Cutaneous leishmaniasis (CL) can present with various skin lesions ranging from a single ulcer to diffuse multiple nodules. Here, we present a case of a 67-year-old man with a large erythematous well-defined indurated plaque over the left face for a duration of 4 months. A slit skin smear was performed, and it was stained with Giemsa stain which showed multiple amastigotes confirming the diagnosis of CL. Oral miltefosine was started at a dose of 150 mg/day but had to be stopped after 20 days as the patient developed diarrhea, bipedal edema, and renal impairment. This case emphasizes an uncommon variant of CL and the role of systemic treatment with oral miltefosine and its associated adverse effects.

Introduction: Sexually transmitted infections (STIs) have a profound impact on sexual and reproductive health worldwide and especially in a developing country like Nepal. However, adequate studies are lacking in our context with regards to the pattern analysis of the STIs in community and in the tertiary care hospitals. The aim of this study is to understand the prevalence and pattern of different STIs in Nepal. Methods: This is a retrospective observational study in which the record of all patients who attended the STD OPD of NAMS, Bir Hospital from 2071 to 2075 B.S. (April 2014 – March 2019) have been analyzed. Results: Among the 2658 patients who visited the STD OPD, majority (27.5%) had been diagnosed with syphilis. The second commonest diagnosis was condyloma acuminata accounting for 22.6 % of cases. Urethral discharge syndrome and vaginal discharge syndrome comprised of 20.1% and 17% respectively. Genital herpes constituted 6% of cases whereas genital molluscum contagiosum comprised of 3.4% of cases. Genital ulcer diseases accounted for 2.1% of total cases. Conclusions: There was a high magnitude of STIs found in this study, among which syphilis constituted the major burden. The results of this study also urge further awareness programs regarding the clinical features and importance of early treatment of STIs.

Introduction: Cutaneous blisters can occur in variety of conditions. They are broadly classified as immunobullous or non-immunobullous. Immunobullous blistering diseases can further classify as intraepidermal or subepidermal. Non-immunobullous blistering disease are commonly due to infections, drugs among others. Some of the blistering disease carry significant mortality and morbidity. There are only limited data on blistering diseases from Nepal, so this study will provide details on the prevalence of this rare dermatological disease from one of the tertiary care referral hospital in the country. Objective: To assess the clinical pattern and prevalence of various blistering diseases in a tertiary care referral hospital. Materials and Methods: All of the data were obtained from the admission register maintained at department of dermatology and venereology, National Academy of Medical Sciences. All the patients admitted with blistering disease from year April 2008 till March 2018 were included. The details including age, sex, type of blistering disease and length of hospital stay were recorded.  Results: A total of 710 patients were admitted in the dermatology ward over the period of 10 years.  There were a total of 193 blistering disease admitted during this period. Autoimmune blistering disease was diagnosed in 59 patients whereas 100 patients had non-immunobullous disease. The age grouped range from 4- 93 years with the mean age of 43± 19.71 years. The average number of hospital stay of all blistering diseases was 11.73±11.36 days. Conclusion: Blistering diseases are one of the most common conditions requiring admission in dermatology ward. Some of these diseases carry a significant morbidity and mortality. So, prompt diagnosis and treatment is of utmost importance.