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Tropical dermatology: Tropical diseases caused by protozoa

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1 Tropical dermatology: Tropical diseases caused by protozoa
Omar Lupi, MD, PhD, Brenda L. Bartlett, MD, Reshma Nair Haugen, MD, Lady C. Dy, MD, Aisha Sethi, MD, Sidney N. Klaus, MD, Jackson Machado Pinto, MD, PhD, Francisco Bravo, MD, Stephen K. Tyring, MD, PhD  Journal of the American Academy of Dermatology  Volume 60, Issue 6, Pages (June 2009) DOI: /j.jaad Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

2 Fig 1 Leishmaniasis life cycle. (Figure used with the permission of the CDC/DPDx.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

3 Fig 2 Cutaneous leishmaniasis: nodule.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

4 Fig 3 A, Chiclero ulcer. B, Cutaneous leishmaniasis: impetigo-like and ecthyma-like lesions (Bauru ulcers). Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

5 Fig 4 Cutaneous leishmaniasis: papulotuberous lesion.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

6 Fig 5 Lymphatic spread of cutaneous leishmaniasis.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

7 Fig 6 Leishmaniasis. Typical scar characterized by thin and pale skin over the ulcer site and surrounded by a hyperpigmented halo. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

8 Fig 7 Lupus-like and impetigo-like lesions of leishmaniasis.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

9 Fig 8 Mucosal leishmaniasis: late destruction of nasal septum.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

10 Fig 9 Leishmaniasis: destruction of glans penis by granulomatous squamous cell carcinoma–like lesion. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

11 Fig 10 Giemsa-stained tissue smears showing promastigotes (arrows). Notice the kinetoplasts which are the smaller round structures adjacent to the nuclei of the promastigotes. (Giemsa stain; original magnification: ×250.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

12 Fig 11 Promastigotes inside macrophages in hematoxylin–eosin-stained tissue section. (Original magnification: ×100.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

13 Fig 12 A, Perianal ulcer of cutaneous amebiasis caused by Entamoeba histolytica in a male after having oral-anal sexual relations with an immigrant from Mexico. B, Two weeks posttreatment with oral metronidazole. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

14 Fig 13 Biopsy from perianal ulcer exhibiting amebas in the tissue. (Hematoxylin–eosin stain; original magnification: ×40.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

15 Fig 14 Cutaneous amebiasis. Typical plaque on central face in an adult. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

16 Fig 15 Amebiasis. Trophozoite in the skin biopsy, showing nucleus and nucleolus. The organism is surrounded by multinucleated giant cells. (Hematoxylin–eosin stain; original magnification: ×1000.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

17 Fig 16 “Barbeiro” bug (Triatoma infestans; courtesy of M. M. O. Cabral, MD, Instituto Oswaldo Cruz/Oswaldo Cruz Foundation). Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

18 Fig 17 Romaña sign. Acute Chagas disease in a young girl with Romaña sign present in the left eye. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

19 Fig 18 Congenital toxoplasmosis. Hemorrhagic lesions on the trunk.
Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

20 Fig 19 Cutaneous toxoplasmosis. Trophozoites are seen within the cytoplasm of macrophages (Giemsa stain; original magnification: ×250.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

21 Fig 20 Cutaneous pneumocystosis. Skin-colored nontender papule on the arm. Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions

22 Fig 21 Typical cysts of Pneumocystis jiroveci (Grocott methenamine silver stain; original magnification: ×250.) Journal of the American Academy of Dermatology  , DOI: ( /j.jaad ) Copyright © 2009 American Academy of Dermatology, Inc. Terms and Conditions


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