Piedra blanca en pacientes de centros dermatológicos de Pereira / Report of cases of white stone in patients of dermatological centers from Pereira

La piedra blanca es una micosis superficial crónica y asintomática poco frecuente del pelo causada por Trichosporon spp. (T. asahii, T. cutaneum o T. beigelii, T. inkin y T. mucoides), caracterizada por presentar nódulos blandos, blanquecinos, adheridos a los tallos pilosos, preferentemente del cuero cabelludo, axilas, cejas, pestañas y con menor frecuencia, en la barba, el bigote, el pubis y el perineo. Suele aparecer con mayor frecuencia en población de climas templados y tropicales. En los tres casos reportados se tomó muestra de los cabellos con los nódulos sospechosos, se le realizaron pruebas diagnósticas que permitieron confirmar la presencia de estructuras levaduriformes compatibles con Trichosporon spp. La sospecha de pediculosis es el motivo de consulta de los pacientes con piedra blanca, confundiendo los nódulos con liendres; por consiguiente es importante que el médico tenga claro las enfermedades micóticas con las cuales se debe hacer el diagnóstico diferencial para poder orientar y establecer el adecuado tratamiento para el paciente

The white stone is a rare, superficial, chronic and asymptomatic mycosis of the hair caused by Trichosporon spp. (T asahii, T. cutaneum or T. beigelli, T. inkin, and T. mucoid), which is characterized by the presence of white soft nodules, adhered to the hair shafts, preferably the scalp, armpits, eyebrows, eyelashes, and less frequently, in the beard, moustache, pubic area and perineum. It usually appears with greater frequency in areas of temperate and tropical climates. In the three reported cases, the sample of hair was taken from suspect hair, and then a series of diagnostic tests were performed to allow the confirmation of the presence of yeast shaped structures compatible with Trichosporon spp. Often, a possible pediculosis was the main reason of consultation of the patients who suffer white stone, and it can be confused with nodules of nits. Therefore, it is important that the physician has a better understanding of the fungal diseases that will be part of the differential diagnosis in order to guide and establish a proper treatment for the patients

Piedra negra y piedra blanca: aspectos diferenciales / Black piedra and white piedra: Differential aspects

Las piedras son infecciones fúngicas superficiales y asintomáticas frecuentes en los países tropicales, que se caracterizan por la presencia de nódulos a lo largo del tallo piloso. Sin embargo, la literatura publicada durante los últimos años es limitada y la taxonomía actual de sus agentes etiológicos es poco conocida. Se presenta un caso de piedra negra y otro de piedra blanca en dos mujeres colombianas inmunocompetentes con numerosas lesiones nodulares en su cabello que consultaron a un centro de referencia nacional en Bogotá, Colombia. A pesar de que las piedras fueron descritas y clasificadas desde el punto de vista clínico y microbiológico hace más de 100 años, aún se conoce poco sobre su historia, ecología, forma de transmisión, epidemiología y presentación clínica. Sin embargo, las diferencias que existen entre las dos micosis ayudan a orientar el diagnóstico clínico y fúngico.

Black piedra and white piedra are common superficial and asymptomatic fungal infections in tropical countries, characterized by the presence of hard nodules located along the hair shaft. However, in recent years literature on this topic has been limited and the current taxonomy of their etiologic agents is poorly understood. Here we report two cases of black piedra and white piedra in two immune competent Colombian women with numerous nodular lesions in their hair who visited a national reference center in Bogota, Colombia. Despite having been described and classified from a clinical and microbiological perspective more than 100 years ago, little is still known about the history, ecology, mode of transmission, epidemiology and clinical presentation of piedras. Nevertheless, the differences between the two mycoses help to orient clinical and fungal diagnoses.

Screening of some essential oils against Trichosporon species.

White Piedra is a superficial mycoses characterized by nodules on the hair shaft, caused by the basidiomycetous yeast Trichosporon species. In this study 25 essential oils were extracted and screened against two Trichosporon species i.e. Trichosporon asahii and Trichosporon cutaneum. Both these fungi procured from MTCC Chandigarh were maintained on yeast malt agar plates and tubes at 25oC. Two screening methods viz., agar well diffusion assay and minimum inhibitory concentration were adopted for the study. The results showed that the maximum anti-yeast activity against T. asahii and T. cutaneum was demonstrated by oil of Mentha piperita showing full inhibition of both the fungi, Melaleuca alternifolia with an inhibition zone of 45 and 40 mm, Cymbopogon winterians with inhibition zone of 45 and 45 mm and Cymbopogon flexuosus with 35 and 30 mm inhibition zones. The oil of Trachyspermum ammi exhibited 10 and 20 mm, Abelmoschus moschatus exhibited 30 and 20 mm, Salvia sclarea showed 20 and 18 mm and Jasminum officinale exhibited 25 and 15 mm inhibition zones showing moderate activity. The oil of Cyperus scariosus, Pogostemon patchouli and Rosa damascene showed no inhibition zone against both the fungi while Vetiveria zizanoides exhibited no inhibition in case of T. asahii and inhibition zone of 10 mm in case of T. cutaneum demonstrating comparatively low activity against both the fungi. These results support that the essential oils can be used to cure superficial mycoses and these oils may have significant role as pharmaceuticals and preservatives.

White Piedra of Scalp Hair Caused by Trichosporon asahii / 대한피부과학회지

No abstract available.

