CUTANEOUS HELMINTHIASIS-Reply

To the Editor:— The elimination of the possibility of concomitant infection with Nector Americanus must be based on two factors: ( a ) the clinical appearance of the skin lesions and ( b ) the absence of ova or parasites in the stool six weeks or more after the cutaneous invasion. Further perusal of Belding's textbook (pages 492-496) clearly differentiates the papulovesicular eruption caused by Necator americanus and less frequently by Ancylostoma duodenale from the classic serpigenous burrows of creeping eruption of Ancylostoma braziliense. The mild, transient vesicular lesions produced by Ancylostoma canjnum are similarly differentiated. If concomitant infection with human hookworm had been present the ova and/or parasites would have appeared in the stool beginning six weeks after the cutaneous invasion. In our original paper (Wright, D. O., and Gold, Edwin M.: Loeffler's Syndrome Associated with Creeping Eruption [Cutaneous Helminthiasis],The Journal, August 11, p. 1082) we stated that "examination of 81 stool