Creeping Eruption

Introduction: Hookworms, which are transmitted from cats or dogs, can involve humans as a host where larvae of this parasite enter the skin and burrow superficial tracks at a speed of a few millimeters to even a few centimeters per day. The parasite is called "Ancylostoma braziliense" and "ancylostoma caninum". The larvae are termed "cutaneous larvae migrans" or in plain English the disease is termed "creeping eruption". Here is an image.

Signs and symptoms:

There is intense itching, particularly at night when the larvae become most active. As the larvae most often enter the skin of the feet, legs, buttocks and the back it is there where the itch is most intense. As the patient scratches the skin open, bacterial superinfection can occur.

A dermatitis can develop from the scratching, which will not respond to the usual topical corticosteroid preparations. In the canine form (A. caninum) the larvae tend to migrate into the wall of the small intestine causing eosinophilic enteritis.

Diagnosis:

The diagnosis is made by history and physical examination, may at times have to be sent to a dermatologist, if there is a problem to diagnose it. The specialist may include in the workup some skin scrapings, microscopic examinations and blood tests.

Treatment:

There are various effective means of treating creeping eruption.

The larvae are very sensitive to either treatment with a 10% thiabendazole suspension (brand name: Mintezol) locally to the affected skin four times daily for 1 week to 10 days or else orally as tablets or suspension for 2 consecutive days. Pyrantel pamoate (brandname: Combantrin) or mebendazole (brand name: Vermox) orally are alternative and effective therapies (Ref. 4, p. 808 and Ref. 2, p.500).

Moreinformation from the CDC throught this link.

Infections Overview

Skin Infections

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 265.

2.James Chin et al., Editors: Control of Communicable Diseases Manual, 17th edition, 2000, American Public Health Association

3.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 112.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 115.

5. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 113.

Last Modified: Jan. 10, 2007