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White piedra in children.

David A Kiken1, Anand Sekaran, Richard J Antaya

  • 1Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.

Journal of the American Academy of Dermatology
|November 14, 2006
PubMed
Summary
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White piedra, a fungal hair infection, is increasingly seen in the northeastern US. Successful treatment of Trichosporon scalp infections in children was achieved using oral and topical azole antifungals, avoiding scalp hair shaving.

Area of Science:

  • Dermatology
  • Mycology
  • Infectious Diseases

Background:

  • White piedra is a fungal infection affecting the hair shaft, primarily caused by Trichosporon species.
  • This infection is infrequently reported in the United States, with historical treatments involving scalp hair shaving.

Observation:

  • The study describes eight cases of Trichosporon scalp infections in children (7 girls, 1 boy) in the northeastern United States.
  • Cases were identified through chart review and prospective evaluation in New Haven, CT, and New York, NY.

Findings:

  • Cultures confirmed Trichosporon scalp infection in all eight pediatric patients.
  • Seven of eight children achieved infection clearance with a combination of oral azole antifungal medication and azole antifungal shampoo, without requiring scalp hair shaving.

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Implications:

  • White piedra is emerging as a prevalent scalp infection in the northeastern US.
  • Effective treatment for scalp and hair piedra can be achieved with combined oral and topical azole antifungals, challenging the necessity of hair shaving.