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News|Articles|November 9, 2026

TMVII Sexually Transmitted Ringworm: Symptoms, Diagnosis, Treatment, and Prevention

An emerging cause of sexually transmitted ringworm, TMVII can resemble other skin conditions and require prolonged treatment. Learn what clinicians and infection preventionists should know about recognition, specialized testing, and patient counseling.

A new fungus identified in Germany in 2019 is causing a concerning number of sexually transmitted cases of ringworm across the US and Europe.1 Trichophyton mentagrophytes genotype VII, known as TMVII (and called TM 7), is a dermatophyte that was first noted when it infected a group of people returning from sex tourism trips in Southeast Asia. It has been spreading among men who have sex with men (MSM) in France since 2021. The first case in the US was reported in June 2024.2 If prevention isn't prioritized and the knowledge gap about the fungus isn’t narrowed, there is a risk of an epidemic. A small survey conducted by the CDC found that many infectious disease specialists were unaware of TMVII, and few knew how to treat it.3

Dermatophytes are the most common cause of superficial fungal infections worldwide.4 TMVII is a dermatophyte, and like all dermatophytes, it infects keratinized tissues such as skin, hair, and nails. TMVII is of the strain T mentagrophytes. Its internal transcribed spacer (ITS) genotype distinguishes it from other T mentagrophytes strains and can only be detected by genomic sequencing.5

While classic dermatophytoses are typically transmitted via fomites, shared surfaces, or animal contact, TMVII is transmitted primarily through sexual contact.1

In 2019, TMVII became considered a sexually transmitted infection (STI) pathogen in Germany, following a number of tinea genitalis cases associated with sexual contact.2 Some other cases were confirmed in Italy, Spain, and the United Kingdom. Cases in China linked to rabbit farming raise concern over zoonotic transmission potential.3

The first US case involved a patient who had a history of sexual contact with multiple partners during travel to Europe and California.6 Many other cases were recorded, and by early 2026, Minnesota alone reported more than 30 cases.7 A recently published systematic review of published cases found that most of the patients were male, from the men having sex with men (MSM) key population.8

TMVII is highly infectious, and it is transmitted via direct skin-to-skin contact during sexual activity. Most patients with it have a history of sexual exposure, with lesions consistently found around the genital and perianal region.4Symptoms can show up anywhere from a few days to weeks after exposure. Individuals without any visible lesions may still shed enough fungus to transmit it but the exact risk from assymptomatic spread is unclear.9 Immune suppression may increase the likelihood that an individual will come down with it upon exposure. Infected individuals are advised to keep away from sexual contact until lesions are fully healed.

Top 3 Takeaways

  1. Recognition can be difficult. TMVII may resemble eczema, psoriasis, or other infections, making persistent genital, perianal, or facial lesions important diagnostic clues.
  1. Confirming the genotype requires specialized testing. KOH microscopy can support a fungal diagnosis but cannot identify TMVII specifically.
  1. Follow-up and counseling matter. Treatment may be prolonged, and patients need clear guidance on medication adherence, avoiding contact with affected skin, and notifying partners.

Even though TMVII causes fungal infections that resemble infections caused by other dermatophytes, TMVII lesions are more inflammatory, extensive, and harder to treat. The most infected parts of the body include the genitals (tinea pubogenitalis), buttocks (tinea glutealis), face (tinea faciei), and trunk or limbs (tinea corporis).6 The most common kind is tinea pubogenitalis.

TMVII lesions have well-defined borders. They are also red, scaly, itchy, and sometimes painful. They can be mistaken for eczema or psoriasis, making diagnosis confusing.10

In Berlin, a cohort study of 51 confirmed TMVII patients found that the median time of diagnosis was long, at 42.5 days, with misdiagnosis and concomitant improper treatment occurring commonly.10

“The emergence and spread of sexually transmitted T mentagrophytes genotype VII (TMVII) may be driven in part by delayed or incorrect diagnosis and inappropriate corticosteroid use. These factors can suppress inflammation without treating the underlying fungal infection, allowing it to persist, worsen, and spread to additional sites in the body or to other individuals. Greater awareness among clinicians is important to facilitate early recognition and appropriate treatment,” says Rosa M. Andrade, MD, a board-certified physician specializing in infectious diseases at UCI Health.

Since TMVII is an STI, patients should be screened for other STIs.11 Because it is possible to have TMVII and other sexually transmitted infections at the same time.

“Add TMVII to the differential when someone has a persistent rash involving the genitals, groin, buttocks, or face,” says Andi Toufexis, DO, founder of Your Doctor Bestie. “A skin scraping with KOH can help confirm a fungal infection, but identifying TMVII specifically requires specialized testing. These infections can also require weeks or even months of oral antifungal treatment, so follow-up matters,” she adds.

