Introduction: Warts are one of the commonest causes for the dermatology outpatient department visits. These are caused by the Human Papilloma Viruses (HPV). Sometime warts can cause significant embarrassment and consequently impair the quality of life. Materials and Methods: All consenting patients with non-genital warts presenting to the clinic from September 2020 to February 2021 were enrolled in this observational study. Clinical evaluation for non-genital warts, sites involved and patient demographics was recorded. All participants were asked to complete the Nepali Dermatology Life Quality Index (DLQI) questionnaire. Results: Out of total 80 patients, 55 (68.8%) were males. The mean age of the study population was 23.86±7.42 years, mean duration was 21.98±26.69 months and the mean DLQI score was 8.0±5.15. The embarrassment or self- consciousness was the most prominent psychological aspect in the patients with the warts, followed closely by the difficulty in carrying out daily household activities. All items measured in DLQI were more impaired in women than in men. Clothing habits and sexual functions were affected based on the site of involvement with the warts. Shorter duration of disease had higher negative impact in the quality of life. Conclusion: Patients with warts had moderate impact in their quality of life. Females seem to be affected more due to their warts. Shorter duration of disease had higher negative impact in cases of warts.

Introduction: Coronavirus disease 19 (COVID-19), which started in China, affected many countries in a short time and spread globally. The Nepal government implemented a strict lockdown to stop the spread of this viral infection. Objectives: Analyzing the impact of COVID-19-induced lockdowns in the pattern of dermatological diseases in comparison to the non-COVID period of 2019. Materials and methods: A retrospective cross-sectional study was done by reviewing the data from dermatology out-patients records for four months of each lockdown and four months of the non-COVID period. Results: There was a 49% and 7% reduction in visits of dermatology outpatients during the first and second lockdown, respectively compared to the pre-COVID period. The number of non-infectious diseases was more compared to infectious diseases. Bacterial infection decreased by 1%. Herpes zoster and scabies increased by 0.5-1% during lockdowns. Cases of eczema and urticaria increased by 2% and 3-5.5% during the first and second lockdowns, respectively. Papular urticaria and sexually transmitted infections decreased by 1% during the second lockdown. Consultations for melasma increased by 1.5%. Conclusion: There was a reduction in patient visits during both lockdowns. However, a marked reduction was seen during the first lockdown compared to the pre-COVID period. Pruritic conditions like eczemas, urticarias, and scabies increased, whereas papular urticaria decreased. Pigmentary disorders decreased, but visits for melasma increased. All bacterial infections decreased, whereas herpes zoster increased among viral infections. Chronic diseases like psoriasis and acne vulgaris decreased slightly. The number of sexually transmitted infections (STIs) also decreased. There was no difference in the proportion of infectious and non-infectious diseases compared to the pre-COVID and the lockdown periods.

Introduction: The presentation of metastatic lesion of malignant melanoma (MM) may be unusual, as this case, in which the lesions were multicystic swelling over right arm and necrotized swelling at right chest wall. Identifying the unusual variants of MM is important to allow application of the most appropriate treatment strategies before something wrong happens. Methods: This case report has been prepared following the SCARE guideline 2018, a surgical case report guidelines. Presentation of the case: A 60-year-old man presented with a 14-month history of swelling on right arm and anterior chest wall with the chief complain of blackish discharge from the latter. Six months ago, he amputated his right thumb for melanoma after a histopathology evaluation. It was an unusual presentation of a metastatic lesion of MM. On the basis of the histopathology report, the final diagnosis of our patient was subcuticular metastatic MM which has a very poor prognosis. According to TNM classification, the final diagnosis of the case was T4bN0M1a. Although he has been under regular follow-up, the lesions are still present and his health condition is deteriorating. Discussion: Metastatic melanomas are often rare; their misdiagnosis potentially jeopardizes patients’ health and survival, and have medico-legal implications. