The larvae of hookworms of cats and dogs usually cause this disease.
They enter the skin accidentally and migrate through the skin leaving a
very itchy, winding red trail of inflamed skin behind them. Larvae may
travel 1 to 5 cm or more daily. Sites of penetration are those in contact
with the ground, usually the feet or especially in small children the thighs
and buttocks. The larva can also be transmitted via towels or clothes,
which have been in contact with the infected soil. Scratching often
causes secondary infection and eczema. If untreated, the larvae
eventually die after some weeks or months.
Management of creeping eruption
- Freezing the skin about 1 cm ahead of the visible trail, this is where the head of the
larva is found. Chlorethyl spray, liquid nitrogen, solid carbon dioxide may be used,
even plain ice can be tried. This is only effective in experienced hands.
- Albendazole 400 mg twice daily for 3 days for adults and children > 2 years of age,
200 mg twice daily for 3 days for children < 2 years of age.
- Thiabendazole 10-15% cream or ointment 4 times daily until 2 days after the
burrows have disappeared (usually 1-2 weeks).
- Treat superinfection with betadine scrub, potassium permanganate solution, gentian
violet paint or if severe antibiotics (see impetigo).
- Ivermectin 3-12 mg in a single dose depending on bodyweight.
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