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Tinea genitalis – a new type of sexually transmitted infection?

August 03 2015

Trichophyton interdigitale is the second most frequent pathogen worldwide and can be transmitted via both human-to-human and animal-to-human contact. The largest case review to date by Luchsinger and colleagues of tinea genitalis in South East Asia reveals that sexual activity is a potentially underappreciated means of transmission.

7 patients (2 female, 5 male between 18-55 years of age) were reviewed at outpatient clinics due to tinea in the genital region. Skin scrapings were taken and directly analysed under the microscope. DNA was also extracted and sequences used for species identification. All patients were systemically treated with antifungals, all with terbinafine except one patient who took itraconazole, for between 2 and 10 weeks. 3 patients suffered inflammation after treatment and were also given prednisone.

Of the four patients who suffered severe inflammation in the affected region, all four reported genital shaving which may have led to breakage of the epidermis, allowing dermatophytes access and the formation of Majocci’s granulomas.

In summary the author’s indicate that clinicians should be alert to tinea genitalis after sexual intercourse, and specifically to differentially consider tinea as a cause of lesions which  otherwise would be attributed to folliculitis, eczema or psoriasis vulgaris. Finally they note that prompt treatment of suspected cases is required to prevent scarring alopecia.

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