# An Itch on the Move: A Diagnostic Dilemma of Cutaneous Serpiginous Eruption

## TL;DR

A woman's itchy, moving skin rash was diagnosed as cutaneous larva migrans, showing the condition can appear in unusual body areas.

## Contribution

This case expands the known clinical presentation of cutaneous larva migrans to atypical anatomical sites.

## Key findings

- Cutaneous larva migrans was diagnosed in a patient with a rash that moved across the ear, neck, and shoulder.
- Systemic albendazole and topical ivermectin effectively treated the condition.
- Dermoscopic findings supported the diagnosis despite the unusual location of the rash.

## Abstract

Cutaneous larva migrans is a common parasitic dermatosis, typically affecting the feet and lower extremities, but involvement of atypical anatomical sites may lead to diagnostic delay. We report a 40-year-old woman who presented with an intensely pruritic, migratory serpiginous eruption that sequentially involved the ear, neck, shoulder, and scapular region over one month. A detailed exposure history, characteristic migratory morphology, and supportive dermoscopic findings established the diagnosis of cutaneous larva migrans. The patient responded well to systemic albendazole with adjunctive topical ivermectin. This case highlights that cutaneous larva migrans should be kept in the differential of a creeping migratory lesion irrespective of site.