Distribution occurs on the dorsa of feet, interdigital spaces of toes, anogenital region, buttocks, hands, and knees. It can be found in the central and southern US, Central America, South America, and the Caribbean. A minority of patients demonstrate peripheral eosinophilia on a CBC and increased IgE levels on total serum immunoglobulins. Chemotherapy with chloroquine, antimony, and diethyl carbamazine also were unsuccessful. Thiabendazole is currently considered the agent of choice.
Topical application is used for early, localized lesions.
The oral route is preferred for widespread lesions or unsuccessful topical treatment. Other effective alternative treatments include albendazole, mebendazole, and ivermectin. Antibiotics are indicated in secondary bacterial superinfections if they occur. As alternative therapy, use liquid nitrogen cryotherapy for progressive end of larval burrow. Anthelmintics - Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.