Cases of white piedra of the hair on the American continent: a case report and a systematic literature review

Ramírez-Soto, Max Carlos; Andagua-Castro, Jonathan; Quispe, M.A.; Aguilar-Ancori, Elsa Gladys

doi:10.1111/jdv.15112

Cited by 9 publications

(13 citation statements)

References 9 publications

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“…WP can present at all ages, although there is a prevalence of up to 89% in subjects < 15 years and most often in girls [4, 6, 9-12], similar to our findings. The development of the disease remains unknown, although it is known that the various species of Trichosporon that cause WP have been reported as part of the microbiota of skin and mucous membranes.…”

Section: Discussionsupporting

confidence: 81%

“…Ramírez-Soto et al [9], in a recent systematic review of cases in the Americas, reported 106 cases of WP, with a predominance of 73.58% for South America, the most endemic countries being Brazil, Colombia, and Venezuela, while in North America, Mexico and the US reported the highest number of cases. In our case series, at least 50% of the cases came from humid and tropical areas.…”

Section: Discussionmentioning

confidence: 99%

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White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases

Bonifáz¹,

Tirado‐Sánchez²,

Santibáñez³

et al. 2018

Skin Appendage Disord

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Background: White piedra (WP) is an asymptomatic superficial mycosis that affects the hair stems, forming whitish nodules caused by various species of the genus Trichosporon. Objective: To present a case series of WP of the head, its epidemiological data, as well as clinical, mycological, and therapeutic experience. Methods: We conducted a 12-year retrospective and observational study of WP cases tested by dermoscopy, mycological study, and the identification of species through morphology, biochemistry, and proteomics (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). The treatment was based on ketoconazole shampoo as well as keratolytics. Results: We included 14 cases of WP, all located in the head and 1 case with both head and scrotum affected. Nine cases (64.3%) presented in children aged < 15 years. The majority of the cases (13/14, 92.8%) were women. Two cases were associated with hyperkeratosis and intertrigo. Most patients had long hair and excessive moisture. In all cases hair nodules were observed and Trichosporon inkin (11/14, 78.6%) was usually isolated. Eleven cases (78.6%) were cured by administering 2% ketoconazole shampoo. Conclusion: WP was observed in school-age girls. The diagnosis was based on the observation of hair nodules and its main etiologic agent was T. inkin, with good response to treatment in most cases.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases

Bonifáz¹,

Tirado‐Sánchez²,

Santibáñez³

et al. 2018

Skin Appendage Disord

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“…The true proportion of scalp WP is probably underestimated as the infection is often asymptomatic and can be easily mistaken for dandruff, nits, and hair casts resulting in delayed diagnosis. 12,13 Abdel-Al et al 14 have identified scalp WP in 14 out of 100 Egyptian female patients complaining of brittle hair. Lack of symptoms in WP is probably due to absent or minimal cell-mediated immune response associated with superficial mycoses, which subsequently can lead to chronicity.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of topical vs combined oral and topical antifungals in white piedra of the scalp

Attar

Eldeen

Wahid

et al. 2020

J of Cosmetic Dermatology

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White piedra (WP) of the scalp is a superficial mycotic infection of the hairs frequently reported in tropical humid regions as Southeast Asia, South America, and Middle East. 1 The majority of cases occur in children and young adult females. 2 It is characterized clinically by the presence of multiple whitish soft nodules along the hair shafts. The patients may also present with dry lusterless hair, hair breakage, and frayed ends. 3 Direct microscopic examination and culture of infected hair enable a definitive diagnosis to be made. 4 Treatment of scalp WP is challenging as eliminating the fungus through cutting the hair is not always acceptable by the patients. Moreover, lack of response and post-treatment relapse is frequently encountered after topical antifungal therapy. 3 Persistent infection is more common in patients with long hair and those who reutilize their infected hairbrushes. 5 It was also hypothesized that the organism may cause penetration of the hair cuticle by its keratolytic activity, which

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“…The genus Trichosporon includes species that are usually found in water sources, wet wood, and organic substrates [ 1 ] or are part of the gastrointestinal microbiota, the oral cavity, the respiratory tract, and the skin [ 2 ]. However, some species like T. inkin, T. cutaneum , T. ovoides T. asahii, T. asteroides , and T. mucoides are associated with superficial infections, such as White Piedra, or with systemic infections, particularly in immunocompromised patients [ [3] , [4] , [5] ].…”

Section: Introductionmentioning

confidence: 99%

Antifungal susceptibility profile of Trichosporon inkin: About three cases of White Piedra

Zapata-Zapata

Giraldo-Galeano

Rojo-Uribe

et al. 2023

Medical Mycology Case Reports

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Cases of white piedra of the hair on the American continent: a case report and a systematic literature review

Cited by 9 publications

References 9 publications

White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases

White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases

Efficacy of topical vs combined oral and topical antifungals in white piedra of the scalp

Antifungal susceptibility profile of Trichosporon inkin: About three cases of White Piedra

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