The diagnostic tools discussed in this review are relevant not only for the diagnosis in endemic regions of the world but also for travellers and workers that following exposure return to non-endemic countries.

Background  Cutaneous larva migrans (CLM) is the result of a nematode infection, and shows a characteristic creeping eruption. As travel to the tropics increases, many British citizens may be returning with this infection, which is often misdiagnosed or treated incorrectly. Objectives  To perform a retrospective survey of 44 cases of CLM presenting to the Hospital for Tropical Diseases in London over the last 2 years. Methods  Cases were reviewed with regard to patient characteristics, source of infection, source of referral, clinical features and therapy. Results  Most infections were acquired in Africa (32%), the Caribbean (30%) and South‐east Asia (25%), but also in Central and South America. There was a history of exposure to a beach in 95% of patients and the median duration of symptoms was 8 weeks (range 1–104). Lesions mainly affected the feet (39%), buttocks (18%) and abdomen (16%), but the lower leg, arm and face were also affected. Multiple lesions were seen in seven of 44 cases (16%). Laboratory abnormalities were absent in all patients. Of 44 patients seen, four needed no treatment, 28 were cured by a single course of treatment, 11 required a second course of therapy and one patient was treated three times. Thirty‐one patients received oral albendazole 400 mg daily for 3–5 days and 24 were cured (77%). Five patients received 10% thiabendazole cream topically for 10 days and four were cured (80%). Four patients received oral thiabendazole 1·5 g daily for 3 days and all required further therapy. Conclusions  In view of the range of treatment regimens recorded, a randomized controlled trial comparing topical and systemic therapies is warranted.

In view of the range of treatment regimens recorded, a randomized controlled trial comparing topical and systemic therapies is warranted.