Phaeoannelomyces werneckii

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Phaeoannelomyces werneckii
Older mould culture
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Black Piedra

• Etiology
• Piedraia hortae or Piedra hortae, an ascomycetous
  fungus
• Epidemiology
• Occurs mostly tropical regions of Central South
  America, and Southeast Asia. Very rare in the
  U.S.
• Mainly affects young adults seems to run in
  families genetics? Family epidemics?
• Clinical manifestations
• Discrete hard, gritty, black to brown nodule
  adhering firmly to a hair shaft on any part of
  the body, but most often the scalp

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Black Piedra
Piedraia hortae on hair
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Black piedra
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Black Piedra

• Clinical manifestations
• Hair on head most often affected
• Occasionally involves beard, mustache, axillary,
  and pubic hair
• Weakened hair results in hair breakage
• Laboratory diagnosis
• KOH preparation squashed nodule on hair
• Reveals compact masses of dark, septate hyphae

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Black Piedra

• Laboratory diagnosis
• Also present in KOH preparation are oval asci
  containing curved non-septate ascospores
• Culture is not necessary to establish the
  diagnosis

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Piedraia hortae I hope
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White Piedra

• Etiology
• Trichosporon species
• T. beigelii, T. cutaneum, T. ovoides, and T.
  inkin have all been reported as the cause of
  white piedra. T.beigelii is considered primary.
• Epidemiology
• Occurs more in temperate subtropical areas
  where black piedra is mainly limited to tropical
  areas
• Occurs sporadically in the S.E. U.S.
• Most prevalent in Africa, Asia, and South America

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White Piedra

• Clinical manifestations
• Where black piedra mainly affects scalp hair,
  white piedra is more likely to affect facial
  hair, axilla and pubic hair
• Can affect scalp in some local populations
• Local populations in endemic areas have
  infections of pubic hair
• Lesion characterized as soft white, yellowish,
  beige, or greenish nodules on the hair shaft

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White piedra
Trichosporon species on Hair
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White piedra
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White piedra
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White Piedra

• Laboratory diagnosis
• KOH preparation squashed nodule on hair
• Reveals intertwined hyaline septate hyphae,
  some with rectangular arthroconidia and
  occasionally blastoconidia. Other sources say
  primarily blastoconidia except in older
  cultures???

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T. beigelii
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White Piedra

• Laboratory diagnosis
• Trichosporon species grow rapidly on SDA as white
  to cream colored yeast colonies
• Identification to species can be accomplished
  using the same methods designed to identify
  Candida and other yeast CMT agar, yeast carbon
  assimilation, urea agar, etc.
• See Yeast Power Point series

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T. beigelii