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CREEPING ERUPTION

PRESENTED BY :FAHMI AWALUDDIN C111 09 344RESTI APRIANI MUZAKKIR C111 09 377FIRA WAHIADH FIRDAUS C111 10 320

ADVISOR : dr. NirmayantiSUPERVISOR : Dr. dr. Nurelly N. Waspodo, Sp. KK

Dermato-Venerology DepartmentMedical Faculty of Hasanuddin University

Dr. Wahidin Sudirohusodo

DEFINITION

Creeping eruption or cutaneus larva migrans is a skin disease in the form of infection which is caused by invasion of hookworm larva (Nematode) which originates from dogs and cats.

EPIDEMIOLOGY

• Creeping eruption is a rare parasite disease and it is found at tropical or subtropical areas which are warm and moist.

• This disease can infect all ages and both sexes.

ETIOLOGY

• Most cased is caused by uncinaria, a hookworm larva from the feces of cats and dogs, which is Ancylostoma brazilienze and Ancylostoma caninum.

• It can also be caused by larva from few types of flies, for example Castrophilus (the horse bot fly) and cattle fly

PATOGENESIS

TRANSMISSION

• Direct skin contact with soil which has been contaminated by the feces of dogs and cats.

CINICAL SYMPTOMPS

• Itchiness worse at night

DIAGNOSIS

Diagnosis is essentially based on history contact with infected soil, physical examination, and laboratory examination.

• AnamnesisThe entering of the larva into the skin is usually accompainaed with itchiness and burn sensation at the affected skin area, the itchiness usually worse at night. Usually there is direct skin contact with soil which has been contaminated by the feces of dogs and cats.

• Physical ExaminationAt physical examination, papule were found at the beginning, and later diameter of 2-3 mm, which is red in colour. The papule later on formed a burrow which reaches few centimeters in feet, hands upper and lower extremities, buttock, anus, or other body parts which had contact with places which has larva.

• Laboratory ExaminationBiopsi

Linier lession of cutaneus larva migran

Eritem characteristic of serpiginous tracks between toes (A) and in hand (B). Vesicobullae (C).

DIFFERENTIAL DIAGNOSIS

1. Scabies

Scabies in hand

2. Herpes Zoster

Herpes Zoster Ofthalmica

3. Insect Bite

Insect bite in feet

4. Tinea Corporis

Tinea corporis

TREATMENTS

Topical UseThiabendazole cream Topically for twice a

daily in 10 days

Systemic Use

Ivermectin oral Dose 200 μg/kg.bw, consume for 7-10 days

Albendazole oral 400 mg, consume for 3 days

PROGNOSIS

Prognosis of this disease is normally good and it is a self limited disease, where the larva will die and the lession will cure within 4-8 weeks. With proper medication, the progression of the lesion of itchiness will eventually disappear within 48 hours.

Complication

• Excoriation and secondary infection by bacteria due scratching, general infection is caused by Streptococcus pyogenes. Cellulitis and allergic reaction could happen.

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