Piedra, whiteB36.2
Synonym(s)
Beige's disease; piedra alba; trichomycosis nodosa; Trichosporosis; white piedra
HistoryThis section has been translated automatically.
Beige, 1869
DefinitionThis section has been translated automatically.
Mycosis of the hair shaft by trichosporon species with characteristic white nodules. In case of inguinal infestation, the typical nodules are also found on cotton fibres of underwear.
PathogenThis section has been translated automatically.
Trichosporon spp. (saprophytic yeast fungi), in particular Trichosporon mucoides, T.inkin, T.ashaii, T.ovoides.
Occurrence/EpidemiologyThis section has been translated automatically.
Mainly subtropical, temperate zones. m:w=1:1;
LocalizationThis section has been translated automatically.
Especially hair on the head, beard and armpits.
Clinical featuresThis section has been translated automatically.
Multiple, pearl-like, rock-hard, adherent, round or spindle-shaped, white nodules a few millimeters in size on the hair shaft. The hair becomes brittle in the area of the nodules. The hair consists of fairly large spores that are clustered together in piles under the hair cuticle.
Differential diagnosisThis section has been translated automatically.
Hair shaft anomalies, see below. Hair nodules.
External therapyThis section has been translated automatically.
Cutting off the affected hair in case of inguinal infestation. If possible, dispose of the underwear, otherwise boil it. Recurrences are frequent, so continued careful hygiene is important.
Internal therapyThis section has been translated automatically.
Antimycotic therapy with Terbinafine (e.g. Lamisil Tbl.) 250 mg/day for 6 weeks. In case of systemic infestation treatment with Amphotericin B, initial dose 0.1 mg/kg bw/day i.v., increase up to 1 mg/kg bw/day. Alternatively flucytosine (ancotil): Adults and children 150-200 mg/kg bw/day i.v. as infusion in 4 doses over 3-4 weeks.
LiteratureThis section has been translated automatically.
- Almeida HL et al (1990) White piedra: ultrastructure and a new microecological aspect. Mycoses 33: 491-497
- Beige H (1869) in: The human hair: its structure, growth and diseases. Henry Renshaw (London), p 120.
- Elmer KB et al (2002) Trichosporon beigelii infection presenting as white piedra and onychomycosis in the same patient. Cutis 70: 209-211
- Khandpur S, Reddy BS (2002) Itraconazole therapy for white piedra affecting scalp hair. J Am Acad Dermatol 47: 415-418
- Nahass GT et al (1993) Disseminated infection with Trichosporon beigelii. Report of a case and review of the cutaneous and histological manifestations. Arch Dermatol 129: 1020-1023
- Nakagawa T et al (2000) Trichosporon cutaneum (Trichosporon asahii) infection mimicking hand eczema in a patient with leukemia. J Am Acad Dermatol 42: 929-931