White Piedra

Beigel 1869

Trichomycosis nodosa, piedra alba, trichosporosis.

Hair shaft infection caused by the saprophytic yeast Trichosporon beigelii.

In particular found in the subtropics.

Exciter:

• Trichosporon spp. especially T. beigelii

• Whitish, derb palpable, pin-sized nodules in the area of the hair shaft
• The hair often becomes brittle

In the area of the head, beard and underarm hair. Inguinal infestation.

• Cut the hair
• Washing should be done at a minimum of 60°C
• Systhemotherapy
  • Terbinafine p.o. 250 mg 1x daily for 6 weeks
  • In case of disseminated infestation:
    • Amphotericin B i.v., initial: 0.1 mg/kg bw/d., if necessary increase the dose up to 1 mg/kg bw/d
    • Alternatively: flucytosine i.v. 40-50 mg/kg bw/d 4x daily for 4 weeks

1. Patteson, R.G., Trichomycosis Nodosa: A Bacillary Disease of Hair. Br Med J, 1889. 1(1482): p. 1166-9.
2. Avram, A., et al., [Clinical and mycological study of 11 cases of genitopubic trichosporosis nodosa (white piedra)]. Ann Dermatol Venereol, 1987. 114(6-7): p. 819-27.
3. Roshan, A.S., C. Janaki, and B. Parveen, White piedra in a mother and daughter. Int J Trichology, 2009. 1(2): p. 140-1.
4. Bonifaz, A., et al., Tinea versicolor, tinea nigra, white piedra, and black piedra. Clin Dermatol, 2010. 28(2): p. 140-5.