Cutaneous protothecosis presenting as recurrent chromomycosis

Chromomycosis and protothecosis are both rare cutaneous infections. We report a case in which protothecosis mimicked a relapse of chromomycosis both clinically and on special stains. The chromomycosis responded to local excision and ketoconazole therapy. The protothecosis failed to respond to ketoconazole but resolved with combined amphotericin B and tetracycline hydrochloride therapy.