Epidemiological and Clinical Profile Analysis of Trichophyton mentagrophytes ITS Genotype VII Infected Dermatomycosis: An Emerging Sexually Transmitted Pathogen.

Background: Trichophyton mentagrophytes ITS genotype VII (TMVII) has recently been identified as a cause of genital infections, raising concerns about its potential as an emerging sexually transmitted pathogen. However, the epidemiology and clinical features of TMVII infection remain poorly understood.

Objectives: To systematically review published TMVII cases and characterise its demographic distribution, transmission patterns, clinical manifestations and treatment outcomes.

Methods: A comprehensive literature review was conducted, including all published molecularly confirmed TMVII cases. Data on demographics, infection sites, co-infections and treatments were extracted and analysed.

Results: A total of 124 TMVII cases from 10 studies were included. Among 60 cases with detailed clinical data, tinea genitalis (36.7%) and tinea faciei/barbae/capitis (51.7%) were the common infection types. TMVII infection predominantly affected men who have sex with men (64%), with high co-infection rates of HIV (29.6%) and gonorrhoea (42.6%). Most cases were reported in France (49%) and Germany (35%), suggesting possible local transmission. Oral terbinafine (250 mg/day for 4-8 weeks) achieved a 64.4% cure rate (38/59 courses), while limited data indicated itraconazole and griseofulvin were also effective. Fluconazole showed no therapeutic efficacy.

Conclusion: TMVII can be transmitted through sexual activities, particularly affecting MSM and individuals with concomitant STDs. Current evidence suggests that oral terbinafine is effective, meanwhile other antifungals need further observation. Increased focus is warranted on the clinical management and monitoring of TMVII infection.