Acanthamoeba is a ubiquitous free-living organism found world-wide and lives in diverse environmental niches including soil, waste dumps, cooling towers of air conditioning systems, humidifiers, aquaria, dialysis machines, dental equipment, as well as bottled tap, and sea waters. Additionally, they have been isolated from the nasal secretions of healthy individuals, including children, students, and military recruits indicating that subclinical infections might be commonThe life cycle of Acanthamoeba includes an active trophozoite stage in which it feeds on bacteria, and a dormant cyst which forms when environmental conditions become harsh. The cyst has a protective double wall that is resistant to chemicals and therapeutic drugs . Acanthamoeba causes two significant clinical infections: amoebic keratitis in immunocompetent contact lens wearers and granulomatous amoebic encephalitis (GAE) in immune suppressed people. Amoebic keratitis is a painful eye infection in which the amoebic organisms directly penetrate the ocular tissues and has been associated with soft contact lenses. Acanthamoebic GAE is a progressive disease of the central nervous system and occurs principally in immunocompromised patients. The route into the central nervous system appears to be from the skin (cutaneous Acanthamoebiasis), naropharynx or lungs after which it disseminates hematogenously. GAE has been an infection of increasing importance in the literature, particularly in organ transplant patients as well as patients with AIDS or those taking immunosuppressant medications. (Andrea D’Auria, Jamie Lin, P. Jan Geiseler, Yvonne Qvarnstrom, Rebecca Bandea, Sharon Roy, Rama Sriram, Christopher Paddock, Sherif Zaki, Gene Kim and Govinda S. Visvesvara: Cutaneous Acanthamoebiasis with CNS Involvement Post-Transplantation: Implication for Differential Diagnosis of Skin Lesions in Immunocompromised Patients). Pigmentary disorders typically indicate an increased amount of melanin, leading to darker color of the skin, called hypermelanosis or hyperpigmentation (Box 1). Decreased or absent pigment makes the skin appear lighter or white, known as hypomelanosis or hypopigmentation. Melanin is the pigment that gives the skin its characteristic color. Vitiligo is caused by a loss of pigment in the skin, due to destruction of pigment-forming cells known as melanocytes. Although vitiligo affects all races equally, it is more noticeable in dark-skinned people.

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