title: Autochthonous cutaneous larva migrans infection in Guipúzcoa.
abstract: BACKGROUND
  Cutaneous larva migrans (LM) infection forms a serpiginous eruption caused by the migration of nematode helminths through the epidermis. The parasites are acquired when the skin comes into contact with soil contaminated by the feces of infected animals. Until now, infections have been believed to be imported from tropical and subtropical regions. Our aim was to study cases of cutaneous LM diagnosed in residents of the Spanish province of Guipúzcoa who had not recently traveled to such regions.
  
  
  METHODS
  Cross-sectional observational study of LM cases diagnosed in Hospital Universitario Donostia from 2011 to 2015 in patients who had not visited a region where this nematode infection is endemic. Clinical diagnoses were based on characteristic lesions. We studied the following variables: age, sex, site of lesions, date of onset of symptoms, possible source of contagion, pathologic findings, treatment, and clinical course.
  
  
  RESULTS
  We found 4 cases, all in men (mean age, 60 years). Lesions were on the lower extremities in 3 patients and on the trunk in 1 patient. All had been in contact with soil that could have been contaminated by feces and was the most likely source of the parasite. The lesions disappeared after treatment with oral albendazole.
  
  
  CONCLUSIONS
  The appearance of cases of autochthonous LM in Europe requires investigation of the culprit species, a review of the epidemiology of this infection, which was once considered imported, and the planning of public health measures to prevent it from becoming endemic.
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España. Electronic address: adriapanes@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Panés-Rodríguez
authors.affiliation: Clínica Veterinaria Anoeta, San Sebastián, Guipúzcoa, España.
authors.forename: L
authors.initials: L
authors.lastname: Piera-Tuneu
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: A
authors.initials: A
authors.lastname: López-Pestaña
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: N
authors.initials: N
authors.lastname: Ormaetxea-Pérez
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: P
authors.initials: P
authors.lastname: Gutiérrez-Támara
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: S
authors.initials: S
authors.lastname: Ibarbia-Oruezabal
authors.affiliation: Servicio de Dermatología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: A
authors.initials: A
authors.lastname: Tuneu-Valls
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D007815:Larva Migrans / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain
keywords: Climate; Cutaneous larva migrans; España; Europa; Europe; Larva migrans cutánea; Meteorología; Nematode infections; Nematodo; Spain