White Piedra Caused by Trichosporon Inkin: A Report of Two Cases in a Northern Climate

The document reported two cases of white piedra, a superficial fungal infection caused by *Trichosporon inkin*, in a northern climate, which is rare in the U.S.A. The first patient, a 35-year-old woman, had tan-colored concretions on her scalp hair, and the infection was confirmed through DNA sequencing after initial culture attempts failed. The second patient, a 23-year-old woman, had similar concretions and was diagnosed using a phenotypic kit after 18 days of incubation. She opted for treatment with ketoconazole shampoo and oral itraconazole instead of cutting her hair. The report highlighted the challenges in diagnosing white piedra due to its subtle presentation and the difficulty in culturing the organism, emphasizing the importance of advanced laboratory techniques for accurate identification.