CREEPING ERUPTION (Cutaneous larva migrans)
This disorder is analogous to swimmer's itch, in that both are due to a parasite that penetrates human skin but is then unable to adapt. Creeping eruption is caused by hookworms, whose natural hosts are usually dogs or cats. After penetrating the skin, the hookworm is unable to find its way into the bloodstream and wanders aimlessly beneath the surface of the skin until it dies.
Creeping eruption is seen most often from New Jersey to Texas. The infective larvae hatch in sandy soil, such as beaches, sandpiles, or under cottages and houses, and enter the skin at an exposed site. The incubation period varies from a few days to several months, but the hallmark of creeping eruption is an irregular, raised, red-to-purple thread-like line about 2 to 4 millimeters in diameter indicating the path of the larva. This lesion is extremely itchy and is often scratched vigorously by the host. The tip of the line advances a few millimeters each day. If several parasites are present, these lines may be less apparent. Eventually the larvae die, sometimes after persisting for several months, but secondary bacterial infection is common.
CREEPING ERUPTION (Cutaneous larva migrans) –Treatment
Thiabendazole (Mintezol), available by prescription only, if taken by mouth or applied to the skin will eliminate the parasite. This medication often causes nausea when taken orally. Liquid nitrogen, dry ice, ethyl chloride, or Freon spray have been used to freeze the worm. One must see a physician for any of these treatments. Secondary infections are treated with antibiotics.
CREEPING ERUPTION - Prevention
Creeping eruption is seen most often from New Jersey to Texas. The infective larvae hatch in sandy soil, such as beaches, sandpiles, or under cottages and houses, and enter the skin at an exposed site. The incubation period varies from a few days to several months, but the hallmark of creeping eruption is an irregular, raised, red-to-purple thread-like line about 2 to 4 millimeters in diameter indicating the path of the larva. This lesion is extremely itchy and is often scratched vigorously by the host. The tip of the line advances a few millimeters each day. If several parasites are present, these lines may be less apparent. Eventually the larvae die, sometimes after persisting for several months, but secondary bacterial infection is common.
CREEPING ERUPTION (Cutaneous larva migrans) –Treatment
Thiabendazole (Mintezol), available by prescription only, if taken by mouth or applied to the skin will eliminate the parasite. This medication often causes nausea when taken orally. Liquid nitrogen, dry ice, ethyl chloride, or Freon spray have been used to freeze the worm. One must see a physician for any of these treatments. Secondary infections are treated with antibiotics.
CREEPING ERUPTION - Prevention
Individuals should wear shoes when walking in sandy soil that is known to house these worms, or soil that is used by dogs and cats as a latrine. One should avoid sitting or lying on damp soil or sand. Sandpiles can be treated to destroy the worms, or the sand can be replaced; protective clothing and gloves should be worn if it is necessary to crawl under houses or cottages or to clean out dog or cat pens.
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