Overview
Cutaneous larva migrans (CLM), also known as 'creeping eruption,' 'sandworm disease,' or 'ground itch,' is a skin infection caused by the larvae of certain hookworms — most commonly Ancylostoma braziliense, a parasite that normally lives in dogs and cats. Humans become infected when their bare skin comes into contact with soil or sand that has been contaminated with infected animal feces. The larvae burrow into the outer layers of the skin but cannot complete their life cycle in humans, so they wander aimlessly under the skin, creating a winding, raised, red track that moves a few millimeters to a centimeter each day. The most noticeable symptom is intense itching, often worse at night, along with a visible, snake-like red line on the skin that slowly moves over days. The feet, legs, and buttocks are most commonly affected, since these areas are most likely to touch contaminated ground. The condition is not life-threatening in most cases and does not spread from person to person. Treatment is very effective. Antiparasitic medications such as ivermectin or albendazole are the standard treatments and typically clear the infection within a few days to weeks. Without treatment, the larvae usually die on their own within a few weeks to months, but the itching and discomfort can be severe. Early treatment is strongly recommended to relieve symptoms and prevent skin damage from scratching.
Key symptoms:
Intense itching of the skin, often worse at nightA raised, red, winding or snake-like track on the skin surfaceThe track slowly moves or extends over daysRedness and swelling around the affected areaSmall fluid-filled blisters along the trackSkin irritation and rawness from scratchingBurning or tingling sensation on the skinMost commonly affects feet, legs, buttocks, or hands
Sporadic
Usually appears on its own, not inherited from a parent
Variable
Can begin at different ages, from infancy through adulthood
Treatments
No FDA-approved treatments are currently listed for Cutaneous larva migrans.
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Specialists
View all specialists →No specialists are currently listed for Cutaneous larva migrans.
Treatment Centers
8 centersBaylor College of Medicine Rare Disease Center ↗
Baylor College of Medicine
📍 Houston, TX
🏥 NORDStanford Medicine Rare Disease Center ↗
Stanford Medicine
📍 Stanford, CA
🔬 UDNNIH Clinical Center Undiagnosed Diseases Program ↗
National Institutes of Health
📍 Bethesda, MD
🔬 UDNUCLA UDN Clinical Site ↗
UCLA Health
📍 Los Angeles, CA
🔬 UDNBaylor College of Medicine UDN Clinical Site ↗
Baylor College of Medicine
📍 Houston, TX
🔬 UDNHarvard/MGH UDN Clinical Site ↗
Massachusetts General Hospital
📍 Boston, MA
🏥 NORDMayo Clinic Center for Individualized Medicine ↗
Mayo Clinic
📍 Rochester, MN
👤 Mayo Clinic Center for Individualized Medicine
🏥 NORDUCLA Rare Disease Day Program ↗
UCLA Health
📍 Los Angeles, CA
Travel Grants
No travel grants are currently matched to Cutaneous larva migrans.
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Caregiver Resources
NORD Caregiver Resources
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Mental Health Support
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Family & Caregiver Grants
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Social Security Disability
Learn how rare disease patients may qualify for SSDI/SSI benefits.
Questions for your doctor
Bring these to your next appointment
- Q1.Which medication do you recommend for my case — ivermectin or albendazole — and why?,How long will it take for the skin track to disappear after I start treatment?,What should I do if the itching is very severe while I wait for the medication to work?,How do I know if the skin has become secondarily infected and needs additional treatment?,Is there anything I can apply to the skin to help with comfort while I recover?,How can I prevent getting this infection again in the future?,Do my pets need to be checked or treated by a vet to prevent spreading this to others?
Common questions about Cutaneous larva migrans
What is Cutaneous larva migrans?
Cutaneous larva migrans (CLM), also known as 'creeping eruption,' 'sandworm disease,' or 'ground itch,' is a skin infection caused by the larvae of certain hookworms — most commonly Ancylostoma braziliense, a parasite that normally lives in dogs and cats. Humans become infected when their bare skin comes into contact with soil or sand that has been contaminated with infected animal feces. The larvae burrow into the outer layers of the skin but cannot complete their life cycle in humans, so they wander aimlessly under the skin, creating a winding, raised, red track that moves a few millimeters
How is Cutaneous larva migrans inherited?
Cutaneous larva migrans follows a sporadic inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.