Trichophyton Mentagrophytes Type VII (TMVII for short) is in the news, and you may have heard about it. It’s a rare fungus that causes a treatable rash on the skin. It was recently found in the U.S. for the first time. The patient is a male New Yorker in his 30s who traveled to California, England, and Greece, where he had sex with men.

He developed a red, itchy rash on his genitals, legs, and buttocks. Despite multiple oral antifungal treatments, it took more than four months for the rash to heal completely.

No one yet knows how TMVII will develop in this country. In France, 13 cases were reported last year, 12 of them in men who have sex with men.

For now, there is no need to panic. But there is a need for vigilance.

Since TMVII is spread through skin-to-skin contact, including during sex, it’s technically a sexually transmitted infection. And while the sole case in the U.S. has been in a man, the fungus can affect a person of any gender, gender identity, or sexual orientation. Stay informed, be aware, and know that seeing a doctor who can report the incidence helps with statistical data and research.

Also know that we are still seeing sporadic mpox cases, and that that poses a higher risk, especially for those who are immunocompromised. Please ensure you are fully vaccinated.

At DAP Health, we believe that good sex is good. Sex is healthy. Shame-and-stigma-free. Live your best sex life by going for regular STI testing, and learning about prevention measures such as DoxyPEP or DoxyPrEP for STI prevention, and PrEP or PEP for HIV prevention. If you’re HIV-positive, stay on your meds. Undetectable = Untransmittable.

More About TMVII

If you develop a new rash, please visit one of DAP Health’s three sexual wellness clinics (in Palm Springs, Cathedral City, or Indio), where our experts can see, diagnose, and treat you.

Symptoms

• Appearance: TMVII infections typically present as red, itchy, and scaly rashes. The rashes often appear in ring-like patterns, which is characteristic of ringworm infections.
• Affected Areas: Commonly affected areas include the groin, legs, buttocks, and other body parts. The rash can expand and may become more pronounced if left untreated.
• Additional Symptoms: In some cases, the affected skin may blister, crack, or ooze. The infection can cause significant discomfort and may impact the quality of life due to persistent itching and irritation​.

Transmission

• Direct Contact: TMVII is primarily transmitted through direct skin-to-skin contact with an infected individual. This can happen during close physical activities, including sexual contact.
• Indirect Contact: The fungus can also spread through contact with contaminated objects such as towels, clothing, bedding, and surfaces.
• Zoonotic Transmission: TMVII can be transmitted from animals to humans, particularly from pets like dogs and cats that may harbor the fungus​.

Prevention

• Personal Hygiene: Maintaining good personal hygiene is crucial. Regularly washing and thoroughly drying the skin, especially after sweating or bathing, helps prevent fungal infections.
• Avoiding Shared Items: Avoid sharing personal items like towels, clothing, and grooming tools with others.
• Pet Care: Ensure pets are free from fungal infections by having them regularly checked by a veterinarian and treating any infections promptly.
• Prompt Treatment: Treating fungal infections promptly in both humans and animals can prevent the spread of the fungus to others​.

Diagnosis

• Clinical Examination: Clinicians typically diagnose TMVII through a clinical examination of the affected skin. The characteristic appearance of the rash often provides initial clues.
• Laboratory Tests: Confirmation is done via laboratory tests, including:
  • Microscopic Examination: Skin scrapings from the affected area are examined under a microscope to detect fungal elements.

Treatment

• Topical Antifungals: For mild infections, topical antifungal creams, lotions, or powders containing terbinafine, clotrimazole, or miconazole are often prescribed.
• Oral Antifungals: In more severe or resistant cases, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be required. These medications have been effective, though resistance can complicate treatment​.
• Combination Therapy: Combining topical and oral treatments may be necessary for persistent infections. Monitoring for side effects and interactions with other medications is important, especially with drugs like itraconazole, which can have significant side effects​.

Research and Future Directions

• Ongoing research aims to better understand the genetic mutations that confer resistance to common antifungal treatments. International collaboration is crucial for tracking and managing the spread of TMVII and similar resistant strains​.

In the News:

What to know about rare sexually transmitted fungal infection TMVII via the Desert Sun