Introduction Skin disease is common in developing countries but the spectrum varies widely. Skin biopsy is an important tool in confirming or establishing diagnoses in cases with diagnostic dilemmas. And, there may be a discrepancy between clinical and pathological diagnoses.  Objective To determine the spectrum of histological diagnoses in skin disease and to know the consistency between clinical and pathological diagnoses. Materials and methods A retrospective review of histological and clinical diagnoses was done at a multi-specialty hospital. A total of 85 cases were included in the study. Clinical and histological data along with demographic details, the site of the biopsy was noted. Concordance between clinical and pathological diagnosis was determined as concordant, partially concordant and discordant. Results There were 60% female and 40% male patients out of 85 biopsies. The most common age group was 31-40 years and the mean age was 41.24 years. The most common histological spectrum was infectious group in 29.4%, followed by papulosquamous disorders in 22.4% and eczema in 12.9% cases. The concordance between clinical and pathological diagnosis was 60%, while partial concordance was seen in 16.5% and discordance was seen in 23.5% cases. Conclusion Skin biopsy is an important tool in confirming clinical diagnoses. There is a wide variation of histological diagnoses and concordance with clinical diagnoses may be increased with proper clinical history, physical findings and differential diagnosis.

Background: The spectrum of skin disease is unique in geriatric population and also varied according to geographical areas. It is emerging major health problem in person above 60 years of age, since the overall life expectancy is increasing. There is not much data on skin disease in geriatric population of Nepal. The study aimed to identify the prevalence and clini­cal characteristics of geriatric dermatoses in a multi-specialty hospital set up. Methods: All patient attending dermatology OPD above 60 years of age and fitting the inclusion criteria were taken in to the study. A detailed history, physical exam and relevant laboratory in­vestigation was done to make a diagnosis. The data collected was entered in Excel and descriptive analysis was done by SPSS version 22. Results: The number of elderly patients was 235 out of 3292 (7.13%). Altogether 246 diagnosis was made in 235 patients which had male preponderance of 53.19%. The pre-dominant diagno­sis was skin infection and infestation (38.61%), followed by eczema or dermatitis (18.69%) and papulo-squamous disease (11.78%). Other common conditions seen were urticaria (4.87%), pho­todermatoses (4.87%), senile xerosis (4.87%) and miliaria (3.65%). Conclusions: Cutaneous infections and infestations were the commonest dermatoses followed by eczema/dermatitis. Fungal infection, allergic contact dermatitis, psoriasis were among common dermatoses. No cases of skin malignancy were found. Elderly population in Nepal is increasing and epidemiological data provide government and health care provider to address their problem in effective way.

Porphyria cutaneatarda, is the most common type of porphyria.It is characterized by defective uroporphyrinogen III decarboxylase enzyme.It presents with erosion, bulla with milia formation and sometimes with hypertrichosis and abnormal pigmentation mostly on the photo-exposed sites. A urine fluorescence of coral red color helps in the diagnosis. Here, we present a rare case of porphyria cutanea tarda in a 15 years old male who presented with multiple targetoid plaques.Keywords: Erythema-multiforme; porphyria cutanea tarda; targetoid.

Introduction: Pediatric dermatoses deal with skin disease in children from birth to 18 years. This age group comprises significant physiological changes, and hence the pattern of disease including skin disease is unique to them. Skin diseases are influenced by the local climatic factor and socio-economic status which differ in different geographic areas including within the country. Objective: The objective of the study was to analyze the clinical spectrum of skin disease in children from 1 day to 18 years of age and to find any seasonal influence on the disease pattern. Methodology: The study was conducted retrospectively in a multi- specialty hospital from May 2014 to April 2015. Data of children from 1 day to 18 years of age were analyzed. Demographic details like age, sex, ethnicity was noted. The month and season of the presentation were also recorded. Patient with a confirmed clinical diagnosis and adequate data was included in the study. Patients were divided into 5 age groups; neonate (0 days to 1 month), infant (1 month to 2 years), young child (2-6 years), child (6-12 years), and adolescent (12-18 years). Data were entered in Microsoft excel and analysis was done with SPSS version 22 along with the Chi-square test. Result: There were 20.65% of pediatric patients out of 3292 patients visiting skin OPD. The male to female ratio was 1.63:1. The majority of the cases (47.8%) were in the adolescent age group. Infection and infestation were the predominant diagnosis (56.02%), followed by eczema (15.88%) and urticaria (6.47%). Among infection, fungal infection was seen as the majority (26.17%).Papular urticaria and urticaria were significantly (p-value <0.05) more common in summer, while scabies was more common in the spring season (p-value <0.05). Conclusion: Infection and infestation followed by eczema/dermatitis and urticaria were the three most common groups of dermatoses. There was a seasonal influence on a few common dermatoses like scabies, urticaria and papular urticaria.

Introduction: Many treatments have been attempted in pityriasis versicolor with different reports of success. No direct comparative study between Ketoconazole 400 mg single dose against Ketoconazole 200 mg od for 5 days have been made earlier. The aim of this study was to study and compare the therapeutic efficacy of oral ketoconazole 400 mg single dose with oral ketoconazole 200 mg once daily for 5 days in pityriasis versicolor. Methods: This was a randomized controlled trial. Patients were randomized to receive either ketoconazole 400 mg single dose (group A) or ketoconazole 200 mg daily for 5 days (group B). Altogether 80 patients were taken, 40 in each group. Patients were assessed after 8 weeks and both clinical and mycological evaluation was done. The treatment success (mycological cure) was defined by a negative KOH at 8 weeks post treatment. Chi-square test was used to identify the significance of the variables. Results: The mycological cure at 8 weeks was 46% in group A and 74% in group B and the result was significant. No significant adverse event was noted in any of the groups. Conclusions: There was significant difference in the treatment outcome in both the groups. Ketoconazole 200 mg daily for 5 days had superior efficacy than ketoconazole 400 mg single dose. There was no significant difference in the adverse events.   Key words: Ketoconazole, Pityriasis versicolor