Amoebiasis cutis: clinical suspicion is the key to early diagnosis.
Amoebiasis cutis is a rare manifestation of Entamoeba histolytica, primarily an intestinal pathogen, which occurs as a complication of amoebic dysentery. Primary cutaneous amoebiasis occurs from contamination of pre-existing wounds. A high degree of clinical suspicion and demonstration of trophozoites from lesions are important for making an early diagnosis lest these patients should suffer significant morbidity. A HIV-negative and otherwise healthy 40-year-old man presented with a well-defined, indurated, painful, progressively enlarging plaque with overlying ulcers and pus discharging sinuses involving buttocks, perianal/perineal area and part of the left thigh of 3 years' duration. A wide array of investigations was unhelpful but demonstration of Entamoeba histolytica trophozoites in wet-drop preparation from the ulcer margin was diagnostic. The trophozoites were also visualized both in H&E and periodic acid Schiff-stained histological sections. Resolution of lesion was observed 2 weeks after treatment with oral metronidazole 800 mg three times a day and wound care.
Departments of Dermatology, Venereology and Leprosy, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001, India. vkm1@rediffmail.com
Ghanshyam K
GK
Verma
Nand Lal
NL
Sharma
Vinay
V
Shanker
Vikram K
VK
Mahajan
Rajani
R
Kaushik
Santwana
S
Verma
Nidhi
N
Jindal
D000328:Adult; D000562:Amebiasis / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D004748:Entamoeba histolytica / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D012883:Skin Ulcer / Q000175:diagnosis* / Q000469:parasitology* / Q000473:pathology; D013492:Suppuration / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology; D053058:Trophozoites
D008795:Metronidazole