PMC10120813_01
Clinical presentation of the patient on admission (A and B) dark red, linear, spiral patches on the lateral side of the upper arm).
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The lesion was well-circumscribed with a slightly raised border, and no ulcerations or erosions (Figure 1A and B).
Dermoscopy images: (A) a tunnel with red arrows formed by larva migration. (B) high refractive dots with red arrows, which may be larval body or paws.
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At the same time, we performed a dermoscopy examination of the patient's lesion, and found that linear, light-yellow, and dark red block area of unequal width was a tunnel burrow, formed in the stratum corneum by larva migration (Figure 2A). We also saw translucent round structures from the apex of the linear lesion, which had several high refractive dots internally, which might be the larval body or paws (Figure 2B).
Reflectance confocal microscopy images: (A) tunnel in the stratum corneum or granular layer, dark oval structures corresponding to vesicles with red arrows. (B) larval body and claw-like structures with red arrows.
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The lesion was assessed by RCM which showed edema in the epidermis and superficial dermis, and a well-circumscribed, oval-shaped tunnel in the stratum corneum or granular layer, which could extend to the superficial dermis (Figure 3A). At one end of the tunnel, there was a well-delineated ovoid larval body and claw-like structures (Figure 3B).
Clinical presentation of the patient after one week of the treatment (A and B) the rash still spread to the proximal part of the left upper arm and left shoulder with red arrows).
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Seven days later, the rash still spread to the proximal part of the left upper arm and left shoulder (Figure 4A and B).
Clinical presentation of the patient after the treatment (A) after one month of the treatment. (B) after two months of the treatment).
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No recurrence was noted after 2 months (Figure 5A and B).