Creeping Eruption (Larva Migrans)?

Question 1

What causes Creeping Eruption (Larva Migrans)?

Answer 1

Creeping Eruption is caused by the larvae of hookworms from cats and dogs, which accidentally enter the skin and migrate, leaving an itchy, winding red trail of inflamed skin.

Question 2

What are common sites of penetration for Creeping Eruption?

Answer 2

Common sites include areas in contact with the ground, such as the feet, thighs, and buttocks, especially in small children. The larvae can also be transmitted via towels or clothes in contact with infected soil.

Question 3

What are the symptoms of Creeping Eruption?

Answer 3

Symptoms include a very itchy, winding red trail of inflamed skin that progresses as the larvae migrate, potentially traveling 1 to 5 cm or more daily. Scratching often leads to secondary infection and eczema.

Question 4

: How long do the larvae of Creeping Eruption survive if untreated?

Answer 4

If untreated, the larvae eventually die after several weeks or months.

Question 5

What is the management approach for Creeping Eruption?

Answer 5

Management includes:
Freezing the skin about 1 cm ahead of the visible trail using chlorethyl spray, liquid nitrogen, solid carbon dioxide, or plain ice (effective in experienced hands)
Albendazole 400 mg twice daily for 3 days for adults and children > 2 years old; 200 mg twice daily for 3 days for children < 2 years old
Thiabendazole 10-15% cream or ointment applied 4 times daily until 2 days after the burrows disappear (usually 1-2 weeks)
Treating superinfection with betadine scrub, potassium permanganate solution, gentian violet paint, or antibiotics if severe
Ivermectin 3-12 mg in a single dose depending on body weight