10.5826/dpc.1303a165
text/xml
2160-9381
3125
en
Daniel  Morgado-Carrasco 
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Black Piedra in an Amerindian Girl With Oculocutaneous Albinism Type 2
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-07-31
2022-12-29
2023-07-31
2023-08-24
e2023165
Dermatol Pract Concept
Daniel  Morgado-Carrasco 
2023/07/31
10.5826/dpc.1303a165
e2023165
Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Spain
2160-9381
en
e2023165
Veasey JV, Avila RB, Miguel BAF, Muramatu LH. White piedra, black piedra, tinea versicolor, and tinea nigra: contribution to the diagnosis of superficial mycosis. An Bras Dermatol. 2017 May-Jun;92(3):413-416.
Black Piedra in an Amerindian Girl With Oculocutaneous Albinism Type 2
https://dpcj.org/index.php/dpc/article/download/3125/2249
                 Black Piedra in an Amerindian Girl with
                    Oculocutaneous Albinism Type 2
           Jaime Piquero-Casals1, Daniel Sesto-Casals2, Jose Sandro Savino-Asprino3,
        Eduardo Rozas-Muñoz4, Juan Francisco Mir-Bonafé5, Daniel Morgado-Carrasco6


1 Department of Dermatology, Dermik Multidisciplinar Dermatology Clinic. Barcelona, Spain
2 Department of Dermatology, Hospital General Santa Maria del Puerto, Cadiz, Spain
3 Department of Ophthalmology, Hospital Mateu Orfila, Menorca, Spain
4 Department of Dermatology, Hospital San Pablo, Coquimbo, Chile
5 Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain
6 Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Spain



Citation: Piquero-Casals J, Sesto-Casals D, Savino-Asprino JS, Rozas-Muñoz E, Mir-Bonafé JF, Morgado-Carrasco D. Black Piedra in an
Amerindian Girl with Oculocutaneous Albinism Type 2. Dermatol Pract Concept. 2023;13(3):e2023165. DOI: https://doi.org/10.5826/
dpc.1303a165
Accepted: January 15, 2023; Published: July 2023
Copyright: ©2023 Piquero-Casals et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Jaime Piquero-Casals, MD PhD, Department of Dermatology Dermik Multidisciplinar Dermatology Clinic.
Barcelona, Spain. Phone: (+34) 932279867, FAX: (+34) 932275438 E-Mail: j.piquero@dermik.es




Case Presentation                                                        of cutting her hair to cure the disease; the patient showed us
                                                                         how when rubbing the hair with the sand from the river the
A 9-year-old Piaroa girl with oculocutaneous albinism type 2             nodules were detached easily. In the city, cleanser scrubs can
hailing from Venezuelan Amazonian, presented with mul-                   be used as an alternative.
tiple 1 to 2-millimeter blackish small nodules attached to
her scalp hair (Figure 1A). Microscopic examination of the
                                                                         Teaching Point
hair shafts revealed brown to black firmly concretions
(Figure 1B). Culture on Sabouraud agar at 25 °C showed                   Black piedra, caused by the dematiaceous filamentous fungus
after two weeks, slow growth of compact, domed black col-                Piedraia hortae, is usually seen in the tropics worldwide. Con-
onies. Microscopic examination of culture isolated shows                 sists of black-colored, firm, irregular nodules, located in the
asci and ascospores of piedraia hortae confirmed the black               hair cuticle. Sources of infection are soil- and environment-
piedra diagnosis.                                                        related in tropical rainforest [1]. Differential diagnosis in-
    Oral and topical antifungal are frequently unsuccessful              cludes pediculosis capitis, white piedra and trichorrhexis
and shaving or clipping the hair is the most accepted alterna-           nodosa. Dermoscopy should be included as a part of the clin-
tive, but this may not be considered cosmetically or socially            ical inspection to avoid unnecessary invasive investigation or
acceptable. When we suggest to our patient the possibility               diagnostic delay [2].




Image Letter | Dermatol Pract Concept. 2023;13(3):e2023165                                                                               1
    Figure 1. (A) Multiple 1 to 2-mm blackish nodules attached to the hair shaft in a OCA-2 patient. (B) 10X microscopic examination
    of the hair shafts revealed brown to black firmly concretions.




References                                                                2017;92(3):413-416. DOI: 10.1590/abd1806-4841.20176018.
                                                                          PMID: 29186263. PMCID: PMC5514591.
1. Veasey JV, Avila RB, Miguel BAF, Muramatu LH. White pie-            2. Piccolo V. Update on Dermoscopy and Infectious Skin Diseases.
   dra, black piedra, tinea versicolor, and tinea nigra: contribu-        Dermatol Pract Concept. 2019;10(1):e2020003. DOI: 10.5826/
   tion to the diagnosis of superficial mycosis. An Bras Dermatol.        dpc.1001a03. PMID: 31921490. PMCID: PMC6936624.




2                                                                            Image Letter | Dermatol Pract Concept. 2023;13(3):e2023165
