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Background: Non-venereal genital dermatoses are the conditions of the genitalia that are not transmitted sexually. They may be confused with venereal diseases and be responsible for concerns among patients as well as diagnostic dilemmas for physicians. This study was conducted to determine the prevalence and describe the patterns of non-venereal genital conditions. Methods: This was a hospital-based, cross-sectional, prospective study conducted in a tertiary center in Kathmandu, Nepal, over a period of one year. Non-probability purposive sampling was employed to select the samples. Two hundred patients were enrolled in the study. Ethical approval was taken prior to the study. Detailed history taking along with a complete cutaneous examination were conducted for all patients and recorded in a preformed proforma. Results: Among 21366 patients, two hundred patients had non-venereal genital dermatoses. The prevalence of non-venereal dermatoses was 0.93 %. The mean age of the patient was 29.5 ± 15 years, ranging from 2 months to 81 years. The male-to-female ratio was 2.7:1. Itching was the most common presentation (46%). Fifty-four different types of non-venereal diseases were encountered and classified into inflammatory lesions (n = 84; 42%), infections and infestations (n = 43; 21.5%), normal variants and benign abnormalities (n = 41; 20.5%), and miscellaneous (n = 21; 10.5%). The most common were, among inflammatory dermatoses, drug reactions (11.5%) and eczema (6.5%) and, among infections and infestations, scabies (9.5%) and fungal infections (7.5%). Conclusion: Non-venereal genital dermatoses are important yet less common dermatological conditions. A number of patients have misconceptions about them as venereal. A comprehensive study of non-venereal dermatological genital conditions is required for careful management to minimize morbidity.

Background: Mucocutaneous manifestations in HIV infections are common. However, they have not, so far, been studied in Nepal. The aim of this study was, therefore, to describe mucocutaneous manifestations in Nepalese HIV patients. Materials and Methods: The following is a hospital-based, descriptive, cross-sectional study conducted in the Department of Dermatology and Venereology and Antiretroviral Treatment (ART) Center of Tribhuvan University Teaching Hospital (TUTH) from May 2017, through October 2018. Patients aged 16 years and above diagnosed with HIV were included in the study, for whom history and clinical examinations were performed. The study variables were age, sex, a clinical diagnosis of dermatological problems, clinical stages of HIV/AIDS, as per the World Health Organization (WHO) classification criteria, and the CD4 count. Results: A total of 52 patients were included in the study. The mean age upon presentation was 38.77 ± 10.9 years. The mean CD4 count was 464.27 ± 255.13. Females were more affected than males (female:male = 1.4:1). Mucocutaneous manifestations were the following: fungal infections (10; 19.3%), viral infections (6; 11.6%), parasitic infestations (3; 5.8%), bacterial infections (4; 7.7%), sexually transmitted infections (2; 3.8%), seborrheic dermatitis (3; 5.8%), idiopathic pruritus (3; 5.8%), recurrent oral ulcers (3; 5.8%), urticaria (3; 5.8%), pruritic papular eruptions (2; 3.8%), eczemas (2; 3.8%), acne (2; 3.8%), angular cheilitis (2; 3.8%), xerosis cutis (2; 3.8%), and others (5; 9.6%). Conclusions: The study showed that fungal infections are common in HIV patients, followed by viral infections and parasitic infestations. Seborrheic dermatitis, idiopathic pruritus, recurrent oral ulcers, and urticaria were found to be common inflammatory skin diseases in HIV.

Introduction: The patterns of positive patch test in Nepal have not been defined so far. The aim of this study was to describe the patterns of patch test reactivity in suspected Allergic Contact Dermatitis (ACD) patients. Methods: This was a hospital based retrospective study performed to investigate patch test reactivity in patients with ACD from April, 2016 through October, 2016. The data of patients who underwent patch test during this period were extracted and analyzed. Results: A total of 35 patients were included in the study. Nineteen (54.3%) tested positive to either one or more allergens. Among them, 17 (89.4%) reacted positively to a single allergen. The following patterns of positives were seen: nickel sulfate, 5 (26.3%), fragrance mix 3 (15.7%), and parthenium 3 (15.7%). Cobalt sulfate, formaldehyde, potassium dichromate, benzocaine, nitrofurazone, chlorocresol each was positive in single patient. Majority of the patients were housewives (22.6%) followed by students and officers (13% each), farmers (10%), health care workers (9.7%), wet work (6.5%) and others (20). Less than half (45%) of the hand eczema showed positive patch test. Similarly,40% of the patient of scattered generalized dermatitis showed reactivity to parthenium, nickel sulfate and multiple antigens. Conclusions: The most common allergens identified were nickel sulfate, fragrance mix and parthenium. Since, there is no well defined contact allergen in the Nepalese community, so patch test kits developed elsewhere might not have been beneficial and calls for need of large scale investigation to identify the local allergens.

We report a case of chronic herpes simplex in a 27 year old lady presenting with a history of persistent verrucous ulcer in the natal cleft of nine months duration. The patient was diagnosed and treated initially as a case of Tuberculosis Verrucosa Cutis (TVC) based on the chronicity of the ulcer, negative HIV serological tests and histopathological findings. The diagnosis had to be revised as the lesion was increasing in size and the patient was not responding to treatment even after completing antituberculous treatment for six months. Repeat histopathological examination and immunohistochemistry showed DNA of herpes simplex. Based on this finding a repeat HIV serology was sent which was positive. The ulcer healed after a course of acyclovir. The case is being reported to highlight the importance of considering chronic herpes simplex infection in a case of chronic genital ulcer. In addition this case reminds us the nature of HIV infection to mislead the diagnosis by altering the natural course of the disease process.