(Last Updated On: December 30, 2019)

Authors: Bryan Edgar K. Guevara, Yu-Chen Chen, Johanna O. Flordelis, Chao-Kai Hsu, Julia Yu-Yun Lee


Introduction: Cutaneous protothecosis usually presents as pyoderma-like lesions or infiltrating papules and plaques on the extensor side of the extremities. It can be misdiagnosed as eczema, pyoderma, or a fungal infection. Although it has been isolated from a swimming pool, sewers and rivers in the Philippines, there has been no reported case of cutaneous protothecosis in the country.

Case summary: A 78-year-old Taiwanese male farmer visited the dermatology clinic due to a six-month history of a large, pruritic erythematous plaque studded with papulopustules on his left forearm. A potassium hydroxide (KOH) examination showed negative for hyphae or spores. And a skin biopsy showed morula-like bodies, which were highlighted by the periodic acid-Schiff stain.

Conclusion: We report a case from Taiwan so Filipino dermatologists will be aware of the clinical and histopathologic manifestations and management of cutaneous protothecosis.




 Guevara BEK, Chen YC, Flordelis JO, Hsu CK, Lee JYY. Cutaneous protothecosis: a case report. J Phil Dermatol Soc 2019, 28(1), 38-41



Protothecosis, dermatopathology, tropical dermatolog

Davies RR, Spencer H, Wakelin PO. A case of human protothecosis. Trans R Soc Trop Med Hyg 1964; 58:448-451.

Leimann BC, Monteiro PC, Lazera M, Candanoza ER, Wanke B. Protothecosis. Med Mycol 2004; 42:95–106.

Fong K, Tee SI, Ho MS , Pan JY. Cutaneous protothecosis in a patient with previously undiagnosed HIV infection. Australas J Dermatol 2015; 56:e71-e73.

Lu S, Xi L, Qin W, Luo Y, Lu C, Li X. Cutaneous protothecosis: two new cases in China and literature review. Int J Dermatol 2012; 51:328-331.

Tseng H, Chen C, Ho J, Cheng Y, Huang H, Sun P et al. Clinicopathological features and course of cutaneous protothecosis. J Eur Acad Dermatol Venereol 2018; 32:1575-1583.

Nelson A, Neafie R, Connor D. Cutaneous protothecosis and chlorellosis, extraordinary “aquatic-borne” algal infections. Clin Dermatol 1987; 5:76-87.

Pore RS, Barnett EA, Barnes WC, Walker JD. Prototheca ecology. Mycopathologia 1983; 81:49-62.

Philippine Dermatological Society Health Information System. Philippine Dermatological Society. c2011 [updated Feb. 19, 2019; cited March 3, 2019]. Available by request from: pdshis@outlook.com

Lass-Flörl C, Mayr A. Human protothecosis. Clinical Microbiology Reviews 2007; 20(2):230-242.

Chao SC, Hsu MML, Lee JYY. Cutaneous protothecosis: report of five cases. British Journal of Dermatology 2002; 146(4):688-693.

More Articles

A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions

  Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS     Abstract Background: Virgin coconut oil (VCO) has been reported...

read more