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 26-year-old male presented with multiple skin-colored umbilicated papules on the penis, without itch and pain (). The lesions first appeared as one skin-colored papule on the penis shaft for the past 1 month PTC. Over time, 3 weeks after, the skin lesions were spread over the base of the penis and increase in number. There was a history of promiscuity with several female prostitutes. Physical examination on the shaft and the base of the penis revealed several papules with central umbilication. VDRL, TPHA, and HIV tests were nonreactive. The patient was treated with 20% KOH solution applied by the patient twice daily for the lesions. All of the MC lesions disappeared on day 20 of observation. The patient felt a stinging sensation after 3–5 minutes application of the 20% KOH solution. Furthermore, it also caused other side effects such as erosions and post-inflammatory hypopigmentation.