Creeping eruption

Alternative names:

cutaneous larvae migrans

Definition:

A skin rash caused by the migration of hookworm larvae beneath the skin.

Causes, incidence, and risk factors:

Creeping eruption is prevalent only in the tropics and the subtropics. In the United States, it is seen along the southern border. This condition represents the interruption of the normal life cycle of animal hookworms.

Hookworm eggs found in the stool of animals hatch, and the larvae infest the soil and vegetation around the droppings. When human skin comes in contact with the infested soil, the larvae burrow into the skin (between the dermis and epidermis layers), causing intense itching. The larvae then migrate between these two layers at rates of almost 1 inch per day. Their passage produces an inflammatory response that follows their progress beneath the skin.

The lesion is raised, long, and snakelike. Its curving path marks the migratory trail of the larvae. Treatment speeds resolution of the condition. However, untreated, the larvae die within a few weeks to months.