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December 2000

Serpiginous Plaques on the Leg

Author Affiliations
 

MICHAEL E.MINGMD

Arch Dermatol. 2000;136(12):1559-1564. doi:

The epidermis revealed spongiosis and an intraepidermal vesicle filled with neutrophils and eosinophils. The dermis and epidermis showed an inflammatory infiltrate with many eosinophils.

The patient was treated with albendazole (400 mg/d) for 3 days. The itching disappeared after 2 days, and the skin eruption healed within 1 week. To our knowledge, there has been no recurrence.

Cutaneous larva migrans, or creeping eruption, is a process in which parasites are moving within the spinous layer of the epidermis or follicular infundibula. A creeping eruption is usually caused by hookworms, most commonly Ancylostoma braziliense and Ancylostoma caninum.1 Adult hookworms live in the intestines of dogs and cats. A survey of stray dogs in Uruguay showed that 96.3% of the dogs were infected by hookworms.2 The ova of hookworms are deposited in feces. Under warm and moist conditions, the ova hatch into infective larvae and can penetrate human skin. Man acts as a "dead-end" host. The condition is common in warm climates but may occur in Northern Europe during a hot summer.3

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