Tyring S K, Lee P C, Walsh P, Garner J F, Little W P
Department of Dermatology, University of Texas Medical Branch, Galveston 77550.
Arch Dermatol. 1989 Sep;125(9):1249-52. doi: 10.1001/archderm.125.9.1249.
A 65-year-old woman presented with cutaneous, pruritic papules of the upper part of her chest. Histologic findings and culture of a biopsy specimen confirmed that these papules were caused by an infection with Prototheca wickerhamii, an achloric alga that rarely infects humans. Natural killer cell activity in this patient was significantly depressed before initiation of therapy. Reevaluation following successful treatment with oral tetracycline hydrochloride and topical amphotericin B cream revealed an improvement in natural killer cell activity. This patient is presented to demonstrate a rare clinical presentation of protothecosis; to document that cutaneous protothecosis can be successfully treated without the risk of toxic side effects associated with systemic antifungal agents; and to illustrate that although most patients with cutaneous protothecosis are immunosuppressed, infection with this alga appears to be at least partially responsible for the immunosuppression.
一名65岁女性胸部上方出现皮肤瘙痒性丘疹。活检标本的组织学检查结果和培养证实这些丘疹是由威克汉姆原藻感染引起的，威克汉姆原藻是一种无叶绿素的藻类，很少感染人类。该患者在开始治疗前自然杀伤细胞活性显著降低。口服盐酸四环素和外用两性霉素B乳膏成功治疗后复查显示自然杀伤细胞活性有所改善。介绍该患者是为了展示原藻病罕见的临床表现；记录皮肤原藻病可以成功治疗，而无全身抗真菌药相关的毒副作用风险；并说明虽然大多数皮肤原藻病患者存在免疫抑制，但这种藻类感染似乎至少部分导致了免疫抑制。
