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Case #523 - September, 2020

A 53-year-old woman from Florida presented to a dermatology clinic with a raised, itchy, red rash on her torso that persisted over the past six months and did not respond to topical treatments. She did not report any recent travel outside of the state. Physical examination noted erythematous papular lesions and punch skin biopsies were collected. Figures A and B show histopathological sectioning of the biopsy revealing numerous eosinophils and a cluster of suspicious parasitic structures (15–25 µm in width). What is your diagnosis? Based on which features?

This case and images courtesy of AmeriPath, Fort Myers, Florida.

Figure A

Figure A

Figure B

Figure B

Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit www.cdc.gov/parasites/.

Page last reviewed: April 28, 2021