Skin Prick Test Positivity in Chronic Urticaria.

BACKGROUND: Skin prick tests identify allergens for chronic urticaria. The objective of this study was to determine skin prick test positivity in patients with chronic urticaria visiting skin outpatient department in one of the tertiary referral centre of Nepal. METHODS: This was a hospital based cross-sectional study conducted at Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital. All patients of chronic urticaria aged more than 16 years were taken into study and were prick tested with seven groups of 21 allergens, taking normal saline as negative control and histamine as positive control as per the standard protocol by the Global Allergy and Asthma European Network. Frequency of positivity to each allergen was assessed. RESULTS: Out of 62 patients of chronic urticaria enrolled in the study, 52% were females and 48% were males. Overall, 71% were positive for at least one allergen. The most common allergens which tested positive included Dermatophagoides farinae (50%), Cotton dust (17.7%), Mosquito (16%), hay dust (14.5%), Cladosporium herbarum (14.5%), Candida albicans (12.9%), Parthenium hysterophorus (9.6%), House fly (9.6%), Soya bean (9.6%) and fish sardine (8%). Out of all these patients, 55% patients showed positivity to more than one allergens. CONCLUSIONS: A significant proportion of cases with chronic urticaria demonstrated sensitivity to various allergens. Skin prick test can be considered as important diagnostic procedure in cases of chronic urticaria in our population.

Fine needle aspiration cytology as a preliminary diagnostic tool in chondroid syringoma: a case report and review.

We report a case of chondroid syringoma (CS) in a 44-year-old male. He presented with a firm asymptomatic nodule in his left upper lip of 2-year duration. The initial clue to the diagnosis was made on fine needle aspiration cytology (FNAC), and a final diagnosis was based on histopathological examination. The case highlights the importance of FNAC in providing clues to the diagnosis of suspected cases of chondroid syringoma before performing large excisions and repair, which would require more skill and time. We have also reviewed the cytological findings of all the cases of benign CS reported until the current date.

Tuberculosis and HIV co-infection; the deadly duos in vulva.

Human Immunodeficiency Virus induced immune suppression leads the way for various infections with tuberculosis being the most common. Tuberculosis of the vulva is an extremely rare entity and is seen in only 1-2% of genital TB with increased risk in HIV co-infection. The co-infection places an immense burden on health care systems and poses particular diagnostic & therapeutic challenges with high mortality and morbidity. We present, here, a rare case of a 47 years postmenopausal female, who presented with itchy ulcerating lesions in the vulva with diagnostic dilemma turned to be vulval tuberculosis and during investigations, was found to be co-infected with HIV. The early diagnosis of TB and HIV in atypical looking lesions of vulva with high index of suspicion could lead to improved outcome.