Phaeohyphomycosis is a rare mycotic infection caused by various heterogenous groups of phaeoid (dematiaceous) fungi involving the skin and subcutaneous tissue. Common clinical manifestations are subcutaneous abscesses or cystic swellings. Here, we report a case of subcutaneous phaeohyphomycosis presenting as multiple asymptomatic cystic swellings over the hands and feet without any predisposing factors. Histopathology showed granulomatous inflammation and special stain with Grocott's methanamine silver stain revealed broad pigmented hyphae. Culture showed black-colored colonies identified as Exophiala jeanselmi. The patient was treated with surgical excision of the lesions.

Background: Currently, sexually transmitted infections (STIs) form a huge public health issue in the global scenario. STIs are commonly more active than other prevailing infections in the community amongst the sexually active population and the epidemiological profile is very distinct and more dynamic than other diseases. Aims & Objectives: To understand the changing scenario of STIs and also the non-STIs among patients attending the STI clinic at the tertiary care centre. Materials and Methods: This is a tertiary care based retrospective study of all the patients attending the STI clinic at the department of Dermatology, Venereology and leprology (DVL), Gandhi Hospital, Secunderabad, for 3 years (from January 2011 to December 2013). STIs were categorized into different syndromes as per the syndromic management of STIs, as depicted by National AIDS Control Organization (NACO). Results: A total of 7,859 patients, with complaints of genital lesions, attending the STI clinic, were included in this study. Our study, from 2011 to 2013, showed a declining trend in bacterial STIs and increasing trend of fungal and viral STIs as seen in developing nations. The most common STI in males was candidial balanoposthitis, and females is vaginal/cervical discharge (candidial) followed by viral infections like genital herpes and condyloma acuminata. Conclusion: A comprehensive study of the epidemiological data is very important in order to decrease the incidence and prevalence of STIs and HIV. In order to decrease the incidence and prevalence of STIs and HIV, we need to further impart health education, counselling and improve the standards of health care facilities.

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Immune reconstitution inflammatory syndrome (IRIS) occurs as an acute symptomatic expression of a latent infection during the recovery of immune system in response to antiretroviral therapy in HIV patients. IRIS triggers both opportunistic and non-opportunistic infections. We report a case of IRIS in a patient with HIV, presenting as erythema nodosum leprosum (ENL), which led to unmasking of lepromatous leprosy following anti-retroviral therapy (ART).

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