Abstract Background: The study aimed to determine the prevalence and genotype of high-risk human papillomavirus (HPV) among women in Punjab region and to assess the association between single/multiple HPV infections and cervical intraepithelial neoplasia (CIN). Materials and Methods: The study involved retrospective analysis of electronic health records for individuals, for which cervical samples were tested for HPV DNA using a real-time polymerase chain reaction assay (Seegene assay) between January 2023 and July 2025. The study included females participating in out-campus screening camps and those attending the department of preventive oncology for routine screening and consenting to undergo HPV testing. Results: Overall HPV prevalence in the study population was 13.8% (544/3919). The most common genotypes were HPV-16 (35.7%), HPV-18 (14%), and HPV-66 (11%). Single genotype infections were most frequent (66.5%). The peak prevalence occurred in women of age group 36–40 years. Multiple HPV infections were significantly associated with higher CIN 2/3 lesions (χ 2 = 4.6; P = 0.032; odds ratio [OR] = 2.8). HPV-16 women had higher, though nonsignificant odds of developing high-grade CIN (OR = 1.96; P = 0.09). HPV-66-positive women had lower odds of developing high-grade CIN, though statistically nonsignificant (OR = 0.47; P = 0.33). Conclusions: There is substantial HPV burden in local population with HPV-16 and HPV-18 as the dominant genotypes. The unexpected high frequency of HPV-66 genotype warrants further molecular and epidemiological investigations. The study findings reinforce the need for implementing systematic large-scale HPV vaccination and HPV screening and molecular testing programs in India to achieve the World Health Organization’s cervical cancer elimination goals.
Abstract Background: Consistent condom use is a key preventive measure against sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection. However, condom use remains inconsistent among individuals attending STI clinics. Objective: To assess perceived barriers to condom use across six theoretical domains and identify independent predictors of condom non-use among our STI clinic attendees. Materials and Methods: A cross-sectional study was conducted among 200 adults at our STI clinic in South India. Perceived barriers to condom use were measured using a 26-item questionnaire covering six domains. Condom non-use during the last five sexual encounters was the primary outcome. Internal consistency was assessed using Cronbach’s α. Mann–Whitney U -test analyzed the differences between condom users and non-users. Multivariable logistic regression identified predictors of condom non-use after adjusting for sociodemographic variables. Results: Condom non-use was reported by 140 participants (70.0%; 95% confidence interval: 63.5–76.0). The stigma associated with condom purchase showed the highest barrier scores. The questionnaire showed acceptable internal consistency (Cronbach’s α = 0.79). Condom non-users had higher misconception-related barrier scores ( P = 0.025). In the multivariable analysis, male sex (adjusted odds ratio [aOR]: 0.17; P = 0.008) and unmarried status (aOR: 0.25; P = 0.001) were associated with lower odds of condom non-use. The model exhibited a good discrimination (area under the curve = 0.78). Conclusion: Condom non-use remains prevalent among STI clinic attendees. Sociodemographic and relationship factors outweigh perceived barriers in influencing condom use, highlighting the need for targeted STI prevention interventions.
Abstract According to the Ministry of Health and Family Welfare, India accounts for 23% of all tuberculosis (TB) cases worldwide, and 2.4 million people living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLHA). From a study conducted in the dermatology outpatient of a tertiary care hospital in northern India, there were 0.7% cases of cutaneous TB, with a human immunodeficiency virus concurrence of 9.1% which is high. It can be attributed that PLHA have low CD4 count, leading to them being prone to reactivation of latent or fresh TB infection and rapid clinical deterioration. We report a case of unusual cutaneous TB in a PLHA with multiple sexually transmitted infections in the light of TB-immune reconstitution syndrome.
Abstract Plasma cell vulvitis is a chronic benign inflammatory disorder of the female genital mucosa which is refractory to therapeutic modalities. An accurate diagnosis and timely intervention is necessary as it may mimic other genital dermatoses. Clinically, it is characterized by a well-circumscribed, shiny, erythematous patch or plaque involving the genital mucosa. Histopathological assessment is indispensable for diagnosis. Typical microscopic features include lozenge-shaped keratinocytes, the presence of siderophages, foci of hemorrhage, and a variable plasma cell infiltrate within the dermis. Therapeutic response to topical agents alone is often unsatisfactory; however, laser-based and surgical modalities have demonstrated efficacy in achieving sustained remission.
Abstract Hair loss in HIV-positive patients can result from various causes, including syphilitic alopecia (SA), a rare manifestation of secondary syphilis. We describe the case of a 31-year-old male on antiretroviral therapy who presented with moth-eaten alopecia – multiple irregular, nonscarring scalp patches – along with signs of secondary syphilis. Trichoscopy revealed focal atrichia, yellow dots, vellus, and broken hairs. Serological tests confirmed syphilis ( Treponema pallidum hemagglutination assay 1:1280; Venereal Disease Research Laboratory 1:4), and neurosyphilis was excluded through lumbar puncture. The patient improved clinically and biologically after intramuscular benzathine penicillin G. Trichoscopy played a key role in differentiating SA from other nonscarring causes of hair loss.
