A Case Report of Cutaneous Protothecosis with Severe Pustules and Ulceration

Abstract

Protothecosis is unusual phycological disorder caused by algae, named Prototheca.

Cutaneous protothecosis has been reported worldwide including Korea. The patient was

eighty-eight year old female who complained of skin lesions developed 15 days prior to

the first visit. She has been living near the seashore and enjoyed bathing in the sea.

Her skin lesions were erythematous, purulent plaque and patch, ulceration on right

forearm. Skin biopsy revealed the possibility of cutaneous protothecosis, and this finding

was confirmed by histological, mycological and electron microscopical studies. The

causative organism was identified as Prototheca wickerhamii. Surgical debridement with

KMnO4 wound irrigation combined with intravenous fluconazole 400 mg/day for 3 weeks

resulted in remarkable improvement of skin lesions. We report a case of cutaneous

protothecosis which showed severe clinical feature and was successfully treated with

combination of systemic antifungal agent and surgical debridement.