Health providers must keep an eye out for a potentially troublesome fungal skin infection after a case was detected in New York City.
Experts say there’s a new strain of tinea, also known as ringworm (or “jock itch” if it’s in the groin area). Although it responds to standard ringworm-treatment, it can take months to clear up.
Although ringworm is usually characterized by the ring-like rashes it causes on the skin, this new variation doesn’t always appear as rings. This makes it less obvious and easy to confuse with other skin complaints, such as eczema.
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It’s also worth pointing out that despite its name, no worms are involved. It’s a fungal infection. And it’s very, very treatable.
New York case
Details of the New York case appeared this week in the journal JAMA Dermatology.
It said a man in his 30s was diagnosed with a new variation of tinea genitalis/pubogenitalis. This is increasing in Europe. There were over a dozen cases in France last year. Until now, it had not been detected in the US.
The man had a rash on his penis, buttocks, and limbs. He’d been on a trip to Greece, England and California before returning to New York City. He said he’d had multiple sexual encounters with other men on his travels.
Genetic testing revealed his fungal infection was Trichophyton mentagrophytes type VII (TMVII). This is the new sexually-transmitted ringworm.
“Healthcare providers should be aware that Trichophyton mentagrophytes type VII is the latest in a group of severe skin infections to have now reached the United States,” said study lead author, Dr. Avrom S. Caplan, of the NYU Grossman School of Medicine.
The study notes that the condition can usually be treated with a standard anti-fungal called terbinafine. However, it may take a while to clear up.
“Since patients are often reluctant to discuss genital problems, physicians need to directly ask about rashes around the groin and buttocks, especially for those who are sexually active, have recently traveled abroad, and report itchy areas elsewhere on the body,” said study co-author Dr. John G. Zampella.
Drug-resistant fungal infection
Last month, JAMA Dermatology reported on the spread of another ringworm skin infection (trichophyton indotineae). Although this variation is widespread in Southeast Asia, it is now spreading worldwide. Eleven cases were diagnosed in New York hospitals last year.
When seven of the patients did not respond to the usual anti-fungal treatment, researchers analyzed the genetic code of the fungus. They found several mutations that made it resistant to the normal medicines. They instead had to use another, more potent medicine called itraconazole. The downside is that this carries a greater likelihood of side effects such as nausea.
Again, health providers are advised to be aware of these new forms of fungal skin infections, even if cases currently remain rare.
If you’ve got a persistent rash that’s not responding to over-the-counter fungal treatments, do seek medical advice.
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