Creeping eruption

Ana Pulido-P
erez, MD,a Virna Judith Rodr
guez-Soria, MD,a Celia Horcajada-Reales, MD,a
Rosa Melero, MD,b and Ricardo Su
arez-Fern
andez, MD, PhDa
Madrid, Spain

A 45-year-old man presented with an intermittent eruption on his trunk and buttocks that began
48 hours earlier. He was born in Ecuador but had lived in Spain for [10 years. He received high-dose
methylprednisolone because of idiopathic thrombocytopenic purpura 3 days before the onset of skin
lesions. The physical examination revealed a pruritic urticarial rash over the lateral aspects of his trunk
(Fig 1). Some of these hives had a serpiginous appearance, moving around the waist in a few hours
(Fig 2). Blood tests revealed fluctuating eosinophil counts. Direct examination of fresh stool specimens were negative.
1.

What is the most likely diagnosis?

A. Dermographism
B. Larva currens
C. Anisakiasis
D. Dracunculiasis
E. Onchocerciasis

2.

What test has the highest sensitivity for the detection of Strongyloides stercoralis infection?
A. Skin biopsy
B. Serology
C. Microscopic identification of larvae in stool samples
D. Entero-Test (string test) and duodenal aspiration
E. Stool culture

From the Departments of Dermatologya and Nephrology,b Hospi
n, Madrid.

tal General Universitario Gregorio Mara~
no
Funding sources: None.
Conflicts of interest: None declared.
Correspondence to: Ana Pulido-P
erez, MD, Department of Der
n,
matology, Hospital General Universitario Gregorio Mara~
no

Calle Doctor Esquerdo, 46, 28007 Madrid, Spain. E-mail: ana.

pulido@madrimasd.net.
J Am Acad Dermatol 2015;73:e45-6.
0190-9622/$36.00
2015 by the American Academy of Dermatology, Inc.
http://dx.doi.org/10.1016/j.jaad.2015.03.023

e45

e46 Pulido-P
e rez et al

3.

What is the treatment of choice?

A. Metronidazole
B. Imiquimod cream
C. Cryotherapy
D. Ivermectin
E. Paromomycin
Please visit http://www.eblueimages.org to answer these questions.

J AM ACAD DERMATOL

AUGUST 2015