Abstract
White piedra (WP) is a rare superficial mycosis that has been poorly described in the literature. This review aims to summarize our current understanding of Trichosporon spp. infection and WP. Trichosporon spp. are part of the human skin microbiome. The mechanism of hair shaft infection and nodule ultrastructure has been identified. Trichoscopy is an important diagnostic tool. Besides the classical WP signs, atypical presentations and concomitant diseases have also been described. Combination of systemic and topical antifungals is more effective than topical therapy alone. Most cases of WP have occurred in Latin America. High humidity, curly, and long hair are predisposing factors for scalp WP in females. Genital WP is more frequently reported in men. There is a paucity of studies describing the pathophysiology. Therapeutic recommendations are limited to small case series. Species identification is strongly encouraged for further basic and clinical research.
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