This skin rash is a manifestation of parasites migrating through the skin, predominately within the spinous layer of the epidermis or follicular infundibula.
Hookworms are the most common parasite.
The classic clinical presentation are serpiginous winding lesions with intense itching. Any area of skin which has had contact with the ground is at risk, including the hands, feet, buttocks, and knees. The hookworm larvae advance about a few millimeters to centimeters a day. Clinical Diagnosis and Management by Laboratory Methods.