Case Number : Case 22 Posted By: Guest

Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I am the one who have very very limited experience Dr McKee, I just read this in a dermatopathology text book. But unfortunately, the information about cutaneous amebiasis in it is limited.

Submitted on 09/07/2010 21:06
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Phillip McKee - Overseas consultations (USA) Wrote:

From my very limited experience, acanthoemeba may present with cyst forms in the tissues. They may also be differentiated with immunohistochemistry

Submitted on 09/07/2010 20:49
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Balmuthia spp is the one that was detected in the walls of small blood vessels.

Submitted on 09/07/2010 18:58
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Mona Abdel Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Could the difference be in the possible detection of the acanthameba and not ameba in the walls of small blood vessels. Also acanthameba and not ameba may show tuberculoid granuloma often with accompanying vasculitis in the deep dermis and SC.

Submitted on 09/07/2010 18:55
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Phillip McKee - Overseas consultations (USA) Wrote:

So far no one has discussed how one distinguishes amoebiasis from acanthomebiasis. This is a question for Wayne as he is the expert on this problem!

Submitted on 09/07/2010 18:17
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

Amoebic infection. My knee-jerk diagnosis is amoebiasis cutis, but I can't see obvious erythrophagocytosis. The differential diagnosis, therefore, is infection with one of the free-living amoeba species, such as Acathamoeba spp. or Balamuthia mandrillaris.

Submitted on 09/07/2010 17:25
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HAE - (London) Wrote:

Cutaneous Amoebiasis (most probable diagnosis). Differential diagnosis: haemophagocytic lymphohistiocytosis??

Submitted on 09/07/2010 17:14
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Iskander Chaudhry - Central Manchester Trust (Manchester, U.K.) Wrote:

A beautiful example of Cutaneous Amebiasis (Entamoeba histolytica). DD. Acanthamebiasis. In general the aim is to have the cases on the site late at night the day before official posting; however, this is not always possible, so the latest the case will be on the site will be as stated 9 a.m. UK time.

Submitted on 09/07/2010 17:01
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Graham Reilly - Princess Elizabeth Hospital (Guernsey, UK) Wrote:

Cutaneous Amoebiasis.The trophozoites look like epithelioid histiocytes with granular cytoplasm.It took a bit of book searching to come to the diagnosis.This site is great and is certainly helping my dermatopath.Will try and contribute again soon after holiday.

Submitted on 09/07/2010 16:25
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Juan Carlos Garces - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Cutaneous Amoebiasis

Submitted on 09/07/2010 14:14
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Marcela Saeb Lima - MSL Dermatopato (Mexico City) Wrote:

Amoebiasis vs acantomoebiasis

Submitted on 09/07/2010 13:55
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Phillip McKee - Overseas consultations (USA) Wrote:

If this is amoebiasis, what is the differential diagnosis? The cases are put on the site in the UK generally late at night. It would be difficult to do it from my home as I am 8 hours behind.

Submitted on 09/07/2010 13:24
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Rachel - (Manchester) Wrote:

Cutaneous amoebiasis - i have never seen this before

Submitted on 09/07/2010 12:30
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Dear Dr McKee, Can we know at what time exactly do you post the new quiz every day?

Submitted on 09/07/2010 10:20
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

This was so challenging to me. My first impression was epithelioid histiocytes in a mucinous stroma (the right half of the field). I thought of progressive mucinous hitiocytosis with the interface between mucinous and non-mucinous stroma visualised in this section. Actually I was not comfortable about the granular nature of the cytoplasm of many of the histiocytes.When I was going to post this diagnosis , I read the other comments of amebiasis. This provoked me to read amebiasis. Apart from the information that the ameba trophozite is usually basophilic, what I read about amebiasis goes with this picture especially the phagocytosis of erythrocytes by the trophozites. This is also substantiated by the presence of granulation tissue in the left part of the field. I changed my mind and I will go with cutaneous amebiasis. If this is correct then I must say that this will be my first time to c cutaneous amebiasis. Thank you so much Dr McKee. I learn from this site every day.

Submitted on 09/07/2010 08:19
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Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt.) Wrote:

Orf.

Submitted on 09/07/2010 08:05
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Eduwiges Martínez - Hospital Gea González (Trainee) (Mexico, City) Wrote:

Cutaneous amoebiasis. You can see erythrophagocytosis, beautiful

Submitted on 09/07/2010 05:50
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Rodrigo Restrepo - UPB (Mdlln.Colombia) Wrote:

Yes, Dr McKee. I may sometimes be somewhat faster, but often not as successful in my diagnostic.

Submitted on 09/07/2010 04:15
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Phillip McKee - Overseasconsultations (USA) Wrote:

Rodrigo, you are very quick off the mark!!!!!

Submitted on 09/07/2010 01:43
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Rodrigo Restrepo - UPB (Mdlln. Colombia) Wrote:

Amoebiasis

Submitted on 09/07/2010 01:25
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