A Creeping Eruption

A 40-year-old male presents to his family physician with a pruritic, erythematous lesion on his foot after returning from vacation in coastal Brazil a week earlier. On examination, a serpiginous, slightly elevated tunnel can be seen on the lateral aspect of his left foot. He is otherwise well, but mentions that the intense pruritus is disturbing his sleep. Which of the following treatments is the next best step?

A. Surgical excision
B. Doxycycline
C. Ivermectin
D. Symptomatic treatment

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