What is it?

Black piedra, also known as trichomycosis nodosa, refers to a fungus infection of hair shafts, causing small black, firm, irregular nodules. If the nodule is dark, the infection is called black piedra. It is more common in middle aged people, usually due to poor hygiene.

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Signs & symptoms

Symptoms include firmly adherent, black, firm, oval or elongated papules, composed of a mass of fungus cells; scalp most common site of involvement, but also seen in the beard, mustache and pubic areas


Diagnosis is based upon findings from medical history and physical examination. Further evaluation may include trichoscopy, direct microscopic examination, fungal culture and histopathology.


Treatment includes antifungal shampoos and creams.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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