Characteristics of men who have sex with men with a dermatophyte infection: a systematic review

Objective: Dermatophytes may be sexually transmissible among men who have sex with men (MSM). Little is known about the characteristics of MSM at-risk of dermatophyte infections. This systematic review aimed to synthesise existing literature to identify and describe the demographic, behavioural, and infection-related characteristics of MSM diagnosed with dermatophyte infections. Methods: In January 2025, five bibliographic databases (Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE, Emcare, and Cochrane CENTRAL) were searched for studies published in English, Spanish, Catalan, French, Arabic, or Russian that reported at least one characteristic of MSM with dermatophyte infections. Two reviewers independently assessed the full texts and conducted a risk of bias appraisal using the Joanna Briggs Institute toolkit. Narrative synthesis was used to derive thematic findings. This review was registered on the International Prospective Register of Systematic Reviews (ID: CRD42024582946). Results: Thirteen studies published between 1997 and 2025 were included: one case control study, two cross-sectional studies, six case series, and four case reports, comprising 230 MSM with dermatophyte infections. Reported characteristics included: demographic (living with HIV [71.8%], low CD4 count [23.0%], HIV-PrEP use [64.6%], contact with soil [ n =1], sexual partner with tinea [ n =1], sex work [ n =5]); behavioural (multiple sexual partners [59.1%], contact with a tantric masseur [ n =16], attendance at sex-on-premises venues [100.0%], gym attendance [83.7%], recent travel [40.0%]); and infection-related (previous sexually transmitted infections [STIs] [63.3%], concurrent STI: Treponema pallidum [13.7%], Neisseria gonorrhoeae [12.9%], Chlamydia trachomatis [17.7%], human papillomavirus [7.3%], herpes simplex virus [2.0%], Pthirus pubis [0.8%]). Conclusion: These findings provide insight into the potential sexual transmissibility of dermatophytes in MSM and inform future clinical guidelines, public health interventions, and research priorities.