Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

A 21-year-old female patient, diagnosed with human immunodeficiency virus (HIV) in 2020 on highly active antiretroviral therapy and antitubercular therapy for 2 months for pulmonary tuberculosis, presented with multiple skin-colored umbilicated papules all over the face and body, accompanied by severe headache and cough with expectoration for the past 10 days. Needling of the lesions yielded serous discharge. Subsequent investigations, including biopsy, cerebrospinal fluid analysis, and stool examination, confirmed the presence of Cryptococcus. A lumbar puncture was performed to alleviate increased intracranial pressure. Although cryptococcal infections are prevalent among HIV individuals, prompt diagnosis is essential to reduce the mortality risk.

One therapeutic option to manage hyperglycemia is to increase renal glucose excretion by inhibiting sodium-glucose cotransporter-2 (SGLT2) glucose transport proteins. SGLT2 inhibitors (SGLT2i) represent a novel class of oral antidiabetic drugs which are associated with drug-induced glucosuria which can be associated with candidial balanoposthitis and genitourinary infections. Our report includes 10 patients. Their glycated hemoglobin (HbA1c) ranged between 7 and 10 before treatment with SGLT2i. They had one or more episodes of candidal balanoposthitis due to uncontrolled diabetes mellitus. 3 patients were on dapagliflozin 5 mg and 7 were on empagliflozin 10 mg. Their HbA1c after SGLT2i ranged from 5 to 5.6. No adverse effects like urinary tract infections were noted. All ten of them had recurrent candidal balanoposthitis and presumed that their sugar levels were under control. The anticipated association of SGLT2i and increased risk of genital infection is a major cause of concern for diabetologists.

We report a rare case of penile papulonecrotic tuberculid (PNT) in a middle-aged male with idiopathic interstitial lung disease (ILD) on chronic steroids, presenting with recurrent, painless genital ulcers. Systemic evaluation revealed disseminated tubercular lymphadenitis as the primary focus. The patient was diagnosed with PNT based on clinical and histopathological findings, and tuberculosis was confirmed through imaging and cytology. This case highlights the diagnostic challenge of penile PNT, particularly in immunosuppressed individuals, and underscores the importance of comprehensive tuberculosis screening in patients with tuberculids, especially those with underlying chronic conditions like ILD.

Introduction: Male genital dermatoses refer to a variety of conditions affecting the genital region, many of which are not sexually transmitted. Due to associated stigma, there is considerable psychological distress. This article aims to provide a thorough clinical overview, pattern, and epidemiology of nonvenereal male genital dermatoses.

Aim and objective: The aim of the study was to evaluate the clinical pattern of nonvenereal male genital dermatoses.

Methodology: The study included 100 male patients with genital dermatoses over a period of 1 year. Informed consent was taken. Patients diagnosed with venereal dermatoses, and those who tested positive for HIV or venereal disease research laboratory, were excluded. Comprehensive information was gathered, and patients were evaluated to establish the diagnosis. Patient information, examination results, and diagnoses were documented and analyzed.

Results: The majority of patients were in the 31-40 year age. The study identified 29 distinct types of nonvenereal dermatoses. The most prevalent condition was scrotal dermatitis, found in 11 cases, followed by vitiligo, which was noted in 10 cases. The frequently observed symptoms included itching and altered pigmentation. The majority of lesion were erythematous followed by papules.

Conclusion: Genital lesions are often misunderstood, with many believing them to be sexually acquired. Increasing awareness and understanding of nonvenereal male genital dermatoses among clinicians and patients can reduce stigma, prevent misdiagnosis, and ensure appropriate and timely treatment. Addressing these conditions with clinical clarity and empathy is key to breaking the stigma and restoring patient confidence.

Giant condyloma of Buschke-Lowenstein (GCBL) is a rare benign verrucous tumor, especially in women. It is primarily caused by human papillomavirus (HPV) types 6 and 11, with a preference for the anogenital area. Immunosuppressive conditions such as pregnancy and HIV infection can accelerate GCBL development due to hormonal changes and immune responses. A 28-week-pregnant HIV-positive woman (CD4 + count 235 cells/μl) who had not started antiretroviral therapy presented with a rapidly growing verrucous mass (20 cm × 7 cm × 2 cm) in the vaginal area extending to the anus, growing in 4 months. Diagnosis of GCBL was confirmed with HPV type 6. HPV, including low-risk types like 6 and 11, infects epithelial cells. Estrogen accelerates HPV gene expression in pregnant women, while HIV suppresses CD8 + T-cell activity and induces changes in the immune response. Increased regulatory T-cells (Treg) impair immune function, contributing to GCBL development. Pregnancy and HIV conditions can influence HPV infection progression to GCBL.

Congenital syphilis, caused by the spirochete Treponema pallidum, is transmitted transplacentally or through direct contact with maternal lesions during delivery. It is classified as early congenital syphilis when symptoms appear within the first 2 years of life, and late when they manifest after 2 years, indicating long-term or delayed complications. We report a case of early congenital syphilis in a preterm neonate, confirmed by venereal disease research laboratory titers more than four times higher than maternal levels and a positive fluorescent treponemal antibody absorption test, presenting with respiratory distress, thrombocytopenia, hepatobiliary dysfunction, and skeletal abnormalities.

Background and objectives: There is a paucity of studies analyzing risk factors and outcomes of treatment of genital warts. Our study evaluated the prevalence of various epidemiological factors in high-risk populations of men versus women, among persons living with HIV (PLHIV) patients and men who have sex with men (MSM) patients, and the comparative efficacy of trichloroacetic acid (TCA) versus podophyllum toxin, among other modalities, in the treatment of anogenital warts.

Materials and methods: It was a retrospective observational study done over 2.5 years including 294 subjects. Demographic, clinical, and epidemiological data were extracted from registration records and analyzed.

Results: Extra/premarital contact, presence of multiple sexual partners, and addiction were significantly higher in men, and illiteracy/unemployment and unprotected intercourse were significantly higher risk factors in females. Multiple sexual partners and addiction as well as compliance to treatment were found to be significantly more prevalent in PLHIV patients versus non-PLHIV. Extra or premarital contact, multiple sexual partners, and average number of sexual partners were significantly higher in MSM with men patients versus heterosexual patients. Among the 294 patients, 137 (46.5%) patients were compliant with the treatment, out of which 122 (89.1%) showed complete resolution, and 10.9% of patients had partial resolution. A total of 110 (37.4%) patients were treated with TCA (70%-90%), and 37.4% achieved complete resolution in 4.6 months on average. Podophyllum resin 20% was used to treat 184 (62.5%) patients, with 62.5% resolving in an average of 4.5 months.

Conclusion: The study highlights the need for targeted screening for epidemiological factors in often-overlooked high-risk population and emphasizes the importance of future research to optimize treatment strategies.