Back issues No.3 - 2002 / Case Report  

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Cutaneous Protothecosis—Report of 5 Cases and Review of the Literature—
Chia-Hui Hung Hung-Wen Kuo Yu-Wen Cheng Yao-Kun Chiu Ji-Chen Ho
Dermatol Sinica 20: 192-199, 2002

Cutaneous protothecosis is an uncommon infection caused by achlorophytic, algae-like unicellular organisms of the genus Prototheca. It was first described by Kruger in 1894 and less than 80 cases have been reported since 1964. It occurs mainly in the immunocompromised patients, otherwise asymptomatic and self-limited cutaneous lesions may be seen in healthy patients. Herein, we present five protothecosis cases with histologically charateristic morula. They aged from 48 to 74 years (3 females, 2 males). All of the five cases had iatrogenic Cushing syndrome, four had diabetes mellitus, three used groundwater in daily life, and three had trauma history. Infiltrative plaques with multiple small ulcers on the extremities are common manifestations. Five cases were treated with antifungal medications, but responses were unsatisfactory and three of the patients lost follow up. One case died of sepsis. Further more, we found that three of them also had scabies at the same time, and this association has not been previously reported.

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