White piedra: ultrastructure and a new microecological aspect

White piedra or trichosporosis is a superficial mycosis of the hair shaft, caused by the yeast Trichosporon beigelii; it has been found in all continents and may involve the hair of any part of the body. We report a case of white piedra on the hairs of the inguinal fold with ultrastructural studies. Transmission electron microscopy showed that the nodules have the same morphological aspects as the fungus in culture (hyphae and arthrospores) except for the presence of a cementant substance. By scanning electron microscopy the elimination of spores was seen on the nodule surface. Interestingly similar nodules were found on cotton fibres of the patient's underwear, which were also studied by scanning electron microscopy. This finding can explain therapeutic failure and demands special hygienic conditions related to clothes.