Postępy Dermatologii i Alergologii XXIX; 2012/1 47
Address for correspondence: Piotr Rzymski MD, PhD, Department of Biology and Environmental Protection, Poznan University of Medical
Sciences, 1/2 Długa, 61-848 Poznan, Poland, e-mail: email@example.com
Dermatotoxins synthesized by blue-green algae
Piotr Rzymski, Barbara Poniedziałek
Department of Biology and Environmental Protection, Poznan University of Medical Sciences, Poland
Head: Prof. Krzysztof Wiktorowicz MD, PhD
Post Dermatol Alergol 2012; XXIX, 1: 47–50
In this paper we have reviewed dermatotoxins produced by blue-green algae. Dermatotoxins are harmful com-
pounds that target human skin. Blue-green algae (Cyanobacteria) are prokaryotic microorganisms, mainly found in
the water environment – marine and freshwater. A number of species are able to synthesize several toxic substances
that affect human health upon exposure to lyngbya-, aplysia- and debromoaplysiatoxin. Lipopolysaccharides pre-
sent in cyanobacteria cell walls can be irritating to human skin. Therefore, surface waters for recreational use should
be monitored for the presence of toxic species of blue-green algae.
Key words: blue-green algae, cyanotoxins, dermatotoxins, lyngbyatoxin, aplysiatoxin, debromoaplysiatoxin.
Blue-green algae (Cyanobacteria) are a group of
prokaryotic, autotrophic microorganisms that contain the
photosynthetic pigments (chlorophyll and phycocyanin).
So far over 2,500 species have been identified, mainly
related to ecosystems of surface waters, both marine and
freshwater [1, 2]. Almost 80 species were recognized as
able to synthesize toxic metabolites showing activity espe-
cially against the warm-blooded vertebrates [3, 4]. These
chemical compounds include alkaloids, cyclic peptides
and lipopolysaccharides with a wide spectrum of health
effects: hepatotoxic, neurotoxic, cytotoxic as well as der-
matotoxic . Cyanotoxins are released mainly during the
rapid growth phase called blue-green algae blooms. This
phenomenon is based on the mass reproduction of a par-
ticular type of Cyanobacteria species for a period of sev-
eral days and is manifested by the appearance of blue-
green color of water and foam, scum, or mats floating on
the water surface. In the temperate climate, blooms are
formed during high availability of nutrients (mineral nitro-
gen and phosphorus), elevated temperature and limited
water waving. The problem of the direct exposure to cyan-
otoxins exists primarily in the summer and early autumn
[6, 7]. Because of the tendency of these compounds to
accumulate in the invertebrate tissues (shrimps, clams,
snails) and fish, there is a risk of health complications as
a result of consumption of food of unknown origin [5, 8,
9]. A new Regulation of the Minister of Health dated
8 April 2011 on the supervision over the quality of bathing
water and the areas used for swimming provides for,
among others, the necessity of monitoring of water used
for recreation for dangerous algal blooms .
This study aims to characterize the dermatotoxic
group of chemical compounds produced by Cyanobacte-
ria and to determine their potential impact on human
Lyngbyatoxins (LA) are indole alkaloids, their name
was taken from a cyanobacteria genus Lyngbya (order:
Oscillatoria) . The main producers are filamentous
cyanobacteria: marine L. majuscule and freshwater
L. wollei – both able to form significant colonies that reveal
as green mats floating on the water surface. Three iso-
forms of lyngbyatoxin were identified: a, b and c; their
molecular mass is 437 Da [12, 13]. The structure of lyng-
byatoxin-a is identical to an isomer of teleocidin A, iso-
lated from mycelium of several species of Streptomyces
. LD50 for mice (oral route) is 250 μg/kg .
Massive occurrence of Lyngbya majuscula was found
in almost 100 locations around the world including trop-
Postępy Dermatologii i Alergologii XXIX; 2012/1
ical, subtropical as well as temperate zones . So far
L. majuscula has not been identified on the Polish coast
of the Baltic Sea. However, there is a risk of expansion in
this area, due to the confirmed presence in the region of
Kattegat Strait, Cape Arkona and the Gulf of Riga .
