Deep cutaneous Trichosporon asahii infection in a patient recovering from toxic epidermal necrolysis

White Piedra: An Uncommon Superficial Fungal Infection of Hair

White piedra is a superficial fungal infection of hair caused by Trichosporon species. It presents clinically as white nodules encasing the hair shafts and may lead to increased fragility. It can usually be differentiated easily from clinically similar conditions based on clinical and microbiologic features. We report a case of white piedra of scalp hair in a 32-year-old female caused by T. ovoides, diagnosed using clinical, trichoscopic, microbiologic and molecular methods. In this case, trichoscopy acted as an interface between clinical and microbiologic examination, obviating the need for hair shaft microscopy. The genus Trichosporon contains 6 species of clinical significance viz., T. asahii, T. asteroides, T. cutaneum, T. inkin, T. mucoides, and T. ovoides, which cannot be differentiated based on their morphologic characteristics. A genotypic identification using molecular methods helped determine the causative species. It was treated successfully with oral itraconazole and topical ketoconazole.

Isavuconazole-Animal Data and Clinical Data

The treatment of invasive fungal infections has deeply evolved in the last years with the inclusion of new antifungals, mainly new azoles (i.e., posaconazole, isavuconazole), to the therapeutic armamentarium. This review focuses on the role of isavuconazole for treating the most important invasive fungal infections both in animals and humans (hematological and non-hematological patients).