White piedra of scalp hair by Trichosporon inkin

Abstract

White piedra is a rare fungal infection of hair and is reported to be all the more rare on scalp. Trichosporon inkin is usually associated with white piedra of pubic hair. We report a case of white piedra of scalp hair caused by T. inkin. This is the first case reported from India and the fifth case reported worldwide. A 50-year-old Muslim female presented with white knots over scalp hair. Diagnosis of Trichosporon was made by examining KOH mounts of epilated hair and Lactophenol Cotton Blue preparations of the growth in culture. Automated mini-API test (for biochemical profiles) and Electronmicroscopy studies (for cell wall structures) helped in identification of the species. Mini-API test was also positive for Cryptococcus curvatus which could be due to similarity in biochemical and physiological properties of the two species. Absence of C. curvatus on culture further supports this view. Topical antifungal therapy resulted in clinical clearance within 2 months. Higher incidence of scalp white piedra is observed in Muslim females; contributing factor being the custom of using a veil, leading to higher humidity and limited sunlight exposure.

White piedra of the scalp caused by Trichosporon inkin: a case report with antifungal susceptibility testing and review of the literature

“…In the systematic review by Ramírez-Soto et al [6], it was found that T. inkin is the main etiologic agent of white piedra on the scalp in patients over 15 years of age, which could explain this distribution of cases between age groups. The patient in the present case, aged 38, and a 50-year-old Indian patient [15], were the ones with the highest age in the cases analyzed, ages that are not so usual in cases of white piedra.…”

“…N.I., not informed. [15], were the ones with the highest age in the cases analyzed, ages that are not so usual in cases of white piedra.…”

“…Indeed, white piedra of scalp shows a higher frequency in females during childhood and early adulthood [3]. The main risk factors are long and curly hair and excessive hair moisture, caused mainly by the habit of tying wet hair, the use of oils and headwear usage, like the veil used by Muslim females [3,14,15].…”

A rare case of white piedra caused by Candida parapsilosis in the Sub-Himalayan Region of North India

“…Trichosporon species has been identified as the causative agent in all reported cases from India; however, all cases were from tropical regions (South India and Chandigarh). [78910] Ours is the first case from a temperate region. A definite relationship between the yeast causing white piedra and geographic location needs to be ascertained in future studies.…”

Nodules on the hair: A rare case of mixed piedra

“…Both black-and-white piedra occur predominantly in humid tropical and semi-tropical areas (Africa, South America, and Asia). [34567] However, white piedra has been reported from temperate climatic areas like Europe, USA and Japan as well. Common sources of infection in both types are stagnant water and soil.…”