Management of Common Skin Conditions Presenting after Travel to Developing Countries
| Condition | Presentation | Treatment/Management |
|---|---|---|
| Cutaneous larva migrans44 | Although rash will heal spontaneously within a few weeks, the unpleasant cosmetic appearance and substantial itching usually dictate treatment | Albendazole (400 mg single dose) Ivermectin (200 mcg/kg single dose) |
| Dog bites/minor trauma | Management of potential rabies after exposure, as indicatedTopical antibiotic, as indicatedOral antibiotic if cellulitis is present | |
| Superficial skin infections | Topical vs oral antibiotic, as indicated | |
| Cutaneous Leishmaniasis43,46 | Can have severe sequelae, including destructive mucosal disease with some New World strains | Some therapeutic agents can be difficult to obtain in some industrialized settingsAlthough topical paromomycin may be effective against some Leishmania strains with very low potential for mucosal spread, prolonged parenteral therapies may be necessaryConsider referral to an expert in tropical medicine/infectious diseases |
| Myiasis45 | Tumbu fly (sub-Saharan Africa)Bot fly (Central and South America) | Place petroleum jelly over the larva's communication to the skin. Larva will then protrude from the lesion and can be removed with forcepsBot fly larvae anatomy make simple removal more difficult than for Tumbu fly, yet the above technique may be attempted. Often lidocaine infiltration followed by removal through incision is necessary |
| Scabies46 | Usually responds to topical permethrin (5%)Lindane should be avoided in young childrenOral ivermectin (200 mcg/kg single dose) is an alternative therapy |