Photo quiz: A 43-year-old man presented with a painful rash on the chest and back. The rash started five days earlier on the left side of the chest and then spread to the left side of the back. The pain was burning in nature. He had no history of a similar rash. He had no exposure to chemicals or physical agents. He had diabetes mellitus, hypertension, and dyslipidemia.
On physical examination, the patient was afebrile. Clusters of vesicles with some pustules and crusting (Figures 1 and 2) were noted on the back and chest. The rest of the body was not affected.
Visual loss is a common presenting complaint in primary care. We present a case of recurrent transient visual loss in a middle aged woman. Her funduscopy showed bilateral optic disc swelling. We have highlighted the differentiation of bilateral optic disc swelling at the primary care level as the management differs according to the diagnosis.
Management of sexually transmitted diseases and human immunodeficiency virus is challenging due to the social stigma attached. We describe the development of a client-friendly sexually transmitted disease service in a primary care clinic in Malaysia with a special focus on key populations. Challenges and key lessons learnt from its development and implementation are discussed.