black piedra

Black Piedra: A Fungal Infection of the Hair Shaft

Black piedra, also known as Trichomycosis nodosa or Tinea nodosa, is a superficial fungal infection that affects the hair shafts. It is characterized by the presence of small, hard, and dark-colored nodules attached to the hair shaft.

Symptoms and Visual Indicators

The most prominent symptom of black piedra is the presence of these hard, black nodules on the hair shafts, which can be felt as small, gritty bumps along the hair strand. These nodules are typically 1-2 mm in diameter and can range from a few millimeters to several centimeters in length.

Prevalence and Geographic Distribution

Black piedra is more commonly found in warm, humid climates or in travelers returning from these areas. It predominantly affects scalp hair, although involvement of the beard, mustache, and pubic hairs is also known. The condition is common in hot and humid countries like South American countries and Southeast Asia.

Causes and Diagnosis

Black piedra is caused by a superficial fungus called Piedraia hortae, which grows very slowly and forms dark hyphae containing chlamydoconidia cells and black colonies when grown on agar. The condition can be diagnosed through a physical examination and microscopic examination of the affected hair strands.

Treatment and Management

The treatment of black piedra typically involves the use of antifungal medications, such as topical creams or oral tablets. In some cases, the condition may resolve on its own without any treatment.

References:

• [1] Black Piedra Symptoms Visual Indicators.
• [3] Piedraia hortae is a superficial fungus that exists in the soils of tropical and subtropical environments and affects both sexes of all ages.
• [5] Black piedra usually affects scalp hair, whereas white piedra more commonly affects pubic hair, axillary hair, beards, mustaches, and eyebrows and/or eyelashes.
• [10] Black piedra is a fungal infection of the hair shafts. It is also known as Trichomycosis nodosa. The fungal elements are attached to the hair shaft to form nodules along the hair shaft.
• [11] Black piedra. Black piedra also known as trichomycosis nodosa, tinea nodosa or trichosporosis, is Piedraia hortae fungus infection of the hair shafts resulting in the formation of small black nodules
• [15] Black piedra is a fungal infection of the hair shafts. It is also known as Trichomycosis nodosa. The fungal elements are attached to the hair shaft to form nodules along the hair shaft.

Characteristics of Black Piedra

Black piedra, also known as Trichomycosis nodosa, is a fungal infection that affects the hair shafts. The hallmark signs and symptoms of this condition include:

• Presence of small, gritty nodules: These nodules are typically 1-2 mm in diameter and can be felt as small, hard bumps along the hair strand [6][10].
• Darkly pigmented nodular concretions: Patients may present with darkly pigmented nodular concretions on the hair of the beard, scalp, brows, or lashes [5].
• Black, hard papules: These papules are up to 1-2mm in diameter and can be found on the hair shafts [6].
• Firmly attached brown-black nodules: On examination, the hair shaft shows firmly attached brown-black nodules, which are less than 1mm in size. These nodules are gritty on palpation [4][10].

Additional Symptoms

In some cases, patients may experience additional symptoms such as:

• Pruritus: Pruritus is the most common presenting symptom, especially when it occurs on the occipital scalp [3].
• Bacterial superinfection: Bacterial superinfection can occur in some cases, leading to further complications [3].

Asymptomatic Cases

It's worth noting that black piedra can be asymptomatic in many patients. Patients may not be able to see the minute nodules that develop on the hair shaft, and the condition may only be noticeable upon examination [8][7].

Treatment Options for Black Piedra

Black piedra, a fungal infection of the hair shafts, can be treated using various methods. While topical treatments are often effective, oral medications may also be prescribed in some cases.

• Topical Antifungals: Shampoos containing ketoconazole (2%), miconazole (2%), or ciclopirox (1-1.5%) can be applied once to twice a week for 3-4 weeks to treat black piedra.
• Oral Terbinafine: In cases where topical therapy is ineffective, oral terbinafine (250 mg once daily) may be prescribed for 6 weeks to help clear the infection.

According to [10], treatment options for black piedra include:

• 2% ketoconazole or 2% miconazole shampoo applied once-to-twice-a-week for 3 to 4 weeks
• Oral terbinafine 250 mg once daily for 6 weeks

Additionally, [13] suggests that oral itraconazole may be used to treat refractory or disseminated cases of black piedra.

Important Note: It is essential to consult a healthcare professional for proper diagnosis and treatment of black piedra. They can recommend the best course of action based on individual circumstances.

References:

[10] [13]