title: White piedra in children.
abstract: BACKGROUND
  White piedra is a fungal infection of the hair shaft caused by species of Trichosporon. Rarely has this infection been reported in the United States. Historically, infected individuals required shaving of their hair to achieve clearance of the infection.
  
  
  OBJECTIVE
  We sought to describe 8 cases of Trichosporon scalp infections seen in the northeastern United States.
  
  
  METHODS
  We conducted chart review and prospective evaluation of 7 girls and 1 boy seen in two dermatology practices in New Haven, Conn, and New York, NY.
  
  
  RESULTS
  Seven girls, ages 4 to 16 years old, and one 4-year-old boy were determined to have Trichosporon scalp infection, all through culture. Of the 8 children who were available for follow-up, 7 had clearance of their infection with a combination of oral azole antifungal medication and azole antifungal shampoo, without shaving the scalp hair.
  
  
  CONCLUSIONS
  This was a sample of patients from a localized region of the United States.
  
  
  CONCLUSIONS
  White piedra is emerging as a commonly seen hair and scalp infection in the northeastern United States. Contrary to prior publications, scalp and hair infection may be successfully treated with a combination of oral azole antifungals and shampoos without shaving the scalp.
authors.affiliation: Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Kiken
authors.forename: Anand
authors.initials: A
authors.lastname: Sekaran
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Antaya
authors.forename: Amy
authors.initials: A
authors.lastname: Davis
authors.forename: Suguru
authors.initials: S
authors.lastname: Imaeda
authors.forename: Nanette B
authors.initials: NB
authors.lastname: Silverberg
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003237:Connecticut / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006197:Hair / Q000382:microbiology; D006203:Hair Preparations; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000627:therapeutic use; D010373:Lice Infestations / Q000175:diagnosis; D008297:Male; D008800:Mexico / Q000208:ethnology; D009519:New York City / Q000453:epidemiology; D010854:Piedra / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014250:Trichosporon / Q000302:isolation & purification*; D006113:United Kingdom / Q000208:ethnology; D015006:Yemen / Q000208:ethnology
chemical_list: D000935:Antifungal Agents; D006203:Hair Preparations; D015725:Fluconazole; D007654:Ketoconazole