How can creeping eruption be prevented

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.

Health Home Conditions and Diseases. What causes creeping eruption? What are the symptoms of creeping eruption? 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. How is creeping eruption diagnosed? How is creeping eruption treated? Can creeping eruption be prevented? 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. Each person may have slightly different symptoms. Symptoms may include:. Winding, snakelike rash because the hookworm burrows along a path that creates a winding rash.

These symptoms may also be caused other skin conditions. Always see your healthcare provider for a diagnosis. Your healthcare provider will often make the diagnosis based on your health history and a physical exam. Creeping eruption may be treated with antiparasitic medicines such as albendazole, ivermectin, and thiabendazole. They may be taken by mouth orally. Or they may be applied as a topical cream used directly on the rash.

This condition goes away on its own, because the hookworm can't survive in human skin for very long. It will disappear in a few weeks or months even if not treated. People are rarely exposed to hookworms in the U. This is because most cats and dogs are treated for worms. 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. It can be caused by exposure to moist sand that has been contaminated by infected dog or cat stool. In 1 series, cryotherapy repeated applications of liquid nitrogen was unsuccessful for 6 patients and resulted in severe blistering or ulceration in 2 patients [ 7 ].

In another series, none of 7 patients treated with liquid nitrogen was cured [ 6 ]. Because this method is both ineffective and painful, it should be avoided. The thiabendazole cream was prepared by crushing mg tablets of thiabendazole in a water-soluble base.

In most patients the pruritus ceased and larval track migration halted within 48 h of treatment. In the other 2 cases, treatment was successful after 2 weeks in 1 case and after 4 weeks in the other [ 7 ].

The main advantage of topical treatments is the absence of systemic side effects. Their main disadvantages are that they have limited value for multiple lesions and hookworm folliculitis and that they require multiple daily applications for several days.

Thiabendazole is the drug with which there has been the most experience in the oral treatment of cutaneous larva migrans [ 5 , 9—12 ] table 1. Thiabendazole is poorly effective when given as a single dose. Thiabendazole is less well tolerated than either albendazole or ivermectin.

In a study of patients treated with thiabendazole 1. Albendazole is a third-generation heterocyclic antihelmintic drug. It has been used for about a decade to treat intestinal helminthiases, such as ascaridiasis, enterobiasis, ancylostomiasis, trichuriasis, and strongyloidiasis. Trials of albendazole in the treatment of cutaneous larva migrans have yielded conflicting results with respect to the optimal dosage.

Albendazole has also been used with success at higher daily doses mg for 3 consecutive days. However, in the largest trial of albendazole in cutaneous larva migrans involving 26 Italian tourists , treatment with mg for 5 consecutive days failed for 2 patients [ 18 ]. In addition, in a study of 11 French tourists, a single mg dose failed in 6 cases [ 19 ]. In 2 of the 3 studies involving tourists, albendazole failed for 2 of 26 Italian patients [ 18 ] and 6 of 11 French patients [ 19 ], while the duration of follow-up was not given in the third study [ 14 ].

Albendazole was well tolerated in trials involving patients with cutaneous larva migrans. Other publications suggest that albendazole is well tolerated unless given at high dosages or for extended periods, such as those required for hydatid disease [ 21 ]. Ivermectin, an avermectin B derivative, is active against Onchocerca volvulus and other nematodes, including gastrointestinal helminths.

Its mechanism of action is poorly understood [ 22 ]. Since then, the efficacy of ivermectin has been confirmed in 3 larger studies. Treatment of cutaneous larva migrans with a single oral mg dose of ivermectin. Another study involved 67 Belgian tourists treated with a single dose 12 mg of ivermectin. The median intervals until disappearance of the pruritus and lesions were 3 days range, 1—7 days for the patients who received a second dose, and 9 days range, 4—30 days for those who received a third dose.

Only 2 patients were not cured by ivermectin [ 27 ]. Ivermectin has been well tolerated in studies of patients with cutaneous larva migrans, and no adverse effects have been reported in indications other than filariasis [ 28 ]. Almost all the adverse effects are a result of the patient's immune response to killed microfilariae [ 22 ]. An open study [ 19 ] compared the efficacy of single doses of oral ivermectin 12 mg and oral albendazole mg in the treatment of cutaneous larva migrans.

No major adverse effects were observed. The investigators concluded that a single mg dose of ivermectin was more effective than a single mg dose of albendazole for the treatment of cutaneous larva migrans [ 19 ]. Because tourists are usually infected by walking or lying on tropical sandy beaches contaminated by dog feces, the best way to prevent cutaneous larva migrans is to ban dogs from beaches figure 2 , top [ 29 ]. Because this is clearly impossible in developing tropical countries, where dogs are ubiquitous, it is best to wear shoes when walking in sandy areas.

When on tropical beaches frequented by dogs, it is best to lie on sand washed by the tide or to use a mattress; avoid lying on dry sand, even on a towel figure 2 , bottom. Google Scholar. Google Preview. Top , Prevention of cutaneous larva migrans: no dogs allowed on beaches Sydney, Australia. Bottom , Avoidance of cutaneous larva migrans: lie on the part of the beach washed by the tide Boracay, Philippines.

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