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Creeping eruption
Definition A creeping eruption is a skin rash caused by the movement of dog or cat hookworm larvae beneath the skin. Alternative Names Cutaneous larvae migrans; Ancylostoma braziliense
Causes, incidence, and risk factors Creeping eruption is more common in countries with warm climates. The southeastern United States have the highest rates of infection. The main risk factor for this disease is contact with damp, sandy soil contaminated with infected cat and dog feces. It affects more children than adults. The dog and cat hookworm eggs found in the stool of these animals will hatch, and the resulting larvae infests the soil and vegetation around the area. When you touch this infested soil, the larvae dig into the skin, causing an intense inflammatory response that leads to severe itching. Symptoms - Raised, snakelike tracks in the skin that may spread over time -- severe infections may cause several tracks
- Itching, may be more severe at night
- Blisters
Signs and tests This condition is diagnosed based on skin findings noted on physical examination -- rarely, a skin biopsy may be done to rule out other conditions. Treatment Thiabendazole or albendazole (anti-parasitic agents) may be used to treat the infection. Ivermectin may also work. Expectations (prognosis) Creeping eruption may clear on its own over a period of weeks to months. Treatment helps the infection go away faster and is highly successful. Complications - Secondary skin infections caused by scratching
- Spread to the lungs or the small intestine (rare)
Calling your health care provider Make an appointment with your health care provider if you or your child have skin lesions that are snakelike, itchy, and migratory. Prevention Public sanitation has decreased the incidence of hookworm infestation in the United States. De-worming of cats and dogs can reduce the incidence among these animals. Wearing shoes in endemic areas (areas where hookworm infections are known to occur frequently) will prevent penetration of the larvae through the feet (a common site). Review date: 11/27/2006 Reviewed By: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.
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