Cutaneous Larva Migrans on Darker Versus Lighter Skin

Two cases of cutaneous larva migrans were diagnosed based on the clinical and morphological characteristics of the rash (itchy, serpiginous eruption migrating by 1–2 cm/day) and the context (tropical climate). A 40-year-old European male living in rural Thailand presented in 2007 with an erythematous rash on the left upper arm (Figure a). A 50-year-old female living in rural Uganda presented in 2025 with a dark black rash in the right gluteal area (Figure b). Both cases were treated with oral albendazole as per local guidelines. This self-limiting disease, which is common in tropical areas, is caused by Ancylostoma caninum or Ancylostoma braziliense larvae transmitted through soil (contaminated with dog or cat feces). Albendazole or ivermectin can accelerate healing. Inflammation appears erythematous (reddish) on lightly pigmented skin, while on darker skin tones, it can cause characteristically violaceous, gray, dark brown, or black color changes.