Abstract Condyloma acuminata is an anogenital human papillomavirus infection, commonly types 6 and 11. In children, vertical or nonsexual transmission is possible, and sexual abuse should not be negated. We report a 10-month-old girl with a 3-month history of linear cauliflower-like perineal growth in the perineal region. Due to linear morphology and infancy onset, verrucous epidermal nevus was initially suspected. However, maternal history of genital warts and paternal palmar warts suspected condyloma acuminatum. Verrucous growth not showing whitening on acetowhite test added to diagnostic dilemma. Excisional biopsy confirmed condyloma via histopathology showing koilocytes. This case underscores the limitations of bedside tests and importance of definitive diagnostic methods in atypical presentations
Abstract Bowenoid papulosis (BP) is caused by human papillomavirus. [1] It is a sexually transmitted condition characterized by papular lesions on the genitalia. [2] Here, we report a case of BP in a young adult female, highlighting its clinical presentation, sequential dermoscopy, diagnostic workup, and management. Many studies have reported clinical, dermoscopic, and histopathological findings of BP. Our study aims to add follow-up dermoscopic findings in a case of BP to see for signs of regression. This information guides treatment decisions, such as continuing with the current therapy, switching to a different approach, or considering additional interventions.
Abstract A rare co-infection of Haemophilus ducreyi and non-albicans Candida was identified in an immunocompetent 31-year-old woman presenting with painful vulvar ulcers and malodorous curdy discharge. Gram stain showed Gram-negative coccobacilli and budding yeast cells, whereas serology for herpes simplex virus, syphilis, and human immunodeficiency virus was negative. Culture confirmed Candida parapsilosis . The patient responded rapidly to azithromycin and weekly fluconazole. This case highlights the need to consider chancroid as a differential diagnosis in painful genital ulcers and underscores the importance of species-level Candida identification and evaluation for polymicrobial infections in persistent vulvovaginal conditions, given the rarity of such coinfections globally.
Abstract A middle-aged promiscuous male presented with multiple painful ulcers over the genitals for the past 2 weeks. Basic side lab procedures were done. Gram stain showed Gram-negative coccobacilli in a school of fish pattern. Tzanck smear revealed acantholytic cells and multinucleated giant cells. On KOH examination from the subpreputial discharge, there were numerous pseudophyphae and spores. Based on the clinical grounds and the laboratory evidence, mixed sexually transmitted infection was diagnosed. Another case presented with painful ulcers and tiny papules over the perianal region. After all bedside and serological investigations, he was diagnosed with herpes genetalis, condyloma late, condyloma acuminata, and Human Immunodeficiency Virus 1 positive.
Abstract The “knife cut sign” in the intertriginous areas is a distinctive presentation of linear erosive herpes simplex virus (HSV) infection in immunocompromised individuals. We report a case of a 40-year-old apparently immunocompetent female with an unusual linear erosive variant of HSV genitalis, resembling a “knife cut” ulcer, complicated by secondary bacterial infection. This case emphasizes the need to recognize such uncommon presentations for early diagnosis and appropriate treatment, and prevent further complications.
Abstract Objective: Monkeypox is a zoonotic viral infection caused by the monkeypox virus. The 2022 global outbreak marked a shift toward sexual transmission, predominantly affecting men who have sex with men (MSM), with frequent genital and urogenital involvement. This review summarizes evidence on genitourinary features to support accurate diagnosis, guide appropriate treatment, and enhance clinical awareness. Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PROSPERO CRD42024626679), three databases were searched through December 2024 for studies reporting genitourinary symptoms in monkeypox. Data extraction and quality assessment were performed independently using Joanna Briggs Institute tools. Results: A total of 40 studies were included. The risk factors for monkeypox infection were predominantly associated with high-risk sexual behaviours. HIV was frequently reported as a comorbid condition. Cutaneous lesions typically appeared within 2–14 days following high-risk contact. Lesion progression followed the classic stages, beginning as papules and evolving into vesicles, pustules with central umbilication, ulceration or erosion, and eventually crust formation, with resolution within 2–4 weeks. Urogenital symptoms such as penile discharge, dysuria, and urinary retention were also reported. Conclusion: The 2022–2023 monkeypox outbreak showed a shift to sexual transmission, primarily among MSM, with frequent genital involvement and occasional urinary symptoms. Integrated HIV and monkeypox care, early detection, and sexual health education are critical for high-risk populations.
Abstract We report a rare case of vulval tuberculosis (TB) in a young woman who presented with painless vulval swelling with papulonodular lesions. Histopathology showed caseating granulomas with Langhans giant cells, while cartridge-based nucleic acid amplification test confirmed Mycobacterium TB sensitive to rifampicin. Acid-fast staining and culture were negative, consistent with the paucibacillary nature of the disease. The patient responded significantly to antitubercular therapy. Vulval TB, often mimicking sexually transmitted infections or malignancy, remains rare. Early recognition with histological confirmation is crucial for effective management and prevention of disfigurement or dissemination.
