Experts are warning doctors and the public about the arrival of difficult-to-treat fungal skin infections in the US

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Trichophyton indotineae causes tinea corporis. Credit: JAMA Dermatology (2024). DOI: 10.1001/jamadermatol.2024.1126

Healthcare providers should beware of new and highly contagious forms of ringworm or jock itch, which a few reports are emerging as a potential threat to public health.

In the first of the studies, experts at NYU Langone Health, who focus on the spread of contagious skin rashes, document the first reported U.S. case of a sexually transmitted fungal infection that can take months to clear, even with treatment.

In the second report, doctors at NYU Langone worked with authorities at the New York State Department of Health to describe the largest group of patients in the country with a similar strain of fungus that is resistant to standard therapies.

Both types of fungi belong to a group that causes a skin rash or tinea, which spreads easily on the face and limbs (ringworm), groin (jock itch) and feet (athlete’s foot). However, the tinea examined in the new reports may look very different from the neat, regular circles you see in most forms of ringworm. They can instead be confused with lesions caused by eczema and can therefore remain for months without proper treatment.

The first report, published online June 5 in the journal JAMA Dermatologydescribes a man in his 30s who developed tinea on his penis, buttocks, and limbs after returning to New York City from a trip to England, Greece, and California.

Genetic testing of fungal samples collected from the patient’s rash revealed that the infection was caused by the species Trichophyton mentagrophytes type VII (TMVII). This sexually transmitted form of ringworm is increasingly diagnosed across Europe, with thirteen cases reported in France by 2023, mainly in men who have sex with men. Notably, the man in the current study said he had had sex with multiple male partners during his travels, none of whom reported similar skin problems.

“Healthcare providers should be aware that Trichophyton mentagrophytes type VII is the latest in a group of serious skin infections that have now reached the United States,” says lead author and dermatologist Avrom Caplan, MD. Caplan is an assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine.

“Because patients are often reluctant to discuss genital problems, doctors should ask directly about rashes around the groin and buttocks, especially in those who are sexually active, have recently traveled abroad, and report itchy areas elsewhere on the body,” researcher added. author John Zampella, MD.

Zampella, associate professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman, says that while infections caused by TMVII are difficult to treat and can take months to clear, so far they appear to respond to standard antifungal therapies such as terbinafine.

Meanwhile, Caplan says the new skin condition explored in his other new report poses a bigger challenge for dermatologists. The study resultspublished online in May JAMA Dermatology, focuses on Trichophyton indotineae (T. indotineae), which is widespread in India and now reported worldwide. The infection was first confirmed in the US last year and causes similar itchy and contagious rashes to TMVII, but is often resistant to treatment with terbinafine.

More information:
Potential sexual transmission of Tinea Pubogenitalis by TMVII, JAMA Dermatology (2024). DOI: 10.1001/jamadermatol.2024.1430

Caplan et al, Clinical Course, Antifungal Susceptibility and Genomic Sequencing of Trichophyton indotineae, JAMA Dermatology (2024). DOI: 10.1001/jamadermatol.2024.1126

Provided by NYU Langone Health

Quote: Experts Warn Doctors and Public of Advent of Difficult-to-Treat Fungal Skin Infections in US (2024, June 5), Retrieved June 5, 2024 from doctors -hard-fungus-skin.html

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