Creeping Eruption Caused by the Larvae of the Cattle Hookworm Bunostomum phlebotomum

Abstract

Several years ago while making a series of inoculations with third stage larvae of the hookworm, Bunostomum phlebotomum, and the nodular worm, Oesophagostomum radiatum, by placing the larvae on the skin of the calves we frequently noted the appearance of small inflamed spots between our fingers. 1 Some of these spots increased after a few hours to about 1/4 inch in diameter, followed after 2 or 3 days by the appearance of a narrow, linear, tortuous eruption which became extended at intervals during the next few days. Following the course of these eruption areas a slightly raised, vesicular line generally developed within a few hours which might be interrupted at points. The entire area became more or less swollen and intensely itchy particularly in the mornings. Within about 2 weeks the surface of the skin was dry, scaly, and the irritation gone. Recently another series of inoculations were undertaken using pure cultures of hookworm larvae 2 and we again noted the appearance of these spots always coincidently with the skin inoculations on the calves.

The following may be taken as a typical description of one of these lesions. On October 3, 1946 several lesions developed following the application of larvae to the skin of a calf, one of these being on the interdigital surface of the ring finger on the side adjacent to the middle finger and at the distal joint. This lesion developed to the diameter of 1/2 inch in 2 or 3 hours, and remained in this condition until the night of October 7, when a narrow, elevated, linear extension about 1/4 inch long appeared directed toward the palmar side of the finger. On the night of October 8 a right angle extension about 1/4 inch long developed toward the tip of the finger.