title: Cutaneous gnathostomiasis: report of 6 cases with emphasis on histopathological demonstration of the larva.
abstract: BACKGROUND
  Cutaneous gnathostomiasis is an emerging food-borne parasitic zoonosis. Histopathological demonstration of the larva on random biopsy specimen of erythematous plaques is infrequent because of its migrating nature.
  
  
  OBJECTIVE
  We sought to determine whether medical treatment with albendazole or ivermectin increases the diagnostic yield of skin biopsy specimen.
  
  
  METHODS
  A retrospective chart review was conducted in a private dermatology practice in Lima, Peru. Cases with a clinical diagnosis of nodular migratory panniculitis and pathological diagnosis of eosinophilic panniculitis or gnathostomiasis were reviewed. Only cases with definitive diagnosis confirmed by histopathology or parasite isolation were included in the study.
  
  
  RESULTS
  A definitive diagnosis of gnathostomiasis was rendered in 6 of 55 reviewed cases. Histopathological or gross identification of the nematode's larva was made obtaining a biopsy specimen of papules or pseudofuruncles that developed after oral antiparasitic treatment.
  
  
  CONCLUSIONS
  This is a retrospective case series study and no serologic testing was available.
  
  
  CONCLUSIONS
  Biopsy of a papule or pseudofuruncle subsequent to oral treatment increases the likelihood of demonstrating the larva on skin biopsy specimen, which allows definitive diagnosis and may have therapeutic benefit.
authors.affiliation: Program in Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. alaga@partners.org
authors.forename: Alvaro C
authors.initials: AC
authors.lastname: Laga
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lezcano
authors.forename: César
authors.initials: C
authors.lastname: Ramos
authors.forename: Humberto
authors.initials: H
authors.lastname: Costa
authors.forename: César
authors.initials: C
authors.lastname: Chian
authors.forename: César
authors.initials: C
authors.lastname: Salinas
authors.forename: Martin
authors.initials: M
authors.lastname: Salomon
authors.forename: Manuel
authors.initials: M
authors.lastname: del Solar
authors.forename: Francisco
authors.initials: F
authors.lastname: Bravo
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D001706:Biopsy; D002648:Child; D005260:Female; D058429:Gnathostomiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D007814:Larva / Q000033:anatomy & histology*; D008297:Male; D012189:Retrospective Studies; D012876:Skin Diseases, Parasitic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin; D015766:Albendazole