Creeping eruption is a hookworm infection of the skin. The skin is invaded by the larvae of the dog or cat hookworm. This causes a thread-like line of inflammation that moves in a "creeping" form over time.
Creeping eruption occurs when human skin comes into contact with soil contaminated with cat or dog feces that are infected with hookworm. The eggs of the hookworm are passed in the feces, and hatch into larvae. The larvae penetrate human skin and begin to wander through the layer below the skin.
The symptoms of creeping eruption include a small blister at the point of penetration. It is usually on an exposed area that has come in contact with the ground, such as the feet, legs, or buttocks. As the parasite migrates, a thread-like red, slightly raised, red line appears on the skin. The rash itches intensely.
Creeping eruption usually affects a person who plays or works in shaded, moist, sandy areas that have been contaminated with animal feces. Children and farmers are at greatest risk. It is more common in warm, humid areas, including the southeastern United States.
Prevention requires awareness of the hookworm parasite, keeping beaches and sandboxes clean, and proper disposal of cat and dog feces.
The characteristic lesions strongly suggest creeping eruption. The person has usually had contact with warm, moist soil within the past few months.
There are no long-term effects from creeping eruption.
There are no risks to others, as creeping eruption is not contagious from person to person.
The treatment of creeping eruption includes thiabendazole (i.e., Mentezol). This medication can be taken by mouth, or applied topically to the rash. Cool, moist cloths applied to the rash can help relieve itching.
Side effects of thiabendazole include nausea, vomiting, abdominal distress, and dizziness.
Creeping eruption usually clears up in 1 to 2 weeks. The rash should clear completely with treatment.
The healthcare professional should be contacted if the rash does not clear up completely, or if it returns.
Professional Guide to Diseases, Sixth Ed., Springhouse, 1998
Harrison's Principles of Internal Medicine, 1998, Fauci et al
The Merck Manual of Medical Information, 1997
