Bumb R A, Mehta R D
Department of Skin, STD and Leprosy, S. P. Medical College, Bikaner, Rajasthan, India.
Indian J Dermatol Venereol Leprol. 2006 May-Jun;72(3):224-6. doi: 10.4103/0378-6323.25786.
Protozoan infections of the skin, particularly cutaneous amoebiasis, are rare in HIV-positive patients. We report a case of amoebiasis cutis in an HIV-positive truck driver with a history of frequent unprotected sexual exposures. He presented with multiple painful ulcers and sinuses with purulent discharge, necrotic slough and scarring in the perianal and gluteal region for the last 2 years. He was positive for HIV-1 and -2. Cutaneous biopsy revealed numerous Entamoeba histolytica in the trophozoite form, in addition to an inflammatory infiltrate and necrotic debris. He responded well to oral metronidazole and chloroquine. Amoebiasis cutis should be considered in the differential diagnosis of perianal ulcers, particularly in HIV-positive patients.
皮肤原虫感染，尤其是皮肤阿米巴病，在HIV阳性患者中较为罕见。我们报告一例HIV阳性卡车司机的皮肤阿米巴病病例，该患者有频繁无保护性行为史。他在过去两年中肛周和臀区出现多处疼痛性溃疡及伴有脓性分泌物、坏死性腐肉和瘢痕形成的窦道。他的HIV-1和HIV-2检测均为阳性。皮肤活检显示除炎性浸润和坏死碎片外，还有大量滋养体形式的溶组织内阿米巴。他对口服甲硝唑和氯喹反应良好。在肛周溃疡的鉴别诊断中应考虑皮肤阿米巴病，尤其是在HIV阳性患者中。
