Diagnosis: hookworm larva. These larvae hatch from eggs which incubate in warm sandy tropical beaches. Dogs and cats are their carrier hosts and they release the larvae in their droppings. When the larva comes into contact with human skin, it burrows in.
The doctor also shared stories about jellyfish stings and sandfly bites.
Although I love our shores and can't wait to explore them, I never go out nowadays without covering all skin. I really don't understand how people can lie down half naked on the sand.
Before you head out for the beach, do this quiz on safety on our shores.
Beach mementoes
Dr Jean Ho, Mind your Body Straits Times 12 Nov 09;
Many families will be making their vacation plans for the year-end school holidays..
A sun-soaked beach getaway is a perennial favourite.
While many of us return showing off a tan, some will come back with less than happy mementoes.
Take eight-year-old Sharon who developed an itchy rash on her right sole when she came back with her family from an island resort holiday in West Malaysia. Her parents took her to the family physician, who diagnosed it as a fungal infection.
She was prescribed some tablets and a cream to apply. The itch seemed to subside but reappeared shortly after.
Several months passed before she came to see me.
Her mother said: 'The rash would not go away. It started on the sole but now it has gone to the top of her foot.'
On closer examination, the rash was raised and red, resembling a coil of rope under the skin.
It was the creeping rash.
This is an infection of the skin caused by the hookworm larva. These larvae hatch from eggs which incubate in warm sandy tropical beaches.
Dogs and cats are their carrier hosts and they release the larvae in their droppings.
When the larva comes into contact with human skin, it burrows in. Children are more prone to getting this rash as they tend to sit and play in the sand.
It is only several weeks later that the victim is aware of this parasitic invasion. By this time, the tiny worm has dug in, tunnelling through the skin and leaving a swollen itchy track in its wake.
The rash appears to migrate as the larva soldiers on. Hence its name, the creeping rash.
The good news is that the parasite eventually overstays its social visit pass and dies. However, it takes several months before this happens.
To hasten this process, and to eradicate the infection, anti-parasite medication can be taken.
Beyond the sand lurks a different danger in the water - the jellyfish.
Incidents of jellyfish stings peak from June to September. Your resort hotel's staff as well as locals will be able to give advice on when it is safe to venture into the sea.
The sting from the jellyfish causes a sharp, burning pain and red streaks will appear on the skin. It is important not to scratch, rub or douse the wound with fresh water.
Doing so will trigger the firing of stingers, causing more toxin to be released into the skin. Instead, use household vinegar or simply wash with sea water to inactivate the remaining stingers.
If there are any visible tentacles or stingers on the skin, these should be gently scraped off using a blunt object. Occasionally, jellyfish stings cause skin ulcers which take a longer time to heal. Medical attention should be sought when possible.
Jellyfish stings can be avoided by wearing a wet suit or using a sting prevention cream.
Finally, sandflies are probably the most common hazard that holiday makers face. Sandfly bites are not painful and rarely dangerous. However, they can put a damper on the holiday mood.
Ubiquitous insects that they are, sandflies can be found up in the mountains, by rivers as well as on beaches. Once a victim is bitten, the bumps swell up and itch for months. The itch from a sandfly bite is reported to be many times worse than a mosquito's.
Scratching will only worsen the condition and result in scars.
Arm yourself with insect repellent to minimise the chances of becoming sandfly fodder. If bitten, timely medical treatment will provide relief from the itch and prevent scars.
Here's hoping that no creeping, swimming or flying critters will get you down during this holiday season.
Dr Jean Ho is a consultant dermatologist with special interests in paediatric dermatology and laser surgery. She practises at Mount Elizabeth Medical Centre
