Piedra

  • Infeção superficial do folículo piloso
  • Etimologia: pedra
    • Os elementos fúngicos aderem uns aos outros para formar nódulos ou “pedras” ao longo dos folículos pilosos
  • Apresentação clínica
    • Black Piedra
    • White Piedra
    • Em imunodeprimidos pode disseminar
  • Transmissão: environmental pathogens, not transmitted person to person
White Piedra
Black Piedra
Caused by Trichosporon beigelii ou asahii
Caused by Piedraia hortae
Soft, less adherent nodules, but hair breakage may still occur
Hard and firm - Hair breakage may occur
Generally white. May be red, green or light brown in color
Asymptomatic brown to black nodules along the hair shaft
Location: face, axillae and pubic (occasionally scalp)
Location: scalp and face (occasionally pubic)
KOH shows non-dematiaceous hyphae with blastoconidia and arthroconidia
KOH shows dematiaceous hyphae with asci and ascospores
Cultura: butter cream frosting, grows fast
Culture: green, black colony, grows slowly
  • Tratamento
    • Clip affected hairs
    • Wash affected hairs with antifungal shampoo (cetoconazol)

Tinea Nigra

  • Etiologia
    • Hortaea werneckii (formerly exophiala werneckii)
  • Apresentação clínica
    • Single, sharply marginated
    • Brown to gray to green macule or patch
    • Can be velvety and have mild scale
    • Most common on palms
      • Also seen on soles, neck and trunk
  • DDx: melanoma!
  • Tratamento
    • Topical keratolytic: Whitfield’s oint (6% benzoic acid + 3% salicyllic acid)
    • Topical azoles and allylamines