larva migrans, cutaneous

Children exposed to pet feces are at risk for several diseases. Pets often defecate into childrens sand boxes, which transfers the eggs of certain cat or dog hookworms into the sand. If larvae penetrate the skin (from playing in sandboxes or at the beach where dogs and cats have defecated) the larvae can penetrate the skin to a shallow depth. From the point of entry they worm their way under the skin in a wandering track that is red, raised, and very itchy. This condition is called cutaneous larva migrans, or "creeping eruption."

Infective larvae of cat and dog hookworms, Ancylostoma braziliense and Ancylostoma caninum, are the usual causes. Other skin-penetrating nematodes are occasional causes.

Treatment is pretty simple if there are just one or two worm tracks. Mintezol (an antiparasitic usually taken orally but in this case applied topically) is applied to the tracks twice a day for three days.1 Alternatively, the older treatment can be used, which consists of spraying ethyl chloride on the skin just ahead of where the track seems to be going, freezing and killing the larva. If there are multiple tracks, oral ivermectin, an antiparasitc drug, is given in a single dose. Ivermectin can also be used to treat drug resistant head lice.

Remember to keep your small child's play sand covered when the sandbox is not in use! Wash you hands after handling pets, and keep puppies and kittens dewormed. See larva migrans, visceral (toxocariasis) Your veterinarian is your best source of information to prevent these sorts of infections, and can test and treat your pets.
1. Archives of Dermatology 129:588-591

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