AUTOCHTHONOUS CUTANEOUS LARVA MIGRANS IN AN 8 YEAR OLD CHILD WITH AUTISM

Cutaneous larva migrans (CLM) is a parasitic dermatosis caused by the epidermal migration of hookworm larvae, most commonly originating from dogs and cats. Human infection occurs through contact with soil or sand contaminated with animal feces, typically in tropical and subtropical regions.It is rare in temperate climates, including North Macedonia, but poses a diagnostic challenge when encountered. Case report: We report the case of an 8-year-old boy with autism who presented in July 2023 with an acute onset of pruritic and burning skin lesions on the plantar surface of the left foot following contact with dogs and cats. Dermatological examination revealed a well-defined erythematous serpiginous tract with associated edema and a central black line at the advancing edge. Dermoscopic evaluation demonstrated a brownish linear structure corresponding to the larval body, a serpiginous erythematous background, brown dots, scaling, and yellow-white linear structures suggestive of empty larval tunnels. Laboratory findings showed mild eosinophilia (5.2%). Treatment with oral albendazole, local cryotherapy, corticosteroids, and antihistamines resulted in marked clinical improvement within 10 days. Conclusion: This case highlights a rare presentation of Cutaneous Larva Migrans in a non-endemic region. While diagnosis is primarily clinical, dermoscopy represents a valuable noninvasive tool for confirming active or residual infestation. Early recognition and timely antiparasitic therapy are essential for rapid symptom resolution and prevention of complications. Increasing reports in non-endemic areas emphasize the need for heightened clinical awareness in the context of travel and climate change.