The larvae of the dog hookworms (Ankylostoma spp) together with certain other parasites are spread by dog faeces. After penetrating the epidermis, they are unable to enter the blood or lymph streams and instead burrow just below the skin, traveling up to an inch a day. Papules mark the site of entry and advancing end of the larva and the tunneling causes linear, slightly elevated erythematous and serpigenous areas which itch intensely. Vesicles may form along the course of the tunnels and scaling develops as the lesions age. The most common sites in children are the buttocks and the dorsa of the feet, but any area can be affected.
Diethylcarbamazine (Hetrazan, Banocide) (5 mg/kg per day for 7 days), or thiabendazole (Mintezol) (50 mg/kg in two divided doses twice daily for 3 days, repeated at weekly intervals if necessary). Best cure rates, however, are achieved with Topical thiabendazole which can easily be made from the oral preparation if not commercially available.