Cutaneous Protothecosis Treatment & Management

Updated: Jul 07, 2022
  • Author: Thomas N Helm, MD; Chief Editor: William D James, MD  more...
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Medical Care

Protothecosis can be difficult to eradicate. Reports describe successful treatment of localized disease with ketoconazole, itraconazole, and fluconazole. [21] Voriconazole is also effective. [22] Surgical removal of isolated lesions in combination with antifungal therapy (eg, with azoles) is effective in immunocompetent individuals. Also reported is dual use of local thermal application as an adjunct to azole therapy. [23] An increasing number of reports indicate that itraconazole 200 mg/day for 2 months can be helpful in some adults. [24]


Surgical Care

Surgical excision is the treatment of choice in all cases amenable to excision. In addition, debridement for necrotic ulcerative lesions may be warranted. Management of olecranon bursitis should consist of bursectomy.