CREEPING ERUPTION 



Asian Dermal Myiasis. 



Myiasis has not been sufficiently studied in Asia, though it is 

 fairly common there. Sarcophaga ruficornis is reported as causing 

 occasionally a very severe form of cutaneous myiasis, but beyond 

 this much cannot be said. 



European Dermal Myiasis. 



The myiasis of Europe scarcely comes under the scope of tropical 

 medicine, but it may be mentioned that dermal myiases are known 

 to be caused by Hypoderma bovis de Geer, 1776 (p. 826) ; H. diana 

 Brauer; H. lineata de Villers, 1789; Gastrophilis nasalis Linnaeus, 

 1758; G. hcumorrhoidalis Leach, 1761; G. veterinus; and Lucilia 

 sericata. 



Creeping Eruption. 



Synonyms. — Creeping disease, Larva migrans. Bulgarian, Nova Bolest, 

 Piilziasta Bolest; German, Hautmaulwarf, Kreechkrankheit, Hautkratzschorf . 



History — -This disease was first described by A. Lee in 1875. 

 Later on, Procke, Blanchard, Topsent, Fiilleborn, and others have 

 recorded several cases. It is not rare in some parts of Europe, 

 Africa, and Asia, and in South America. We have seen numerous 

 cases in Ceylon. It is extremely rare in North America. 



lEiiology and Pathology. — Larvae of the genera Gastrophilus, 

 G. hamorrhoidalis and G. nasalis, (Estromyia satyrus, Hypoderma 

 bovis, and H. lineata have been found in several cases. Tn others 

 no larva whatever was found. Looss states that the same clinical 

 picture may be caused occasionally by Ancylostoma and. Strongy- 

 loides {Angmllula) larvae, or even by an inanimate object like a 

 piece of horsehair. A larva has been found 2 milhmetres from in- 

 flamed end, under a small dark spot. 



Symptomatology. — The eruption is characterized by the presence 

 of a narrow raised red line, ^ to i inch broad. This line extends 

 daily one or several inches, and is generally sinuous, but may be 

 straight. While the advancing end progresses, the opposite end 

 slowly fades away. The duration of the malady is long, generally 

 several months, but occasionally two or three years. There is much 

 pruritus. 



Treatment, — Hypodermic injections of various disinfectants 

 have been tried, with little success. Hutchins recommends a 

 cocaine injection, followed by the injection of i or 2 drops of chloro- 

 form. 



ALLIED CONDITIONS. 



Allied to the myiases are infestations by the larvae or imagines 

 of the Lepidoptera, Coleoptera, Diplopoda. Chilopoda, and 

 Derm opt era. 



