Causes and risk factors
Creeping eruption can be caused by larva migrans, zoonotic hookworm, Ancylostoma caninum, Ancylostoma braziliense, Bunostomum phlebotomum, Uncinaria stenocephala. The hookworm eggs are shed in the dog feces and when the eggs hatch the larvae infest the contaminated soil. When one comes in contact with this contaminated soil, the larvae burrow into the skin causing rash and itching. It is common in warm climates and more common in children than adults. Risk factor include contact with damp and sandy, contaminated soil while gardening, etc., walking bare foot on sandy beach where the soil may be contaminated with the larvae. People at a high risk include sun bathers, barefoot beachcombers, farmers, gardeners, plumbers, hunters, carpenters, pest examiners, etc.
Clinical presentation
An eruption occurs at the site of entry of larvae. There is tingling and prickling sensation. The larvae remain in dormant form or may even start creeping on adjacent skin area. They form 2-3 mm wide snake like tracks on the skin. They are raised and pink in color. Patient presents with intense itching and blisters. Most often it affects the feet, interphalangeal spaces, buttocks, knees, and hands. These eruptions spread gradually.
Investigation
Medical history by the patient and clinical examination by the dermatologist helps in diagnosis. Skin biopsy is required to rule out other health conditions. Blood tests are recommended to check the eosinophil count.
Treatment
No treatment is required for many patients as the disease is self-limiting and resolves within 4-8 weeks. To hasten the recovery, antihelminthics may be prescribed. Medicines like anti-histaminic, corticosteroids may be given to treat itching. Antibiotics may be required to treat secondary infection, if any. Topical creams are given for soothing and symptomatic relief from itching.
Other Modes of treatment
The other modes of treatment can also be effective in treating a creeping eruption. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating a creeping eruption.
