Creeping eruption- skin infestations

Question 1

what causes it

Answer 1

larvae of hookworms of cats and dogs.

Question 2

how does creeping eruption come about (2)

Answer 2

1. Eggs are deposited in the soil, from where the larvae hatch and accidentally enter human host via exposed areas (buttocks, feet, hands).
2. Humans being the wrong host, the larvae will wander around seeking blood vessels to enter, but with no proper adherence molecules, they die.

Question 3

what are the treatment options (4)

Answer 3

Disease is usually self-limited , but the itch and infection necessitate treatment:
1. Albendazole 400mg BD for 5 days
2. Thiobendazole cream 15 % 4x daily till 2 days after track disappears.
3. Oral Ivermectin 12 mg single dose.
4. Cryosurgery: freeze 1 cm ahead of visible trail to target the head.

Question 3

what are the clinical features (2)

Answer 3

1. itchy
2. erratic winding trail.
   - which may be obscured by excoriations