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May 1998

Creeping Eruption

Arch Dermatol. 1998;134(5):619-620. doi:10.1001/archderm.134.5.619

IN THIS issue of the ARCHIVES there is a report of cases of gnathostomiasis, a form of creeping eruption sometimes known as eosinophilic nodular migratory panniculitis or larva migrans profundus.1 This disease, rare in the United States, is caused by a roundworm, which is generally a parasite of freshwater fish (Gnathostoma doloresi) or dogs (Gnathostoma spinigerum). Humans are accidental hosts, and they become infested when they ingest raw or inadequately cooked fish or meat. The ingestion of raw snake meat might be considered unusual in the United States, but we are not immune to this kind of problem. Some people like to consume raw meat under the guise of steak tartare or even rare hamburgers. Sushi and sashimi consist of raw fish, and we are at the mercy of the sushi chef to be certain that no parasitized fish were prepared. One might think that the recent scare regarding Escherichia coli in our meat supply and Salmonella in chickens and eggs would convince most of us to process our animal proteins more thoroughly. Clearly, meticulous cooking of food would eliminate all these diseases.