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Case Reports
. 2013 Nov-Dec;88(6 Suppl 1):183-5.
doi: 10.1590/abd1806-4841.20132232.

Cutaneous protothecosis--case report

Pâmela Craveiro Gomes da Silva  1 , Sabrina Beirão da Costa e Silva  1 , Ricardo Barbosa Lima  1 , Antonio Macedo D'Acri  1 , Omar Lupi  2 , Carlos José Martins  3
Affiliations
Case Reports

Cutaneous protothecosis--case report

Pâmela Craveiro Gomes da Silva et al. An Bras Dermatol. 2013 Nov-Dec.

Abstract
in English, Portuguese

Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in immunocompromised patients. The most common clinical presentation is a vesicobullous and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or herpetic infections or eczema. The diagnosis is determined by agent identification through histopathology, culture and the carbohydrates assimilation test. The finding of morula-like spherules is characteristic of Prototheca sp. Its rarity and non-specific clinical aspect may difficult the disease diagnosis. We report a case of a diabetic patient, in chronic use of systemic corticosteroids, that developed a skin lesion after trauma to the right leg.

A prototecose cutânea é uma infecção rara causada por algas aclorofílicas do gênero Prototheca. Geralmente as lesões ocorrem em áreas expostas, relacionadas à trauma, em indivíduos imunocomprometidos. A apresentação clínica mais comum é uma lesão vesico-bolhosa e ulcerativa com pústulas e crostas, simulando piodermites, infecções fúngicas, infecções herpéticas ou eczemas. O diagnóstico é realizado pela identificação do agente através do exame histopatológico, da cultura e do teste de assimilação dos carboidratos. O achado de esférulas com aspecto de mórula são características da Prototheca sp. A raridade da doença e o aspecto clínico inespecífico dificultam o diagnóstico da doença. Relatamos um caso em paciente diabética, em uso crônico de corticoide sistêmico, que desenvolveu lesão cutânea após trauma na perna direita.

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Conflict of interest statement

Conflict of interest: None

Figures

FIGURE 1
FIGURE 1
Erythematous plaque covered by pustules and scabs, on the right leg
FIGURE 2
FIGURE 2
White, creamy, yeast-like colonies on Sabouraud dextrose agar
FIGURE 3
FIGURE 3
Histopathology revealed morula-like structures (arrows), typical of Prototheca sp., colored in red by PAS. (X400)
FIGURE 4
FIGURE 4
Histopathology showing Prototheca sp. structures, colored in black, by Grocott silver stain. (X400)
See this image and copyright information in PMC

References

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