A 26-year-old female presented with multiple papules on the upper and lower left eyelid with occasional itch. The first lesion appeared as a single pin-sized papule on the left eyelid six months prior to consult, which multiplied and spread quickly within one month to the upper and lower left eyelids. Patient admitted to being in the habit of rubbing the eye. The pre-existing papules increased in number in the past month and became confluent with a diameter of 1 cm (). The patient was diagnosed with HIV in 2016 and consumed ARV routinely. CD4+ value was 46 cells/μL. Tzanck smear from the skin lesion revealed Henderson–Paterson bodies (). Other physical examination was within normal limits. The patient was diagnosed with giant MC on the eyelid and stage 2 HIV. The patient was treated with 20% KOH solution applied once daily at night. The application methods were as follows: the surrounding healthy skin was covered with vaseline album, the upper and lower eyelids covered with wet gauze to prevent the solution from dripping or irritating the eye. Then, the 20% KOH solution was spread evenly using a cotton tip on the skin lesions. Follow up visit three weeks later revealed slight erythema and edema on the right eyelids and smaller lesion (). All the lesions were cleared completely four weeks after therapy (). Side effects reported by the patient include stinging and burning sensation immediately after application, but these symptoms improved after one to five minutes without any additional treatment. The patient was satisfied with the final result.
A 24-year-old female presented with erythematous papules without itch and pain around the vulva. The lesions first appeared 3 weeks prior to consultation (PTC) as one erythematous papule on the vulva, then spread to the pubic area. She admitted having promiscuity, and mostly her partners did not use condoms. Physical examination on the pubic and vulva showed erythematous papules with umbilication at the central part (). Venereal disease research laboratory (VDRL), Treponema pallidum hemagglutination (TPHA), and human immunodeficiency virus (HIV) tests were nonreactive. The patient was treated with 20% KOH solution applied by the patient once daily before bedtime for 25 days. The patient felt a stinging sensation a short time after the first 5 minutes of the application. The MC lesions gradually subsided from day 17 after treatment, disappeared on day 25, and became post-inflammatory hyperpigmentation on day 51 of observation.