Trichophyton mentagrophytes type VII: cohort study on patient characteristics, clinical features, disease course, and treatment

Summary Background and Objectives Sexually transmitted infections with Trichophyton mentagrophytes type VII (TMVII) have been reported in several countries. The aim of our study was to identify epidemiological and clinical features in order to improve prevention, diagnosis, and treatment. Patients and Methods Patients with culture‐confirmed TMVII infection diagnosed between 2020 and 2024 at the Department of Dermatology, Charité – Universitätsmedizin Berlin, Germany, were included. Patient characteristics, clinical presentation, and treatment were assessed. Results Fifty‐one patients were included (96.1% male; median age, 34 years), with 94.6% of male patients reporting male sex partners. Among 47 patients with known HIV status, 19.1% were living with HIV, while 71.1% of HIV‐negative patients reported using pre‐exposure prophylaxis (PrEP). Median time to diagnosis was 42.5 days (Q1–Q3: 29.25–73.5). Atypical morphologies, such as purulent or infiltrated subcutaneous lesions, occurred in 82.4%, and 96.1% had genital, perianal, or perioral manifestations. Median systemic treatment duration was 83.5 days (Q1–Q3: 57–110.25), with no significant differences by morphology ( p = 0.69) or HIV/PrEP status ( p = 0.88). Conclusions TMVII infections often present with atypical morphology and should be considered in the differential diagnosis of genital, perianal, and perioral dermatoses, particularly among men with multiple male partners. Clinicians should anticipate prolonged treatment durations to achieve clearance and prevent recurrence.