Piedra Differential Diagnoses

Updated: Mar 26, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Also consider the following:

  • Nits [42, 43]

  • Hair casts

  • Developmental defects of the hair shaft

  • Trichomycosis axillaris infection: Unlike the organisms that cause piedra, T axillaris fluoresces under ultraviolet illumination. Dermatoscopy shows irregular yellowish-white concretions around the hairs, some with a brushlike or feathery appearance. [44]

  • Tinea capitis: Unlike piedra, tinea capitis affects the base of the hair shaft and the follicle.

  • Monilethrix, trichorrhexis nodosa, and trichoptilosis: White piedra can be clinically indistinguishable from these conditions.

  • Hand eczema: This condition is a superficial infection caused by Trichosporon species that can mimic hand eczema in one who is immunocompromised. [45]

  • Trichobacteriosis [46]

  • Pubic dermatitis [47]

Differential Diagnoses