Pop Quiz #144

The correct answer is E. Treat with oral ivermectin.

This is hookworm, or cutaneous larva migrans and it is often self-limiting. Due to her discomfort, systemic ivermectin, systemic albendazole or topical thiobendazole would be appropriate treatments. The causative organism is the larvae of Ancylostoma braziliensis or A. canium.

The patient is not directly contagious and extracting the worm is not feasable in this situation. While clobetasol will help the itch, it is not treating the underlying pathology.

References: 

Bolognia, Jean., Jorizzo, Joseph L.Schaffer, Julie V. (Eds.) (2012) “Protazoa and Worms.” Dermatology /[Philadelphia] : Elsevier Saunders.