Hookworm Infection: Creeping Eruption

What is creeping eruption?

Creeping eruption is a skin infection caused by hookworms. The infection is also called cutaneous larva migrans or sandworm disease.

Creeping eruption causes severe itching, blisters, and a red growing, winding rash. The rash can grow up to 1 to 2 centimeters per day. The infection usually appears on areas of the body that have been exposed to the contaminated ground. These include the feet, legs, buttocks, or back.

What causes creeping eruption?

Creeping eruption is caused by hookworms. Hookworm eggs are found in the feces of dogs and cats. After the eggs hatch, they mature into worms. The infection can be spread to people from skin contact with the worms in the feces. Hookworms may be found in moist, sandy areas. Walking barefoot on contaminated grounds in warm climates is how most people get this condition. 

What are the symptoms of creeping eruption?

The rash usually shows up 1 to 5 days after you have been exposed to the hookworms. But sometimes it can take more than 1 month to show up. Each person may have slightly different symptoms. Symptoms may include:

  • Winding, snake-like rash. This is because the hookworm burrows along a path that creates a winding rash.
  • Itching
  • Blisters

The symptoms of creeping eruption may look like other skin conditions. Always see your healthcare provider for a diagnosis.

How is creeping eruption diagnosed?

Your healthcare provider will usually make the diagnosis based on your medical history and a physical exam.

How is creeping eruption treated?

Creeping eruption may be treated with antiparasitic medicines (orally or topical creams) such as albendazole, and ivermectin, and thiabendazole. This condition is self-limiting and will disappear over weeks to months even if not treated.

Can creeping eruption be prevented?

People are rarely exposed to hookworms in the U.S. This is because most cats and dogs are dewormed. Public areas are also kept clean. Infection is more likely in tropical and semitropical countries. Most cases are reported in people who have traveled to the Caribbean, Africa, Asia, and South America. Since the hookworm larvae often enter the body through bare feet, wearing shoes will help stop infection.

Key points about creeping eruption

  • Creeping eruption is a skin infection caused by hookworms.
  • Hookworms are found in dogs and cats.
  • Exposure to moist sand that has been contaminated by dog or cat feces can cause creeping eruption.
  • Creeping eruption appears as a winding, snake-like rash with blisters and itching.
  • Creeping eruption may be treated with antiparasitic medicines.
  • Creeping eruption is not common in the U.S., but it affects travelers to the Caribbean, Africa, Asia, and South America.
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