Lyngbyatoxin-a has a skin tumour promoting activ-
ity similar to 12-O-tetradecanoylphorbol-13-acetate (TPA)
basing on the activation of protein kinase C (PKC) as
a result of replacing endogenous activator of this
enzyme – 1,2 diacyloglycerol. The observed damages of
nexus junctions are most likely induced by connexin
phosphorylation of PKC [17, 18]. Lyngbyatoxin-b and lyn-
gbyatoxin-c have 1/200th and 1/20th the activity of lyn-
gbyatoxin-a, respectively . Lyngbyatoxins are slight-
ly lipophilic, penetration through human skin after 1 h
of exposure to 26 μg/cm2was estimated as 6% of the
Medical literature described several confirmed cases
of significant lyngbyatoxins effects on humans having
contact with water resources with high occurrence of Lyn-
gbya. The most common symptoms involve skin and are
usually defined as “seaweed dermatitis” . Osbourne
et al. examined a group of 5000 marine recreational users
in northern Moreton Bay (Queensland, Australia) during
a period of L. majuscula occurrence. The most frequently
observed symptoms were: skin itching (23%), skin red-
ness (10.5%), skin burning (10.5%), skin blistering (2.2%)
and skin swelling (0.8%) . These symptoms were most
intense in genital, perineum and perianal areas [12, 22].
The irritant properties of lyngbyatoxin also affected ears
(sore, discharge) and eyes (sore). The most frequent gen-
eral symptoms were headache, nausea, vomiting and diar-
rhea probably resulting from simultaneous ingestion of
intact cyanobacterium with water . Young adults (18-
29 years of age) had the highest sensitivity to lyngbya-
toxin. First symptoms occurred within a few minutes to
a few hours after exposure. Visible dermatitis with red-
ness began to occur after 3-20 h and lasted for 2-12 days.
No connection between the type of symptoms and their
intensity with duration of bathing was found. Similar
symptoms were observed for people staying in water from
2 min to 4 h [24, 25].
Histopathologic examination of human skin exposed
to L. majuscule (topical application) found acute, vesicu-
lar dermatitis. Superficial desquamation and edema of
the epidermis was apparent in the microscope image.
Within the epidermis (stratum malpighii) numerous vesi-
cles of various size were observed. Some vesicles con-
tained red blood cells and polymorphonuclear leukocytes
which were also present in the deepest part of epidermis.
The superficial dermis showed the infiltration of chronic
and acute inflammatory cells including mononuclear cells,
eosinophils and neutrophils .
Lyngbyatoxins can also be carried by wind in an
aerosolized form and cause a health risk for people not
exposed to water. L. majuscula dermatitis was diagnosed
in subjects walking on the beach during strong winds.
Most common symptoms included facial rash, groin and
torso skin itching, conjunctivitis, inflamed eyes and
lacrimation [26, 27]. Fishers cleaning fish nets and crab
pots from L. majuscula also reported skin and eye irrita-
Osbourne et al.  listed treatment methods for
Lyngbya-induced dermatitis that included: ice packs,
loratadine (10 mg/day) and 1% hydrocortisone cream
(topically four times daily).
Another issue associated with Cyanobacteria able to
synthesize lyngbyatoxins is their accumulation in tissues
of aquatic organisms being a source of food as sea tur-
tles Chelonia mydas . Consumption of such products,
as well as ingestion of water containing lyngbyatoxin
leads to inflammation of the esophagus and digestive
Aplysiatoxin and debromoaplysiatoxin
Aplysiatoxin (AT) and debromoaplysiatoxin (DAT)
belong to phenolic bislactones. Their molecular mass is
671 Da and 592 Da, respectively . They were first iso-
lated from marine mollusks belonging to Stylocheilus
genus , feeding upon Cyanobacteria species from Lyn-
gbya, Schizothrix and Planktothrix genus that have an abil-
ity of AT and DAT synthesis . Chemically the only dif-
ference between aplysiatoxin and debromoaplysiatoxin
is that the phenolic structure of AT is replaced with single
bromine atom in DAT .
