Meryeme Marhraoui, Kenza Khachani, Meryem El Moustaoui, Mariame Meziane, Nadia Ismaili
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 8
Date of Publication: 2026/08/19
White piedra is a rare, usually asymptomatic superficial mycosis of the hair shaft caused by yeasts of the genus Trichosporon. We report a 19-year-old woman with a 2-year history of asymptomatic whitish concretions on the scalp hair shafts. The concretions were readily detachable and measured 1-1.5 mm. Mycological examination identified Trichosporon asahii. Trichoscopy showed white-to-yellow peripilar concretions along the distal hair shafts, helping distinguish white piedra from hair casts and structural hair-shaft disorders. Wood's lamp examination revealed fluorescence of the affected hair-shaft concretions, an atypical finding because white piedra is usually non-fluorescent. Previously reported synergistic colonization by coryneform bacteria may provide a possible explanation; however, no bacterial investigation was performed in our patient. Treatment with 2% ketoconazole shampoo, oral fluconazole, and hair-drying measures resulted in clinical resolution. This case highlights the complementary role of trichoscopy and Wood's lamp examination in evaluating atypical presentations of white piedra.
White Piedra; Trichosporon Asahii; Wood's Lamp; Dermoscopy; Fluorescence
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