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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.
Background:
White piedra is a fungal infection of the hair shaft caused by species of Trichosporon. Rarely has this infection been reported in the United States. Historically, infected individuals required shaving of their hair to achieve clearance of the infection.
Objective:
We sought to describe 8 cases of Trichosporon scalp infections seen in the northeastern United States.
Methods:
We conducted chart review and prospective evaluation of 7 girls and 1 boy seen in two dermatology practices in New Haven, Conn, and New York, NY.
Results:
Seven girls, ages 4 to 16 years old, and one 4-year-old boy were determined to have Trichosporon scalp infection, all through culture. Of the 8 children who were available for follow-up, 7 had clearance of their infection with a combination of oral azole antifungal medication and azole antifungal shampoo, without shaving the scalp hair.
Limitations:
This was a sample of patients from a localized region of the United States.
Conclusions:
White piedra is emerging as a commonly seen hair and scalp infection in the northeastern United States. Contrary to prior publications, scalp and hair infection may be successfully treated with a combination of oral azole antifungals and shampoos without shaving the scalp.
Insights
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.
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.
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