Several experimental studies showed the potential
negative impact of aplysiatoxin and debromoaplysiatox-
in on mammals’ health. In mice, both toxins caused severe
ear irritation . Inhibition of epidermal growth factor
(EGF) (10 times higher for aplysiatoxin)  and activa-
tion of ornithine decarboxylase in human skin cells was
observed . Both substances are considered to have
tumorigenic properties and are activators of protein kinase
C . Aplysiatoxin and debromoaplysiatoxin caused dif-
ferentiation of HL-60 cells into macrophages . Applied
topically, debromoaplysiatoxin was found to cause an irri-
tant pustular folliculitis in humans and severe cutaneous
inflammatory reaction in the rabbits and in hairless mice
. Direct contact with aplysia- and debromoaplysiatox-
in contaminated water caused acute skin irritation,
rashes and blisters [12, 38, 39]. There is also a risk of
inhalation of aplysia- and debromoaplysiatoxin from
aerosols transported by the wind along the coasts. Wil-
ley et al.  suggested that both toxins induce terminal
squamous differentiation in normal human bronchial
Bioaccumulation in aquatic organisms and potential
biomagnification of AT and DAT are still poorly understood
. However, the tendency of some benthic snails to
accumulate these toxins in different parts of the body was
demonstrated . Further analyses are necessary to esti-
Piotr Rzymski, Barbara Poniedziałek
Postępy Dermatologii i Alergologii XXIX; 2012/1 49
mate the exposure possibility to AT and DAT by con-
sumption of organisms obtained from water.
Lipopolysaccharide (LPS) is commonly present in
cyanobacterium cell wall, forming complexes with pro-
teins and phospholipids. Its structure is made of lipid A,
R-type core oligosaccharide and O-specific polysaccharide
chains . Toxicity of cyanobacterium LPS is lower than
LPS of Enterobacteriaceae, although it differs between
species. Orally, LD50 for mice varies from 40 mg/kg to
425 mg/kg. In most common blue-green algae Microcys-
tis aeruginosa LD50 was 50 mg/kg [32, 44]. There are only
few publications on impact of cyanobacterium LPS on
human health and its mechanism of action remains
unclear . This is due to the difficulties in distinguish-
ing the symptoms caused only by LPS and caused by sec-
ondary metabolites synthesized by blue-green algae.
Therefore, the whole range of symptoms were attributed
to LPS such as: skin [45, 46] and eye [47, 48] irritation, hay
fever , respiratory problems , headaches and dizzi-
ness , blistering of mucous membranes and fever .
It must be assumed that contact with any water charac-
terized by high concentration of Cyanobacteria can lead
to human health complication, including dermatitis.
The role of dermatotoxic metabolites synthesized by
blue-green algae in human health is still not clear. A few
papers on this subject have been published due to der-
matologic complications not being connected with
cyanobacterium occurrence and production of a wide
range of toxic compounds. Therefore, knowledge of the
above substances is based mainly on studies of animal
models. Described cases clearly reveal negative impact of
lyngbya-, aplysia- and debromoaplysiatoxin on human
skin, even during a short-term exposure. Health hazard
concerns also people not directly using water resources
but residing or walking near the coasts, especially in windy
weather. Cyanobacterium toxins can be spread with
aerosols from water surface causing dermatitis and aller-
gic reactions. Prolonged exposure can lead to promotion
of carcinogenesis. In the case of massive occurrence of
blue-green algae (even species not producing toxic
metabolites) there is a risk of exposure to lipopolysac-
charide which in a few reports seems to have an irritant
effect on human skin.
Climate change and water pollution can have a sig-
nificant role in expansion of toxic Cyanobacteria [53, 54].
New locations of dermatotoxic species may occur and
raise human health concern. Water resources used recre-
ationally should be regularly monitored. Dermatologists
should consider diagnosis of water-linked dermatitis for
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