Patients present with intensely pruritic, thin, erythematous, serpiginous, raised eruptions on the sole of the foot, hand, or buttock (Fig. 166.1). The patient may remember recently walking barefoot or sitting in the sand or soil in an area frequented by dogs or cats. Most commonly, this is seen in travelers returning from tropical or subtropical locations in the Caribbean, Central America, and South America, as well as in the southeastern United States.

 

The etiology of these symptoms is from dog or cat hookworm infections. Beaches and sandboxes provide reservoirs for these parasites. Humans become a dead-end host for the microorganisms by walking through contaminated areas with bare feet or with open footwear or by sitting in the tainted sand or soil.