A 50-year-old man, a known case of human immunodeficiency virus infection for the past 1 year, was on antiretroviral therapy in the form of stavudine, lamivudine, and nevirapine. Three days after replacing stavudine with tenofovir, he developed redness on the face and neck and within 48 h the rash became generalized. Dermatological examination revealed involvement of photoexposed areas of the face in the form of erythema and ill-defined hyperpigmented plaques, with mild periorbital edema. There was specific involvement of V and nape of the neck. Extensive erythema and scaling were also present on buttocks, thighs, and upper third of legs. A diagnosis of photoallergic dermatitis to tenofovir was considered and confirmed by histopathology and photopatch test. He responded well to the stoppage of the drug and oral corticosteroids. This is the first report of a photoallergic reaction to tenofovir in the literature.
Introduction: Teledermatology provides virtual consultation to patients using telecommunication technology. Using this method dermatologists can diagnose a condition with the help of pictures of the lesions and short history. During the COVID-19 pandemic, practicing this method has become more relevant. Providing teleconsultations to patients with fungal skin infections can prevent inadvertent use of topical corticosteroids. The objective of this study was to find the prevalence of fungal infections among teledermatology consultations done in a tertiary care hospital.
Methods: It was a descriptive cross-sectional study where the store and forward and real-time methods were used between February 2020 to July 2020. Ethical clearance was taken from the institutional review board (reference number: 245). Data of those patients who wanted consultations from this department were sent by medical officers deployed in military hospitals that are under the central army hospital located in Kathmandu. Convenient sampling was used. The collected data was entered and analyzed in the Statistical Package of Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data.
Results: A total of 451 (33.45%) (30.93-35.97 at 95% Confidence Interval) were diagnosed with fungal infections out of 1348 patients who were enrolled for the study. About 361 (80%) of the patients suffering from fungal infections belonged to the Terai region and 90 (20%) belonged to mountainous areas.
Conclusions: The prevalence of fungal infection among teledermatology consultation was lower than the findings from a similar international study.
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