OSCE — Cutaneous larva migrans (creeping eruption)

Brief (to candidate)

You will assess a patient with a presentation consistent with Cutaneous larva migrans (creeping eruption).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Cutaneous larva migrans (CLM), also known as creeping eruption, is a common tropically acquired dermatosis in returned travellers, caused by percutaneous penetration and intraepidermal migration of animal hookworm larvae from dogs and cats. Humans are an accidental (aberrant) host — the larvae cannot penetrate the basement membrane and migrate tortuously within the upper epidermis, producing the characteristic intensely pruritic, serpiginous, creeping erythematous tract that advances day by day. Distribution favours the feet, buttocks, abdomen, and thighs (areas that contacted contaminated sand or soil). Di

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[2]