Like GAE, cutaneous infections caused by Acanthamoeba species are rare and are mostly seen in immunocompromised persons. The diagnosis must exclude viral, fungal, mycobacterial, and bacterial infections. Cutaneous lesions, shown in the images, usually begin as papules or hard nodules. Non-healing necrotic skin ulcers may also occur. The lesions, which may or may not be painful, are mostly found on the lower limbs. In addition to Acanthamoeba trophozoites, pathological examination shows an intense inflammatory reaction with histiocyte predominance. Patients showing skin involvement alone can expect a 76% mortality rate.