Management and Therapy
CLM heals spontaneously within weeks or months, but there are rare cases of it lasting up to two years. Due to complications (see Clinical Presentation) treatment is mandatory.
Physical remedies result in cosmetic problems with the skin.
~Cryotherapy: freezing the leading edge of the skin track with ethylene chloride spray, solid carbon dioxide or liquid nitrogen rarely workspainful and ineffective, results in severe blistering, ulceration, scarring.
~Surgical incision: rarely works because larva is usually 1-2cm ahead of the visible burrow.
~Chemotherapy: Albendazole: 200mg orally twice a day for 3 days, has few toxic side effects. Topical thiabendazole 10-15%: 10% cream for 10 days has a 98% effective rate. Oral thiabendazole: 1.5g for 3 days, but it can have severe side effects, usually nausea and vomiting and dizziness. Both albendazole and thiabendazole are contraindicated in pregnancy, so use physical procedures. Albendazole and Thiabendazole (oral and topical) are being abandoned (neither of these drugs is currently available for use in humans in the U.S.) in favor of Ivermectin (single dose of 200 mg).
Symptoms can be treated with antihistamines, antipruritics, sedatives, and/or topical anesthetics.