Introduction: Cutaneous Leishmaniasis is a vector borne disease caused by the bite of an infected sandfly. The disease is rare in Nepal with only few cases reported till date. We report the largest collection of patients over six years.Objective: To describe the clinical, epidemiological and pathological aspect of Cutaneous Leishmaniasis in Midwestern region of Nepal Materials and Methods: Thirty-three patients referred to the department of Pathology for fine needle aspiration were diagnosed as Cutaneous leishmaniasis based on detection of Leishmania donovani in the fine needle aspiration smears. Demographic data and clinical details including site, size, and duration of disease onset were recorded on a printed proforma. Statistical analysis was done using SPSS version 16.0 for windows. Results:A total of 33 patients with age ranging from 11 years to 65 years were included in the study. Mean age was 26.5±11.5 years. Most patients were in the age group 21-40 years. Male: Female ratio was 1.7:1. Mean duration of disease was 5.3±4.4 months. Thirty patients had single lesion. Lesions were either of plaque type (84.9 %) or papulonodular type (15.1%). Conclusion:Cutaneous leishmaniasis is uncommon in Nepal. So, it is often neglected. It is in an increasing trend. Cutaneous leishmaniasis should be included in the differential diagnosis of a non-healing ulcer.
Background: Urticaria is a short-lived swelling of skin and mucosa due to plasma leakage by immune and non immune mediated activation and released of mediators from mast cell and basophil. Autoimmune urticaria tends to have a high itch and wheal score than other type of urticaria. Its diagnosis is practically relied upon clinical suspicion and autologous serum skin test. Autologous serum skin test (ASST) is the simple and cost effective test to differentiate autoimmune urticaria from the bulk of chronic urticaria patients. Objective: To compare the features of chronic urticaria in patients having positive versus negative autologous serum skin test (ASST).Materials and methods: Cross-sectional hospital based study was conducted among 90 chronic urticaria patients (CIU) attending the outpatient dermatology department of Nepalgunj Medical College, Nepalgunj, during one year period. The study was conducted after ethical approval from the institutional committee. The patients were diagnosed on the basis of the appearance of continuous or recurrent hives with or without angioedema for more than 6 weeks. Patients who suffered from either acute urticaria or urticarial vasculitis or physical urticaria or other systemic diseases known to cause urticaria were excluded. Standard tools and techniques were used to prepare antilogous serum and injection of the serum and interpretation of the result. The test result was Interpreted as positive and negative autologous serum skin test.Results: ASST was positive in 42% of the patients and negative in 58% of the patients. The ASST-positive patients had a higher mean urticaria activity score and median duration of wheals in comparison with the ASST-negative patients. Wheals lasted for significantly longer duration in patients with positive ASST. Patients with positive ASST had more frequent attacks which was statistically significant compared to the ASST-negative group. The mean urticaria activity score was significantly higher in the ASST-positive patients than that in the ASST-negative patients.Conclusions: Autologous serum skin test may be a useful screening test for autoimmune urticaria and may be used as a simple and cost-effective test for the classification of chronic urticaria.JNGMC Vol. 12 No. 2 December 2014, page: 6-10
Background: Skin diseases are the major cause of out-patient visit in Nepal. Department of Health Services, Nepal ranks skin diseases as fourth common cause of out-patient visit throughout the country. The objective of the study was to determine the pattern of different skin diseases in Himalayan region of Nepal.Material and methods: A cross sectional descriptive study design was conducted in a health camp setting in which 148 community people visited the camp with dermatological diseases. Information about socio-demographic and dermatological diseases were collected with a structured performa.Results: The most common primary diagnosis was pigmentary anomaly (20.3%) followed by Eczemas (18.9%), Superficial mycoses (10.8%), and acne (10.1%). In all skin diseases male were more affected as compared to female.Conclusions: The dermatoses of Himalayan region are pigmentary anomalies being most common, followed by eczemas, superficial mycoses, acne, photodermatoses, scabies, urticaria, benign tumours and pyodermas.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.25-28
A case of 23 year old man with histoid leprosy who had ENL is being reported because of its late presentation.The patient had presented with history of skin colored shiny nodules on ankle, extensor part of lower limbs, forearm and pinna for 1 year. There was history of intermittent fever and joint pains of same duration. Slit skin smear from the lesion was positive for AFB. Histopathology of lesions was consistent with histoid leprosy. Patient was successfully treated with multidrug therapy.
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