cutaneous larva migrans creeping eruption

3 min read 13-03-2025

Meta Description: Cutaneous larva migrans (creeping eruption) is a skin infection caused by hookworm larvae. Learn about its causes, symptoms, diagnosis, treatment, and prevention in this comprehensive guide. Discover how to identify and effectively manage this uncomfortable skin condition. Get expert advice on protecting yourself from this parasitic infection.

What is Cutaneous Larva Migrans (Creeping Eruption)?

Cutaneous larva migrans (CLM), also known as creeping eruption, is a skin infection caused by hookworm larvae. These larvae, typically from animal hookworms, burrow under the skin, causing a characteristic, itchy, and meandering rash. It's not contagious between humans, but it's important to understand how you can contract it.

Causes of Creeping Eruption

CLM is primarily caused by hookworm larvae, most often Ancylostoma braziliense and Ancylostoma caninum, which commonly infect cats and dogs. Humans are accidental hosts; the larvae cannot complete their lifecycle in humans. Infection occurs when the larvae penetrate the skin, usually through contact with contaminated soil or sand. This often happens barefoot on beaches, in playgrounds, or in areas where animals have defecated.

How it Spreads

The hookworm larvae are passed in animal feces. These larvae survive in warm, moist soil. When they come into contact with human skin, they penetrate the epidermis, causing the characteristic creeping rash. The larvae are not transmitted person-to-person.

Symptoms of Cutaneous Larva Migrans

The hallmark symptom of CLM is a serpiginous (snake-like) rash. It typically appears as a raised, reddish line or track under the skin. The rash is intensely itchy and can be quite uncomfortable. Other symptoms may include:

Intense itching: This is the most common and bothersome symptom.
Redness and swelling: Around the affected area.
Small, raised bumps: Along the track of the larva.
Blistering or papules: In some cases.

The rash typically begins as a small papule, which then develops into a curving, raised line. The larva moves about 1-2 cm per day, leaving a trail of inflammation behind it. The rash can be anywhere on the body, but it commonly affects the feet, legs, buttocks, and hands.

Diagnosing Creeping Eruption

Diagnosis of CLM is usually based on the characteristic clinical presentation of the rash. The appearance of the serpiginous tracks and the patient's history of exposure to potentially contaminated soil or sand are key indicators. A skin biopsy, while rarely necessary, can confirm the diagnosis by identifying the hookworm larvae.

Treating Creeping Eruption

Several treatments are effective for CLM. The goal is to kill the larvae and alleviate symptoms. Common treatments include:

Topical medications: Thiabendazole cream or other antiparasitic creams can be applied directly to the rash. These are often effective in killing the larvae.
Oral medications: Ivermectin is an effective oral medication used to treat CLM. A single dose is often sufficient.
Other treatments: In some cases, freezing the affected area with liquid nitrogen (cryotherapy) may be used.

The itching can be managed with over-the-counter hydrocortisone cream or oral antihistamines. It's important to avoid scratching the rash, as this can lead to secondary skin infections.

Preventing Cutaneous Larva Migrans

Prevention is key to avoiding CLM. Follow these guidelines to minimize your risk:

Wear shoes: When walking on beaches, in parks, or in other areas where animals may have defecated.
Avoid contact with contaminated soil: Wear gloves when gardening or working in areas where animals may frequent.
Wash hands thoroughly: After contact with soil or sand.
Proper sanitation: Ensure proper disposal of animal waste.

When to See a Doctor

While many cases of CLM resolve on their own with minimal treatment, it’s important to seek medical attention if:

The rash is widespread or severe.
Symptoms persist despite home treatment.
You develop a secondary skin infection.
You experience fever or other systemic symptoms.

By understanding the causes, symptoms, and treatments of Cutaneous Larva Migrans, you can effectively manage this condition and protect yourself from future infections. Remember, prevention is often the best medicine! Consult your doctor for diagnosis and treatment.