies, and sanitation are important determinant of transmission of these infection. The pathogenesis into developing the Cutaneous Larva Migrans basically starts through the invasion of the third stage larva (L3) into the human skin, usually between the stratum germinativum and stratum corneum. As a beginning, we must know the life cycle of nematodes in order to understand the infection and then nematodes must overcome a variety of host physical barriers and immunologic defences to reach the small intestine or the inner part of the dermis. Clinical signs and symptoms usually occur in 1 to 6 days after being infected by the helminthes that changes of the skin with the creeping eruptions. The lesions and creeping eruption of CLM are about 3 mm wide and may reach 15 to 20 cm in length. It may also be intensely pruritic and painful for some patients. Normally visual inspection of the skin would reveal telltale itchy red lines and blisters. In contrast with creeping dermatitis, skin scarping in patiens with folliculitis and creeping eruption may reveal live and dead nematode under light microscopy with mineral oil. Early infection of the nematodes into the skin of a person may produce a certain laboratory finding, so there may be found transient peripheral eosinophilia in the patients. A biopsy specimen taken at the leading edge of the track may contain the larva. Recently, epiluminescence microscopy has been used to visualise migrating larvae. The sensitivity of this method is not known. Differential

diagnosis of Cutaneous Larva Migran includes; contact dermatitis dermatophytoses and Scabies with any certain differences that has been shown. Left untreated, cutaneous larva migrans resolves spontaneously, but this can take 8 to 12 weeks. In at least one case, the larvae have been known to migrate for up to 1 year. But given the potential severity of common complications (eg, intense pruritus, folliculitis, impetigo, and allergic reactions such as eosinophilia),5 and given the ability of effective, well-tolerated anthelminthic drugs to clear the symptoms quickly, treatment is considered mandatory in most cases. List of drugs can be used to the patient who have been infected by cutaneous larva migran are albendazole, ivermectin, and thiabendazole.