White piedra

White piedra is a superficial fungal infection of the hair shaft, caused by the yeast-like fungus Trichosporon. The infection is characterized by the presence of soft, white-to-tan nodules along the hair shaft. These nodules are easily removable and are composed of yeast cells and arthroconidia that are tightly packed and surrounded by a cement substance.

Etiology

White piedra is caused by several species of the genus Trichosporon, including Trichosporon asahii, Trichosporon inkin, and Trichosporon mucoides. These fungi are part of the normal flora of the skin, but can become pathogenic under certain conditions.

Epidemiology

White piedra is a rare infection that can affect individuals of any age, gender, or race. It is more common in tropical and subtropical regions, but can occur in any geographic location. The infection is not contagious and does not spread from person to person.

Clinical Presentation

The primary symptom of white piedra is the presence of soft, white-to-tan nodules along the hair shaft. These nodules can be easily removed and do not cause any pain or discomfort. In some cases, the affected hair may become brittle and break off easily.

Diagnosis

Diagnosis of white piedra is typically made based on the clinical presentation and confirmed by microscopic examination of the nodules. The nodules are composed of yeast cells and arthroconidia that are tightly packed and surrounded by a cement substance.

Treatment

Treatment for white piedra typically involves the use of antifungal medications, such as ketoconazole or itraconazole. In severe cases, or when the infection is resistant to medication, the affected hair may need to be shaved or cut off.

Prevention

Prevention of white piedra involves maintaining good personal hygiene and avoiding the use of oily hair products that can create a favorable environment for the growth of Trichosporon.