Summary
A 23-year-old Swedish Caucasian man presented with typical clinical signs of black piedra of his scalp after his return from 4-months' stay in India There were black nodules around the hair shafts, and the crushed nodules revealed numerous asci and ascospores on microscopy Piedraia hortae was isolated from the concretions He was treated with oral terbinafine 250 mg daily for 6 weeks At the end of treatment no nodules were visible, but 16 days later a few ‘new’ black concretions appeared Microscopy of these nodules revealed markedly degenerated fungal elements, and cultures were negative No further signs of the disease were seen 2 months after cessation of therapy In vitro susceptibility tests showed that Piedraia hortae was sensitive to terbinafine This case demonstrates that terbinafine is effective in the treatment of black piedra

Black piedra: the first case treated with terbinafine (Lamisil®)

1
Etiologic Agents

2
Ecology

3
White Piedra

4
Black Piedra

5
Tinea Nigra



Keywords:

White piedra, Black piedra, and tinea nigra;
Hortaea werneckii (Phaeoannellomyces werneckii)-causative agent of human tinea nigra;
White piedra-by species of Trichosporon Behrend;
Commensal fungi assimilating compounds produced by human body;
White piedra of groin-not depending on personal hygiene;
trichosporon ovoides Behrend;
Piedraia quintanilhae van Uden-reported from chimpanzees in Central Africa;
tinea nigra-brown to black lesions forming on skin of palm

White Piedra, Black Piedra, and Tinea Nigra

Summary

Black piedra, an infection of the hair shaft by Piedra hortai, is present in peninsular Malaysia and is known to the indigenous population as‘rambut berbuah’(fruit-bearing hair). Thirty-one patients, the majority being from rural areas, were studied. Though most of the patients were aware of the infection they did not seek medical treatment spontaneously, as the fungus causes minimal damage to the hair. Penetration of the fungus beyond the cuticle of the hair shaft was not seen. The source of the fungus was not identified.

Black piedra in west malaysia

Recently identified features that help to distinguish ceremonial tsantsa from commercial shrunken heads

We provide clear evidence ol' the keratinolytic activity of this fungus at the cuticular and at the cortex level. Hairs with black piedra isolated from Brazilian Indians (Xingu) were investigated studying serial sections i'or light and transmission electron microscopy. The fungus showed a strong keratinolytic activity being able to destroy both the cuticle and the hair cortex. The sequence of degradation of the histological components of the hair followed a similar pattern lo ihat reported for dermatophytes and other keratinolytic fungi.

New findings in black piedra infection

Piedra hortai, an ascomycete causing black piedra, was studied with light and electron microscopy. The nodule on the hair contains septate hyphae, asci and free ascospores, all of which were smaller than those previously reported. A mode of spread of infection is suggested.

K. C. Chong

Papers

Black piedra in west malaysia

Morphology of Piedra hortai