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KEY FEATURES

  • Caused by larvae of the dog and cat hookworms, Ancylostoma braziliense and Ancylostoma caninum

  • Worms migrate through skin; they cannot complete their life cycles so only cause cutaneous disease

  • May also be caused by other animal hookworms, gnathostomiasis, strongyloidiasis

  • Infection common in warm areas, including the southeastern United States

  • Most common in children

CLINICAL FINDINGS

  • Intensely pruritic erythematous papules develop, usually on the feet or hands

  • Papules are followed within a few days by serpiginous tracks marking the course of the parasite, which may travel several millimeters per day

  • Several tracks may be present

  • The process may continue for weeks, with lesions becoming vesiculated, encrusted, or secondarily infected

  • Without treatment, the larvae eventually die and are absorbed

DIAGNOSIS

  • Based on the characteristic appearance of the lesions

  • Biopsy is usually not indicated

TREATMENT

  • Mild cases do not require treatment

  • Thiabendazole (10% aqueous suspension) can be applied topically three times daily for 5 or more days

  • Systemic therapy with albendazole (400 mg orally once or twice daily for 3–5 days) or ivermectin (200 mcg/kg orally single dose) is highly effective

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