Imaging of cutaneous larva migrans by optical coherence tomography

Background: Cutaneous larva migrans is a parasitic skin eruption caused by migration of larvae of various nematodes. Diagnosis of cutaneous larva migrans is currently based on the clinical signs of the creeping eruption. We are investigating a new diagnostic technology called optical coherence tomography (OCT), which is potentially able to visualize structures in the skin with an 8 μm resolution. This technology could therefore potentially allow rapid, non-invasive, in vivo diagnosis of infestations. Method: Clinical cases of cutaneous larva migrans (n=3) were studied. All patients had a characteristic itching, serpinginous eruption typical of cutaneous larva migrans. The parasites were acquired on beach holidays in Thailand and Malaysia. All skin lesions were imaged by an OCT system developed at Risoe National Laboratory, Denmark. Result: Two out of three patients showed a round to oval structure (diameter 0.3-0.5 mm) in the epidermis, Thus distinct OCT morphology in skin areas affected by cutaneous larva migrans was demonstrated. The larvae were not visualized in any of the patients. Conclusion: This study demonstrates that OCT a novel optical imaging technology, can image the larva tunnel in the skin with adequate spatial resolution, but not the larvae itself. OCT has a potential in imaging of skin infestations.