Background  Cutaneous acanthamebiasis is a rare infection and few patients have been reported worldwide.Methods  Observational and descriptive study carried out from March 1996 to February 2006 in patients with diagnosis of cutaneous free‐living amebic infection caused by Acanthamoeba spp. The patients were diagnosed at the Dos de Mayo National Hospital (Lima‐Peru) where skin biopsies, histopathologic studies and cultures were performed. The clinical and epidemiologic characteristics, diagnosis, treatment and evolution were recorded in a survey.Results  Five patients with cutaneous free‐living amebic infection caused by Acanthamoeba spp. were identified. Skin lesions were ulceronecrotic (four patients), an infiltrative bluish plaque (one patient), and a periorbital tumor (one patient). Three patients were positive for human immunodeficiency virus (HIV), had only cutaneous involvement, and died of opportunistic infections. The two immunocompetent patients developed Acanthamoeba granulomatous encephalitis and meningoencephalitis that progressed to intracranial hypertension and death.Conclusion  The clinical manifestations of cutaneous free‐living amebic infection caused by Acanthamoeba spp. appear to vary according to the underlying immunologic status.

BACKGROUND: Significant associations have been described between climatic factors and human health, which can occur in dermatologic diseases too. OBJECTIVE: To determine the influence of the climatic factors on the medical attentions of dermatologic diseases in a general hospital in Lima (Peru). PATIENTS AND METHODS: Observational study which was carried out in a national hospital between January 2004 and December 2007. The diagnoses were classified according to the ICD-10 system. The climate information was provided by the National Oceanographic and Atmospheric Administration from USA(NOAA). RESULTS: 3 294 patients were included in the study, the average age was 35.4 ± 20.7 years old, and 53.2% were females. The "El Niño" phenomenon was associated with an increase in the prevalence of actinic keratosis (p=0.002), viral warts (p=0.001) and rosacea (p=0.014). The "La Niña" phenomenon was associated with a reduction in viral warts (p=0.026). Spring was associated with an increase of dermatitis (p=0.003), and summer was associated with an increase of benign neoplasms (p=0.049). CONCLUSION: The climatic variations influenced the occurrence of certain dermatologic diseases. The present study may represent an orientation guide to specialists and general practitioners identifying the most common dermatologic diagnoses and thus enabling better preparation to treat these cases in determined seasons of the year.

In a public hospital in Lima, Peru, 24 patients with 16 types of paraneoplastic dermatoses were identified by data collection. The most frequent dermatosis was dermatomyositis (four patients). The other dermatoses were malignant acanthosis nigricans, palmoplantar keratoderma, bullous dermatoses, lymphomatoid papulosis, edematous scarring vasculitic panniculitis, Norwegian scabies, primary systemic amyloidosis, necrolytic migratory erythema, infective dermatitis, pancreatic panniculitis, generalized pruritus, Lesser-Trelat syndrome, and acquired ichthyosis. Most of these paraneoplastic dermatoses were diagnosed before (45.8%) or at the time of (38.5%) the diagnosis of the underlying malignancy. The most frequent underlying malignancies were lymphoma, adenocarcinomas of the upper digestive tract, and malignant neoplasms of the pancreas. The average age of the patients was 47.0 ± 16.9 years and the length of the disease since diagnosis was 13.7 months. The mortality rate was 75%. Paraneoplastic dermatoses are rare dermatologic entities that are difficult to diagnose. Surveillance is also hampered when patients do not have easy access to health care centers due to financial and geographical issues. However, when identified, they might facilitate the early diagnosis of an associated tumor and contribute to increase the surveillance of patients.