The OC Health Care Agency (HCA) recently identified the first case of Trichophyton mentagrophytes (TMVII) in Orange County. TMVII is a recently emerged cause of dermatophyte (e.g. ringworm, or tinea) infection and is transmitted via sexual contact. Presentation involves inflammatory, sometimes painful, persistent skin lesions of the anogenital, buttocks, trunk, extremities, and perioral areas. TMVII cases have been associated with resistance to topical antifungals and may require prolonged treatment courses with oral terbinafine. Cases which did not resolve with terbinafine and required itraconazole treatment have also been reported. Routine culture may identify either T. mentagrophytes or T. interdigitale. Identification of TMVII requires specialized testing (e.g., ITS genome sequencing) available only at public health laboratories. More info...