Cutaneous Strongyloides stercoralis infection: an unusual presentation

Abstract

Strongyloides stercoralis is a widespread, soil-transmitted, intestinal nematode common in tropical and subtropical countries. The parasite is unique in its capability to carry out its entire life cycle inside the human body. Human beings contract strongyloidiasis by penetration of filariform larvae into the skin or mucous membrane after contact with contaminated soil. The larvae travel by the venous systems to the lungs, then ascend the bronchi to the trachea, where the larvae are coughed up by the human host, subsequently swallowed, and attain their habitat in the small intestine. Chronic strongyloidiasis acquired in endemic areas may last decades and gives rise to various dermatologic lesions, the most characteristic of which is larva currens, a serpiginous, creeping urticarial eruption. In disseminated strongyloidiasis, the characteristic skin lesions are widespread petechiae and purpura. We present a case of disseminated strongyloidiasis with an unusual manifestation mimicking a drug rash and review the dermatologic manifestations of strongyloidiasis infestation.