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.
A 28-year-old male presented with multiple skin-colored papules with umbilication on the face, especially forehead and temple area, without itch and pain (). The lesions first appeared as skin-colored papules on the forehead for the past one-month PTC. Two weeks later, the number of papules increasing and spread to the temple area. There was a history of promiscuity with female prostitutes. He had no concern of his sexual partners who also have the same lesions. Physical examination on the forehead and the temple area showed many papules with skin-colored and central umbilication. The HIV test was reactive, otherwise VDRL and TPHA tests were nonreactive. The patient was treated with 20% KOH solution applied by the patient twice daily. He complained stinging and burning sensation after 20% KOH applied for 3 minutes. The patient died due to brain toxoplasmosis on day 7 observations, but almost all the lesions became smaller.