Rare Ringworm Discovered In NYC
Health officials are sounding the alarm about a new case of ringworm, likely spread through sexual contact, that has been reported in New York City. This marks the first such case in the United States.
The infection is caused by a rare fungus known as trichophyton mentagrophytes type VII (TMVII). According to a study published in JAMA Dermatology by doctors at NYU Langone Health, the fungus was detected in a man in his 30s. The man had engaged in sexual activity with multiple partners during trips to England, Greece, and California.
Upon returning from his travels, the man developed a red, itchy rash on his penis, legs, groin, and buttocks. The rash was similar to eczema, a condition that causes dry, itchy, and inflamed skin, rather than the circular lesions typically associated with ringworm. After extensive testing, the man was diagnosed with TMVII.
Treatment for the infection proved challenging. The patient was prescribed standard antifungal medications, but it took four and a half months for his body to clear the infection. He initially took fluconazole for four weeks without improvement, then switched to terbinafine for six weeks, and finally to itraconazole for eight weeks.
Dr. Avrom Caplan, an assistant professor of dermatology at the NYU Grossman School of Medicine and author of the report, reassured the public, stating there is no widespread cause for concern. "There’s no evidence that this is widespread, or that this is something that people really need to be worried about," Caplan told NBC. He advised that anyone experiencing persistent itchy rashes in areas like the groin should see a doctor.
John Zampella, co-author of the study, emphasized the importance of physician awareness in identifying the fungus. He urged doctors to directly ask patients about rashes around the groin and buttocks, particularly if they are sexually active, have recently traveled abroad, and report itching elsewhere on the body.
This case is the first recorded instance in the U.S., following reports of 13 similar cases in France last year, 12 of which involved men who have sex with men. The man in the New York case reported having multiple male partners during his travels, though none of them reported similar skin issues. Caplan suggested the infection was likely transmitted through sexual contact but did not rule out the possibility of contraction from a sauna visit two months prior to symptom onset.
The study highlighted an increasing prevalence of male genital fungi in India, consistent with the emergence of a slightly different form of ringworm called trichophyton indotineae. Factors such as climate, hygiene, and bathing practices likely contribute to the spread of this fungus, alongside sexual contact.
Caplan's team has previously identified cases of trichophyton indotineae in New York City, noting that it presents similar itchy, contagious rashes and poses significant treatment challenges. This particular fungus often resists terbinafine treatment, complicating management for dermatologists.
“These findings offer new insight into how some of the fungal skin infections spreading from South Asia can evade our go-to therapies,” Caplan said. “Beyond learning to recognize their misleading signs, physicians will need to ensure their treatment addresses each patient’s quality-of-life needs.”
Caplan plans to collaborate with leading fungi experts across the U.S. and internationally in the coming months to expand research efforts and track emerging cases. This initiative aims to better understand and manage these rare but persistent infections, ultimately improving patient care and outcomes.