What are the other Names for this Condition? (Also known as/Synonyms)

• Molestia de Biegel

What is Black Piedra (Definition/Background Information)

• Black Piedra is a fungal infection caused by the fungus Piedraia hortae. It most commonly affects the hair but can infect the nails and skin. The condition is more common in tropical and subtropical regions and affects individuals of all age groups
• Black Piedra is often seen in those with hair that is frequently wet, such as in swimmers and those living in humid climates. The fungus is usually contracted through the soil. There are no cases of human-human transmission resulting in Black Piedra
• The fungus forms small nodules cylindrically arrayed along the hair shafts. These fungal colonies can vary in size and color (black or brown). The fungus uses the hair shaft as its nutritional source, causing itching, breakage, and discoloration of the hair. In severe cases, it can cause hair loss. Involvement of the scalp is usual, with facial and body hair less frequently involved
• Black Piedra is usually diagnosed based on the characteristic clinical appearance of the hair shaft. Still, a fungal culture or a skin scraping for a microscopic exam may be taken to confirm the diagnosis
• The treatment of Black Piedra includes antifungal shampoos, with ketoconazole as the active ingredient. Clipping or shaving of the involved hair is a helpful first measure.  Oral antifungal medications, particularly terbinafine, may be prescribed
• To prevent Black Piedra, practice good hygiene, such as washing hair and scalp regularly, especially after contact with soil. Avoiding sharing personal grooming items and drying hair thoroughly after washing are prudent measures to be considered
• With proper treatment, most people recover from Black Piedra without complications. The hair will typically grow back, but the areas with prior involvement may be discolored or have a rough texture

Who gets Black Piedra? (Age and Sex Distribution)

• Black Piedra is more common in people living in tropical and subtropical regions
• It can affect individuals of all ages, genders, and ethnicities

What are the Risk Factors for Black Piedra? (Predisposing Factors)

Factors that increase the risk of contracting Black Piedra include:

• Living in tropical and subtropical regions (humid climates)
• Swimmers - having hair that is frequently wet
• Frequent and extensive contact with soil
• Possibly, sharing personal grooming items with an infected person
• People who work in agriculture or otherwise have contact with soil and stillwater

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Black Piedra? (Etiology)

• Black Piedra is caused by the fungus Piedraia hortae, which can survive in the hair, nails, and skin
• The fungus is usually contracted from direct contact with contaminated soil

What are the Signs and Symptoms of Black Piedra?

• Black Piedra forms concentric nodules of cylindrically arranged shafts which, along the hair, can vary in size and color (brown to black)
• The fungal colonies can cause itching, breakage, and discoloration of the hair
• In severe cases, it can cause hair loss

How is Black Piedra Diagnosed?

• Black Piedra is usually diagnosed based on the characteristic nodules on the hair shafts
• A fungal culture or a skin scraping for microscopic examination may be taken to confirm the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Black Piedra?

• Black Piedra can cause hair loss and discoloration
• It can also lead to itching, pain, hair loss, and scarring in severe cases

How is Black Piedra Treated?

• Black Piedra can be treated with antifungal shampoos containing ketoconazole
• Clipping off the hair is a helpful first measure, where cosmetically acceptable
• Oral antifungal antibiotics, such as terbinafine, are sometimes necessary
• In cases where hair is severely matted or infected, it may need to be shaved or cut off

How can Black Piedra be Prevented?

To prevent Black Piedra, it is vital to consider the following measures:

• Practice good hygiene, such as washing hair and scalp regularly
• Avoid extensive contact with soil or contaminated water. If exposed, prompt hygiene measures are necessary
• Dry hair thoroughly after washing

What is the Prognosis of Black Piedra? (Outcomes/Resolutions)

• With proper treatment, most individuals recover from Black Piedra without complications
• The hair will typically grow back, but it may be discolored or have a rough texture

Additional and Relevant Useful Information for Black Piedra:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/focused-health-topics/black-piedra-causes-symptoms-diagnosis-and-treatment