It is most often acquired on beaches in Asia, Africa, South and Central America, and the Caribbean. 3.2 EpidemiologyĬutaneous larva migrans is one of the most common skin diseases seen in returning travelers, accounting for about 10 % of all skin disease.
The worms invade the skin but lack a secreted collagenase enzyme required to penetrate the basement membrane and thus become trapped in the epidermis, which results in serpiginous erythema and pruritus. The parasites are excreted in the host animal feces, often on soil or sand (beaches) and subsequently acquired by direct skin contact with individuals laying out on beaches or walking barefoot along the water. The worms themselves are approximately 0.5 mm in diameter, but are occasionally longer. Ĭutaneous larva migrans is a skin disease caused by the hookworms Ancylostoma braziliense, Ancylostoma caninum, and Uncinaria stenocephala, natural parasites of dogs and cats. Measures to remove bedbugs include heat treatments, as bedbugs cannot tolerate temperatures above 50 ☌, and insecticides, though resistance to some compounds has been reported. Once a building is infested with bedbugs, eradication is difficult. Thus, suitcases should be kept off the floor and closed when not in use. Bedbugs can reside in luggage, which can result in infestation of a traveler’s home on their return. Specks of blood on sheets are also suggestive. Other signs of bedbug infestation include specks of feces on bedsheets, wallpaper, or box springs. The papules of bedbug bites are often in a linear pattern as a bug probes multiple sites looking for a suitable blood vessel on which to feed (Fig. The bite is painless and occurs on exposed skin-primarily the face, neck, hands, and arms. They feed when the host is sleeping or otherwise distracted and still. Bedbugs are more common in poor areas, but can potentially be found anywhere humans sit, rest, or sleep, including hotels, theaters, airplanes, workplaces, and schools. They live within the cracks, crevices, and seams of mattresses and chairs and generally only come out onto the resting surface to obtain a blood meal from a host. Bedbugs (genus Cimex) are sub-centimeter reddish-brown flat arthropods found throughout the world. One of the most common biting insects encountered by travelers is the bedbug. Pruritus often results either as a direct result of the bite or as a host response to proteins injected into the skin by the insect. A robust host response to the bite can produce a bulla. Clinically, they appear as erythematous edematous papules that can be distributed singly, grouped, or generalized, depending on the amount of accessible skin and the number and type of insects biting. Bites typically result from an insect trying to obtain a blood meal from a host. Insect bites are a common complaint in returning travelers.
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