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case_images: Clinical appearance of patient with cutaneous amebiasis at the first dermatological consultation: nodular lesions and tumors on the abdomen, anterior and posterior thorax covered by slightly desquamative erythematous-violaceous skin; some lesions showed spontaneous drainage of purulent secretion.
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case_images: Direct examination of secretion collected by ultrasound-guided puncture (A) showing the parasite Entamoeba histolytica in the form of cysts and, in the center of the image (B), trophozoites.
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case_images: The collected material was sent to the microbiology laboratory for culture of aerobic, anaerobic and micro bacteria, which did not show growth of bacterial colonies, and to the parasitology laboratory, where direct examination showed structures compatible with cysts and trophozoites of Entamoeba histolytica (Fig. 2).
case_images: Histopathology. (A) Skin section showing an histiocytic reaction surrounding abscesses in the superficial and deep dermis (Hematoxylin & eosin, x40). (B) Evidence of Entamoeba histolytica trophozoites with similar morphology as on direct examination (Hematoxylin & eosin, x1000 under immersion oil).
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case_images: A skin biopsy was also performed, and histopathology showed an histiocytic reaction surrounding abscesses in the superficial and deep dermis, with trophozoites of Entamoeba histolytica identified on high power microscopy (Fig. 3).
case_images: Clinical appearance of the patient with cutaneous amebiasis after treatment with metronidazole and ivermectin, showing only residual lesions.
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case_images: The patient was reevaluated 30 days after the end of metronidazole therapy, showing significant improvement in the lesions, with regression of the nodules and subcutaneous tumors, absence of erythema, and only residual hyperchromia (Fig. 4).