White piedra

{{Infobox medical condition (new)

| name = White piedra

| image = Piedra Blanca Micosis.jpg

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| field = Infectious disease

| synonyms = Tinea blanca

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White piedra (or tinea blanca) is a mycosis of the hair{{cite journal |vauthors=Pontes ZB, Ramos AL, Lima Ede O, Guerra Mde F, Oliveira NM, Santos JP |title=Clinical and mycological study of scalp white piedra in the State of Paraíba, Brazil |journal=Memórias do Instituto Oswaldo Cruz |volume=97 |issue=5 |pages=747–50 |date=July 2002 |pmid=12219146 |doi=10.1590/S0074-02762002000500028 |doi-access=free |url=http://pdfs.semanticscholar.org/5f8a/c9dc62761626d66f9874f17376165289ca44.pdf }} caused by several species of fungi in the genus Trichosporon. It is characterized by soft nodules composed of yeast cells and arthroconidia that encompass hair shafts.

Signs and symptoms

White piedra is asymptomatic.{{Cite journal |last1=Bieber |first1=Amy Kalowitz |last2=Pomeranz |first2=Miriam Keltz |last3=Kim |first3=Randie H. |date=2021-03-01 |title=White Piedra |url=https://doi.org/10.1001/jamadermatol.2020.4266 |journal=JAMA Dermatology |volume=157 |issue=3 |pages=339 |doi=10.1001/jamadermatol.2020.4266 |pmid=33471028 |issn=2168-6068|url-access=subscription }}{{Cite journal |last1=Bonifaz |first1=Alexandro |last2=Tirado-Sánchez |first2=Andrés |last3=Araiza |first3=Javier |last4=Rodríguez-Leviz |first4=Alejandra |last5=Guzmán-Sánchez |first5=Daniela |last6=Gutiérrez-Mendoza |first6=Selene |last7=Castrejón |first7=Laura |date=2018-12-13 |title=White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases |url=http://dx.doi.org/10.1159/000493374 |journal=Skin Appendage Disorders |volume=5 |issue=3 |pages=135–141 |doi=10.1159/000493374 |pmid=31049333 |pmc=6489071 |issn=2296-9195}}{{Cite journal |last1=Roshan |first1=Anupama S. |last2=Janaki |first2=C |last3=Parveen |first3=B |date=2009 |title=White piedra in a mother and daughter |journal=International Journal of Trichology |volume=1 |issue=2 |pages=140–141 |doi=10.4103/0974-7753.58559 |pmid=20927238 |pmc=2938578 |issn=0974-7753 |doi-access=free }}

Diagnosis

White piedra is caused by Trichosporon beigelii.{{Cite journal |last1=Tambe |first1=Swagata A. |last2=Dhurat |first2=S. Rachita |last3=Kumar |first3=Chaya A. |last4=Thakare |first4=Preeti |last5=Lade |first5=Nitin |last6=Jerajani |first6=Hemangi |last7=Mathur |first7=Meenakshi |date=2009 |title=Two cases of scalp white piedra caused by Trichosporon ovoides |journal=Indian Journal of Dermatology, Venereology and Leprology |volume=75 |issue=3 |pages=293–295 |doi=10.4103/0378-6323.51256 |issn=0973-3922 |pmid=19439885|doi-access=free }}{{Cite journal |last1=Jain |first1=Suresh Kumar |last2=Singh |first2=Arti |last3=Nyati |first3=Asha |last4=Mohta |first4=Alpana |last5=Kushwaha |first5=Ramesh Kumar |date=2019 |title=A case of scalp white piedra caused by trichosporon ovoides |journal=International Journal of Trichology |volume=11 |issue=3 |pages=134–137 |doi=10.4103/ijt.ijt_19_19 |pmid=31360044 |pmc=6580808 |issn=0974-7753 |doi-access=free }} White piedra can occur on the hair of the scalp; Trichosporon ovoides is likely the cause in this case. White piedra on scalp hair is rarely caused by Trichosporon inkin; pubic hair with white piedra is what T. inkin is mainly associated with.{{cite journal |doi=10.4103/0378-6323.84065 |pmid=21860159 |title=White piedra of scalp hair by Trichosporon inkin |journal=Indian Journal of Dermatology, Venereology and Leprology |volume=77 |issue=5 |pages=591–3 |year=2011 |last1=Kriplani |first1=Dimple |last2=Patel |first2=Bharti |last3=Viswanath |first3=Vishalakshi |last4=Miskeen |first4=Autarkishen |last5=Torsekar |first5=Raghunandangovind |doi-access=free }} White piedra can occur on pubic hair; T. inkin likely causes this.{{cite book |doi=10.1016/B978-1-4557-4801-3.00268-X |chapter=Dermatophytosis (Ringworm) and Other Superficial Mycoses |title=Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases |first1=Roderick J. |last1=Hay |year=2015 |pages=2985–2994.e1 |isbn=9781455748013 }}

Trichosporon mucoides can also cause white piedra. In such cases, a periodic acid-Schiff–diastase stain and fungal culture may aid in diagnosis.

Treatment

There are several approaches to treat this infectious disease. One approach involves shaving the affected areas. Another approach involves the use of antifungal medication, such as ketaconazole shampoo.{{cite journal |vauthors=Kiken DA, Sekaran A, Antaya RJ, Davis A, Imaeda S, Silverberg NB |title=White piedra in children |journal=Journal of the American Academy of Dermatology |volume=55 |issue=6 |pages=956–61 |date=December 2006 |pmid=17097391 |doi=10.1016/j.jaad.2005.11.1033 }}

See also

References

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