Ectopic cutaneous schistosomiasis: extragenital involvement with progressive upward spread

The ectopic deposition of ova of Schistosoma haematobium within the dermis is very rare, even in countries where infection with this trematode is widespread. When it does occur, it usually affects the genital area. We report a patient who developed ectopic genital and extragenital cutaneous involvement 4 months after swimming in Lake Malawi. The lesions appeared sequentially and spread from the genitalia in a caudocephalic manner. Doppler imaging of the pelvic veins did not reveal any anomalous venous drainage to account for the distribution of these lesions.