This patient presented with a hookworm infection involving the toes of the right foot, which is also known as “ground itch”. Usually the first sign of infection is itching, and a rash at the site where skin touched contaminated soil or sand, which occurs when the larvae penetrate the skin, followed by anemia, abdominal pain, diarrhea, loss of appetite, and weight loss..

Picture & text from CDC/PHIL. For more information see Hookworm Pictures from CDC