TMVII infection is difficult to distinguish from infections caused by other dermatophytes by symptoms alone. Like infections with TMVII, other dermatophyte infections can cause itching, redness, and pain. Although standard microscopy of skin scrapings (KOH preparation) is limited, it should be performed in all cases.4 Molecular sequencing and genome analysis are what satisfactorily tell the difference. TMVII has a distinctive ITS region that other dermatophytes don't have.

While a number of laboratories in the US have the equipment to analyze fungus, this equipment is limited in certain regions of the world.

While other regular tinea infections generally improve within 2 to 4 weeks with local treatment, TMVII infections require longer systemic antifungal therapy, sometimes for 6 to 10 weeks. The standard first-line treatment of TMVII is 250mg of oral terbinafine taken once daily. Itraconazole can be used as a second-line treatment if terbinafine fails. 13 Antifungal susceptibility testing may be needed in some cases to determine which medication is likely to work.

Sexual contact must be avoided until all TMVII lesions have cleared completely following treatment. Medication should be taken for the required course, even when symptoms start to clear.

All patients should be screened for other sexually transmitted diseases. Their sexual partners should be screened for TMVII if they have lesions. Contaminated personal items should be disinfected. Since having multiple sexual partners is a risk factor, patients should be advised that it is safer to have sex with a particular partner at a time.

Clinicians should suspect TMVII in people who have lesions not responding to regular treatment and a background of sexual exposure, especially people in the MSM demographic, PrEP users, and persons living with HIV.12 It helps to note that condoms offer only partial prevention against TMVII. Using them may reduce the risk of TMVII, but the risk does not drop to 0%.

Every suspected and confirmed case should be reported to local or state health departments as part of efforts to improve surveillance and prevention.

References

  1. Descalzo V, Martín MT, Álvarez-López P, et al. Trichophyton mentagrophytes genotype VII and sexually transmitted tinea: an observational study in Spain. Mycoses. 2025;68(4):e70049. doi:10.1111/myc.70049
  2. Zucker J, Caplan AS, Gunaratne SH, et al. Notes from the field: Trichophyton mentagrophytes genotype VII—New York City, April–July 2024. MMWR Morb Mortal Wkly Rep. 2024;73(43):985-988. doi:10.15585/mmwr.mm7343a5
  3. Anand P, Quilter LAS, Penney J, Polgreen PM, Beekmann SE, Gold JAW. Emerging sexual transmission of Trichophyton mentagrophytes genotype VII infections, United States. Emerg Infect Dis. 2025;31(10):2064-2066. doi:10.3201/eid3110.251056
  4. Dellière S, Jabet A, Abdolrasouli A. Current and emerging issues in dermatophyte infections. PLoS Pathog. 2024;20(6):e1012258. doi:10.1371/journal.ppat.1012258
  5. Caplan AS, Sikora M, Strome A, et al. Potential sexual transmission of tinea pubogenitalis from TMVII. JAMA Dermatol. 2024;160(7):783-785. doi:10.1001/jamadermatol.2024.1430
  6. Minnesota Department of Health. Minnesota Lab System laboratory update: sexually transmitted dermatophyte outbreak in Minnesota. Published February 13, 2026. Accessed September 28, 2026. https://www.health.state.mn.us/diseases/idlab/mls/LabAlerts/260213tmentag.pdf
  7. Zhang Y, Xie W, Liu W, Li X, Liang G. Epidemiological and clinical profile analysis of Trichophyton mentagrophytes ITS genotype VII infected dermatomycosis: an emerging sexually transmitted pathogen. Mycoses. 2025;68(6):e70075. doi:10.1111/myc.70075
  8. American Academy of Dermatology Association. Trichophyton mentagrophytes genotype VII. Accessed September 28, 2026. https://www.aad.org/member/clinical-quality/clinical-care/emerging-diseases/dermatophytes/other-emerging-dermatophytes
  9. Kämmerer K, Huynh J, Deutsch C, et al. Trichophyton mentagrophytes type VII: cohort study on patient characteristics, clinical features, disease course, and treatment. J Dtsch Dermatol Ges. 2025;23(12):1566-1573. doi:10.1111/ddg.15837
  10. Lapa T, Banerji A, Kus J, Billick K. First reported Canadian case of Trichophyton mentagrophytes genotype VII infection among men who have sex with men (MSM). Can Commun Dis Rep. 2025;51(9):359-363. doi:10.14745/ccdr.v51i09a05
  11. Minnesota Department of Health. TMVII for health professionals. Updated February 25, 2026. Accessed September 28, 2026. https://www.health.state.mn.us/diseases/tmvii/hcp.html
  12. Monsel G, Jabet A. Sexually transmitted dermatophytosis: what do we know about epidemiology, transmission, and treatment of this emerging class of STI? Curr Opin Infect Dis. 2026;39(1):51-60. doi:10.1097/QCO.0000000000001171

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