What is the role of a skin biopsy in the workup of strongyloidiasis?

Updated: Jun 20, 2019
  • Author: Pranatharthi Haran Chandrasekar, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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In acute or chronic infection, skin biopsy is usually neither necessary nor sufficient, because parasites are rarely visualized. When they are, speciation is difficult.

In severe infection, skin biopsy may be useful, because filariform larvae are often observed. Larvae can be observed in all levels of the dermis and occasionally in the subcutis. Obtain specimens from the purpuric eruptions, because these areas contain the largest amount of larvae.

Other findings include edema, extravasated red blood cells (RBCs), and some lymphocytes in the superficial dermis. The larvae range in size from 9 to 15 µm and contain a triradiate digestive tract.

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