Well, there's a number of porblems that can arise, including elevated phosphates and micro-algae proliferation that you can see...but, I don't think there's a reef that can't benefit from the addition of a protein skimmer.
Avi is correct. A protein skimmer is just a tool that helps remove waste products mechanically before bacteria get a chance to break them down. This lightens the overall load on the tank and compliments the biological filtration provided by the LR and LS. It is good for any size tank.
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