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An Unusual Case of White Piedra Due to Trichosporon inkin Mimicking Trichobacteriosis

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Abstract

White piedra is a superficial mycosis characterized by soft, white-to-tan, irregular nodules attached to the hair shafts. A 36-year-old man presented with small lumps in his pubic hair, without any other symptoms. The clinical features were suggestive of trichobacteriosis. Pathology analysis of the infected hair revealed that the concretions surrounding the hair shaft were full of fungal elements, parts of which had invaded into the cuticle. Culture on Sabouraud dextrose agar grew creamy, yellow–white colonies identified as Trichosporon inkin by the sequence of the nuclear ribosomal intergenic spacer region. The condition was treated by shaving the pubic hair and administering antifungal therapy (oral itraconazole and topical ketoconazole).

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References

  1. Shivaprakash M, Singh G, Gupta P, Dhaliwal M, Kanwar A, Chakrabarti A. Extensive white piedra of the scalp caused by Trichosporon inkin: a case report and review of literature. Mycopathologia. 2011;172:481–6.

    Article  CAS  PubMed  Google Scholar 

  2. Goldberg L, Wise E, Miller N. White piedra in a northern climate caused by Trichosporon inkin: a report of two cases. Br J Dermatol. 2015;173:866–8.

    Article  CAS  PubMed  Google Scholar 

  3. Liao W, Xue Y, Chen P, Xu DQ, Zhang JZ, Li SQ, Chen QT. Cepholosporium acremonium: a new strain of fungus causing white piedra. China Med J. 1991;104:425–7 (in Chinese).

    CAS  Google Scholar 

  4. Zhuang K, Ran X, Lei S, Zhang C, Lama J, Ran Y. Scanning and transmission electron microscopic observation of the parasitic form of Trichophyton violaceum in the infected hair from tinea capitis. Scanning. 2014;36:465–70.

    Article  PubMed  Google Scholar 

  5. Zhang H, Ran Y, Liu Y, Zhang R, Lin X, Yan W, Dai Y. Arthroderma vanbreuseghemii infection in three family members with kerion and tinea corporis. Med Mycol. 2009;47:539–44.

    Article  PubMed  Google Scholar 

  6. Youker S, Andreozzi R, Appelbaum P, Credito K, Miller J. White piedra: further evidence of a synergistic infection. J Am Acad Dermatol. 2003;49:746–9.

    Article  PubMed  Google Scholar 

  7. Colombo A, Padovan A, Chaves G. Current knowledge of Trichosporon spp. and trichosporonosis. Clin Microbiol Rev. 2011;24:628–700.

    Article  Google Scholar 

  8. Magalhães AR, Mondino SS, Silva M, Nishikawa MM. Morphological and biochemical characterization of the aetiological agents of white piedra. Mem Inst Oswaldo Cruz. 2008;103:786–90.

    Article  PubMed  Google Scholar 

  9. Iturrieta-González IA, Padovan AC, Bizerra FC, Hahn RC, Colombo AL. Multiple species of Trichosporon produce biofilms highly resistant to triazoles and amphotericin B. PLoS ONE. 2014;9:e109553.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kiken DA, Sekaran A, Antaya RJ, Davis A, Imaeda S, Silverberg NB. White piedra in children. J Am Acad Dermatol. 2006;55:956–61.

    Article  PubMed  Google Scholar 

  11. Fischman O, Bezerra FC, Francisco EC, et al. Trichosporon inkin: an uncommon agent of scalp white piedra. Report of four cases in Brazilian children. Mycopathologia. 2014;178:85–9.

    Article  PubMed  Google Scholar 

  12. Zhang E, Sugita T, Tsuboi R, Yamazaki T, Makimura K. The opportunistic yeast pathogen Trichosporon asahii colonizes the skin of healthy individuals: analysis of 380 healthy individuals by age and gender using a nested polymerase chain reaction assay. Microbiol Immunol. 2011;55:483–8.

    Article  CAS  PubMed  Google Scholar 

  13. Inácio CP, Rocha AP, Barbosa Rdo N, Oliveira NT, Silva JC, de Lima-Neto RG, Macêdo DP, Neves RP. Experimental white piedra: a robust approach to ultrastructural analysis, scanning electron microscopy and etiological discoveries. Exp Dermatol. 2016;25:79–81.

    Article  PubMed  Google Scholar 

  14. Bentubo H, Gompertz O. Effects of temperature and incubation time on the in vitro expression of proteases, phospholipases, lipases and DNases by different species of Trichosporon. SpringerPlus. 2014;3:377.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tendolkar U, Shinde A, Baveja S, Dhurat R, Phiske M. Trichosporon inkin and Trichosporon mucoides as unusual causes of white piedra of scalp hair. Indian J Dermatol Venereol Leprol. 2014;80:324–7.

    Article  PubMed  Google Scholar 

  16. Ji J, Park T, Lee H. The ethnic differences of the damage of hair and integral hair lipid after ultra violet radiation. Ann Dermatol. 2013;25:54–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Schwartz RA. Superficial fungal infections. Lancet. 2004;364:1173–82.

    Article  PubMed  Google Scholar 

  18. Alexandro B, Denisse V, Leonel F, Javier A, Rosa M. Trichomycosis (Trichobacteriosis): clinical and microbiological experience with 56 cases. Int J Trichol. 2013;5:12–6.

    Article  Google Scholar 

  19. García-Martos P, Ruiz-Henestrosa JR, Pérez-Requena J, Marín P, Mira J, Calap J. Hyperhidrosis and multiple nodules in the hairs of the axilla. Enferm Infecc Microbiol Clin. 2001;19:177–8.

    Article  PubMed  Google Scholar 

  20. Salim G, Zahra MF. Trichobacteriosis: contribution of dermoscopy. Dermatol Online J. 2014;20.

  21. Guiotoku MM, Ramos PM, Miot HA, Marques SA. Trichobacteriosis: case report and dermoscopic study. An Bras Dermatol. 2012;87:315–6.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work is partly supported by Project 81472539 of the National Natural Science Foundation of China.

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    Authors and Affiliations

    1. Department of Dermatovenereology, West China Hospital, Sichuan University, Yuping Ran. No. 37, Guo Xue Xiang, Wuhou District, Chengdu, 610041, Sichuan Province, China

      Kaiwen Zhuang, Xin Ran, Jiaoqing Tang, Qin Yang, Sushmita Pradhan & Yuping Ran

    2. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China

      Yaling Dai

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    1. Kaiwen Zhuang
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    Correspondence to Yuping Ran.

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    Kaiwen Zhuang and Xin Ran have contributed equally.

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    Zhuang, K., Ran, X., Dai, Y. et al. An Unusual Case of White Piedra Due to Trichosporon inkin Mimicking Trichobacteriosis. Mycopathologia 181, 909–914 (2016). https://doi.org/10.1007/s11046-016-0049-9

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    • DOI: https://doi.org/10.1007/s11046-016-0049-9

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