Piedra blanca genital / Genital white piedra

ANTECEDENTES: la piedra blanca es una micosis caracterizada por la presencia de nódulos de color blanco a pardo claro, adheridos a los pelos de la región genital, axilas, cejas, pestañas y cuero cabelludo, es causada principalmente por Trichosporon inkin y Trichosporon ovoides. PRESENTACIÓN DEL CASO: paciente del sexo femenino de 35 años, originaria de San Pedro Sula, Honduras, de buena presencia física y buenos hábitos higiénicos, acude a consulta por presentar nódulos en los pelos púbicos, asintomáticos, de 2 meses de evolución. Al examen físico se pudo observar la presencia de nódulos de color blanquecino a pardo claro, blandos, de 1 a 2 mm, que rodeaban los pelos. No se detectó fluorescencia de los pelos a la luz de Wood. Al examen microscópico se observaron blastoconidios y artroconidios; en el cultivo se obtuvo el crecimiento de colonias levaduriformes, elevadas, de aspecto cerebriforme; en el microcultivo en agar extracto de malta se observaron hifas hialinas, tabicadas que formaban apresorios, pseudohifas fragmentadas, artroconidios rectangulares y blastoconidios. Mediante el sistema API ID32C fue identificado como Trichosporon inkin. Se instauró tratamiento con crema de isoconazol, previo rasurado del vello púbico. Los exámenes realizados al final del tratamiento fueron negativos. CONCLUSIONES: se presenta un caso de piedra blanca genital en el sexo femenino y se hace una actualización sobre la taxonomía del género Trichosporon sobre la base de los estudios moleculares, se discute el papel de T. inkin en esta micosis y su relevancia creciente como agente de infecciones invasivas en pacientes inmunocomprometidos, así como la importancia del diagnóstico de laboratorio para la confirmación de los casos.

INTRODUCTION: white piedra is a type of mycosis characterized by white to light brown nodules attached the hair shafts of genitals, axilla, eyelashes, eyebrowns, and scalp and is mainly caused by Trichosporon inkin and Trichosporon ovoides. CASE PRESENTATION: a 35 years-old female with good physical condition and good hygienic habits, who came from San Pedro Sula in Honduras, went to the doctor because of some nodules in their genital hair, asymptomatic, two months of evolution. On physical examination, it was observed that there were white-to-light brown coloured nodules measuring 1-2mm and surrounding the hair shafts. No fluorescence was detected in the hair on Wood´s light. On microscopic examination, blastoconidia and arthroconidia were observed; the culture yielded the growth of elevated yeastlike colonies; the microculture in malt extract agar showed disarticulating hyaline hyphae, partitioned appressoria, fragmented pseudohyphae, rectangular arthroconidia and blastoconidia. Through the API ID32C system, it was identified as Trichosporon inkin. The patient was treated with Isoconazole cream after her genital hair had been shaved. At the end of treatment, the exam results were negative. CONCLUSIONS: the case of a female with genital white piedra was presented and an updating on Trichosporon genus taxonomy on the basis of molecular studies. The role of T. inkin in this mycosis, and its growing importance as an agent of invasive infections in immunocompromised patients, as well as the relevance of lab diagnosis to confirm cases, were discussed.

Two cases of scalp white piedra caused by Trichosporon ovoides.

White piedra is a superficial fungal infection of the hair shaft, caused by Trichosporon beigelii . We report two cases of white piedra presenting as brown palpable nodules along the hair shaft with a fragility of scalp hairs. T. beigelii was demonstrated in hair culture of both the patients and T. ovoides as a species was confirmed on carbohydrate assimilation test. The first patient responded to oral itraconazole and topical ketoconazole, with a decrease in the palpability of nodules and fragility of scalp hairs at the end of two months.

Morphological and biochemical characterization of the aetiological agents of white piedra

The Trichosporon genus is constituted by many species, of which Trichosporon ovoides and Trichosporon inkin are the causative agents of white piedra. They can cause nodules in genital hair or on the scalp. At present, Brazilian laboratory routines generally do not include the identification of the species of Trichosporon genus, which, although morphologically and physiologically distinct, present many similarities, making the identification difficult. The aim of this study was to identify the aetiological agents at the species level of white piedra from clinical specimens. Therefore, both the macro and micro morphology were studied, and physiological tests were performed. Trichosporon spp. was isolated from 10 clinical samples; T. ovoides was predominant, as it was found in seven samples, while T. inkin was identified just in two samples. One isolate could not be identified at the species level. T. inkin was identified for the first time as a white piedra agent in the hair shaft on child under the age of 10.

An outbreak of scalp white piedra in a Brazilian children day care / Surto de piedra branca afetando os cabelos do couro cabeludo de crianças em creche brasileira

White piedra is a superficial mycosis caused by Trichosporon spp. that affects the hair shaft of any part of the body. It is presented an outbreak of scalp white piedra seen in 5.8 percent of the children frequenting a day care in Northeastern of São Paulo State, Brazil. Mycological exam and culture identified T. cutaneum in all five cases, and scanning electron microscopy of nodules around hair shaft infected by Trichosporon spp. is demonstrated comparing them with those of black piedra and with nits of Pediculous capitis.

Piedra branca caracteriza-se por ser micose superficial, causada por Trichosporon spp., que compromete a haste dos pelos de qualquer região do corpo. Um surto de piedra branca, afetando os cabelos do couro cabeludo, foi registrado em 5,8 por cento das crianças que freqüentavam uma creche na região nordeste do estado de São Paulo. Exame micológico direto e cultura identificaram T. cutaneum nas cinco crianças afetadas. Enfatiza-se a utilização da microscopia eletrônica de varredura, que mostrou nódulos circundando a haste dos cabelos infectada por Trichosporon spp., comparando-os com nódulos de Piedra nigra e com lêndeas de Pediculus capitis.