In a recent development that has alarmed health experts, a man in his 30s from New York City has contracted a sexually transmitted form of ringworm, marking the first reported case of its kind in the United States.
The emergence of this new and highly contagious fungal strain, Trichophyton mentagrophytes type VII (TMVII), has prompted a call for increased vigilance among healthcare providers.
Dr. Avrom S. Caplan, an assistant professor in the dermatology department at NYU Grossman School of Medicine, stated, "Healthcare providers should be aware that Trichophyton mentagrophytes type VII [TMVII] is the latest in a group of severe skin infections to have now reached the United States." Dr. Caplan co-authored a case study about the New York patient, who developed a rash on his penis, buttocks, and limbs after contracting TMVII. This fungal strain has seen a surge in Europe, particularly among men who have sex with men.
The patient, whose identity remains undisclosed, had traveled to England, Greece, and California, and reported having sexual encounters with men during his travels. None of his partners reported similar skin conditions. Dr. John G. Zampella, the senior author of the study, emphasized the importance of physicians inquiring about potential rashes in the groin and buttock areas, particularly in patients who are sexually active, have recently traveled abroad, or report itchy areas on their bodies.
TMVII infections, according to Dr. Zampella, generally respond to standard antifungal therapies such as terbinafine (also known as Lamisil). However, these infections can take months to clear and may be mistaken for eczema lesions, potentially delaying treatment.
Another fungal strain, Trichophyton indotineae, which causes similar rashes and is prevalent in India, has proven more challenging for dermatologists. This strain often resists terbinafine treatment, as noted by the researchers at NYU Grossman. They examined data from 11 patients treated for Trichophyton indotineae in NYC hospitals between May 2022 and May 2023. Seven of these patients, despite receiving standard doses of terbinafine, did not see their rashes clear, possibly due to genetic mutations in the fungus.
The antifungal pill itraconazole showed more promising results, but Dr. Caplan warned of potential side effects, including interference with other medications and symptoms such as nausea and diarrhea.
Despite the emergence of these new fungal strains, Dr. Caplan reassured that the rates of TMVII and Trichophyton indotineae in the U.S. remain low. His team plans to expand their research into these two fungal species in the coming months. He concluded, "These [initial] findings offer new insight into how some of the fungal skin infections spreading from South Asia can evade our go-to therapies. Beyond learning to recognize their misleading signs, physicians will need to ensure their treatment addresses each patients quality of life needs."
Login