Abstract Primary cutaneous genital tuberculosis is a rare manifestation of tuberculosis facilitated by immune compromise due to concomitant human immunodeficiency virus (HIV) infection. We present a case of a 51-year-old male with HIV coinfection who developed noduloulcerative lesions on the penis, scrotum, and inguinal skin. Despite initial negative results from histopathology, serology, and conventional molecular tests, a tissue sample tested positive for Mycobacterium tuberculosis using a cartridge-based nucleic acid amplification test. The patient was initiated on standard antitubercular therapy, resulting in complete resolution of lesions after 6 months. This case highlights the importance of molecular diagnostics in diagnosing primary cutaneous genital tuberculosis, especially in immunocompromised individuals.
Abstract Secondary syphilis is notorious for its diverse cutaneous manifestations, often mimicking a wide range of dermatoses. While classical papulosquamous lesions are well described, uncommon morphological variants are infrequently reported and frequently misdiagnosed. We report five patients with uncommon morphological presentations of secondary syphilis, including imbricate, corymbose, serpiginous, psoriasiform, nodular, and acneiform variants. Clinical findings were correlated with serology and histopathology. Awareness of atypical morphologies of secondary syphilis is crucial to avoid diagnostic delay and prevent disease transmission.
Condyloma acuminata (CA), a human papillomavirus (HPV)-linked sexually transmitted infection, frequently persists or recurs, especially with high-risk (HR) strains. This systematic review and meta-analysis examine how specific HPV subtypes influence CA persistence/recurrence. We searched four databases (Science Direct, PubMed, Cochrane/CENTRAL, and Google Scholar) for relevant observational studies and randomized controlled trials (2005-2025). All meta-analytic statistics were processed using RevMan 5.4.1. Eight studies comprising a total of 1,070 subjects analyzed in this review demonstrated variable findings regarding the association between HPV subtypes and the persistence or recurrence of CA. The distribution of HPV types showed wide variability. The identified low-risk HPV (LR-HPV) subtypes included types 2, 6, 11, 27, 40, 42, 43, 44, 46, and 61, while the HR subtypes were 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 54, 56, 58, 59, 61, 66, 68, 69, and 70. In addition, 413 cases were reported without specific HPV type information from the studies analyzed. The meta-analysis showed a nonsignificant trend where HR HPV was linked to greater recurrence/persistence than LR-HPV (pooled OR 1.45, 95% CI: 0.81-2.61; P = 0.22, I2 =65%). To conclude, HPV subtype is not significantly associated with the recurrence or persistence of CA.
Bowenoid papulosis (BP) is a rare human papillomavirus-induced intra-epithelial neoplasia that typically presents as multiple pigmented or erythematous papules in the anogenital region of sexually active young adults. Despite its low malignant potential (<1% risk of progression to invasive squamous cell carcinoma), prompt recognition and management remain essential to mitigate this risk. Dermoscopy can be a valuable noninvasive diagnostic adjunct, aiding differentiation from mimickers like genital warts and pigmented Bowen’s disease. However, literature on dermoscopic features of BP remains limited to a few case reports. This case highlights the role of dermoscopy in the early identification of BP and also reviews the dermoscopic features documented in the literature, intending to promote the more frequent use of dermoscopy in its clinical diagnosis.
Genital mucosal lesions encompass a diverse spectrum of infectious, inflammatory, and neoplastic conditions and go beyond sexually transmitted infections. Accurate clinical diagnosis can be challenging due to anatomical location, overlapping presentations, and secondary changes. Histopathological examination remains a crucial tool to establish the definitive diagnosis and guide management. To study the clinical patterns of genital mucosal lesions other than STIs and analyse the correlation between clinical diagnosis and histopathological findings. Cross sectional study; Department of Dermatology in a tertiary care teaching hospital. A prospective cross-sectional study was conducted from July 2022 to January 2024 at a tertiary care hospital. A total of 27 patients presenting with genital mucosal lesions were included. Detailed history, clinical examination, and biopsy of the lesions were performed. Clinical and histopathological diagnoses were compared to assess correlation. Among the 27 patients, males were more frequently affected (63%) than females (37%), with the most common age group being 31–40 years (33.3%). The most frequently observed clinical diagnoses included genital lichen planus (LP) (25.9%), LSCA (14.8%), and squamous cell carcinoma (SCC) (14.8%). Clinicopathological concordance was observed in 66.7% of cases. The highest correlation was seen in inflammatory disorders such as LP and lichen sclerosus, while lower correlation was noted in premalignant and malignant lesions including SCC and erythroplasia of Queyrat. A moderate clinicopathological correlation was observed in genital mucosal lesions, particularly among inflammatory dermatoses. Biopsy remains essential in confirming diagnosis and identifying cases with atypical or misleading features.
