Erythema nodosum leprosum (ENL) is a type III hypersensitivity phenomenon seen in the lepromatous spectrum of leprosy. Involvement of external genitalia is very rare, and genital mucosal involvement is still rare. We report a 39-year-old man with episodic fever, red raised skin lesions predominantly in the lower extremities, and painful genital ulcers for 1-month duration. Genital examination revealed two irregularly shaped, mildly indurated, punched-out tender ulcers with yellowish slough on an erythematous base. Bilateral ulnar and common peroneal nerves were moderately thickened, more on the left side with bilateral stocking type of anesthesia associated with the left side fixed ulnar claw hand and left foot drop. By appropriate investigations and therapeutic elimination, the patient was diagnosed as borderline lepromatous Hansen's disease with type 2 reaction and grade 2 deformity. This case is reported for the rare occurrence of ENL lesions involving the genital mucosa in the form of ulceration.

Background: Sexually transmitted infections (STI) prevalence in pregnancy is high and causes severe risk of transmission to the newborn. Usually they are asymptomatic and underdiagnosed. Most common STI's are VVC, HPV, genital herpes, HIV, etc. Methods: A hospital-based cross-sectional study was done for a period of one year (September 2017-August 2018) and 31 pregnant genital dermatoses were encountered. Results: Among 31, infective etiology was seen in 15 cases (48%), non-infective etiology was seen in 3 cases (10%) and no STI's were seen in 13 patients (42%). Vulvovaginal candidiasis was most common among pregnant females in 9 patients (60%) followed by genital warts in 3 patients (20%) followed by molluscum contagiosum, herpes genitalis and oral candidiasis in one patient (7%) respectively among infective etiology. Non-infective causes include vulval lymphangiectasia, epidermoid cyst and vascular swelling in one patient respectively (33.3%). Conclusions: Screening of antenatal cases is more important to prevent complications.