Trichophyton mentagrophytes Genotype VII and Sexually Transmitted Tinea: An Observational Study in Spain

Area of Science:

• Dermatology
• Infectious Diseases
• Mycology

Background:

• Trichophyton mentagrophytes genotype VII (TMVII) identified in 2019 in Germany as a cause of sexually transmitted tinea.
• Since 2023, TMVII has been reported in men who have sex with men (MSM) across France, Italy, and the United States.
• No prior cases of TMVII had been documented in Spain.

Purpose of the Study:

• To determine the prevalence of TMVII in an STI clinic in Barcelona, Spain.
• To characterize the demographic and clinical features of TMVII infections.
• To evaluate the effectiveness of different antifungal treatments for TMVII.

Main Methods:

• Prospective identification of TMVII cases from January 2020 to January 2025 via internal transcribed spacer sequencing of T. mentagrophytes-interdigitale isolates.
• Retrospective collection of patient data including demographics, clinical presentation, and treatment regimens.
• Analysis of treatment outcomes (cure vs. recurrence) in relation to therapies received.

Main Results:

• Fourteen out of 15 T. mentagrophytes-interdigitale isolates were identified as TMVII.
• All TMVII patients were MSM, with most being HIV-positive or on pre-exposure prophylaxis.
• Common infection sites included pubogenital, buttocks-perianal, and beard areas; six patients experienced recurrence, necessitating multiple treatment courses.

Conclusions:

• This study confirms the introduction and circulation of TMVII in Spain, indicating its spread across Europe.
• The epidemiological profile and infection sites strongly suggest sexual transmission.
• While patients responded to terbinafine, treatment courses longer than the standard 2-week duration were associated with higher cure rates (80%).