Clinical features:
(1) The patient has a history of (a) recent intra-abdominal surgery, typically involving the intestines or appendix, (b) drainage of a hepatic abscess, or (c) drainage of a thoracic empyema.
(2) A skin lesion develops 10-14 days after surgery, usually on the trunk.
(3) The lesion is associated with severe pain.
(4) The lesion is slowly progressive over weeks.
(5) The lesion has 3 distinctive zones, with an outer zone of erythema, a raised purple margin and central granulation tissue.
Possible causes of the clinical lesion:
(1) cutaneous amebiasis
(2) secondary bacterial infection of cutaneous amebiasis
(3) mixed bacterial cellulitis
The diagnosis of cutaneous amebiasis may be difficult unless it is suspected. With modern techniques it should be possible to demonstrate serum antibodies to Entamoeba histolytica, amoeba in the stool, or immunostain the organism in the histologic sections or smears.
