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Sexually Transmitted Dermatophyte Infections-A Scoping Review
Aditya K Gupta1,2, Amanda Liddy2, Lee Megal3
1Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract:
Sexually transmitted dermatophyte infections are an emerging public health concern, with increasing incidence reported across multiple countries. These infections are mainly spread through direct skin-to-skin contact during sexual activity and are more commonly found in individuals with high-risk sexual practices. The likelihood of infection is heightened by frequent pubic hair grooming or regular use of shared spaces like gyms and saunas. Clinically, presentations are often severe, widespread and atypical, which may delay diagnosis or lead to misidentification. Accurate species-level identification is critical and increasingly reliant on molecular sequencing techniques, including ITS and tef1α regions, which are also valuable for strain surveillance and contact tracing. Management strategies should emphasise systemic antifungal therapy, with consideration for adjunctive topical agents or antibiotics in cases of secondary infection. Individualised treatment plans may require extended therapy durations or combination regimens to ensure clinical resolution. In addition to pharmacologic intervention, education on hygiene practices, risk of reinfection and the importance of environmental decontamination and follow-up care is essential for preventing recurrence and curbing transmission.
Insights
Sexually transmitted fungal skin infections are rising globally. Early diagnosis and effective antifungal treatment are key to managing these severe, atypical infections and preventing spread.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Sexually transmitted dermatophyte infections represent a growing global health issue.
- Transmission occurs via direct skin-to-skin contact during sexual activity, with increased risk in specific populations and behaviors.
- Infections often present with severe, widespread, and atypical clinical features, complicating diagnosis.
Purpose of the Study:
- To highlight the emerging public health concern of sexually transmitted dermatophyte infections.
- To discuss diagnostic challenges and the importance of molecular identification methods.
- To outline current and recommended management strategies for these infections.
Main Methods:
- Review of clinical presentations and transmission dynamics.
- Emphasis on molecular sequencing techniques (ITS and tef1α) for accurate species identification.
- Analysis of treatment strategies, including systemic and topical antifungal therapies.
Main Results:
- Increasing incidence of sexually transmitted dermatophyte infections worldwide.
- Clinical presentations are frequently severe, widespread, and atypical, leading to diagnostic delays.
- Molecular methods are crucial for precise identification, strain surveillance, and contact tracing.
Conclusions:
- Accurate species identification using molecular techniques is critical for effective management.
- Systemic antifungal therapy, potentially combined with other treatments, is essential for clinical resolution.
- Patient education on hygiene, reinfection risks, and environmental decontamination is vital for controlling transmission and preventing recurrence.
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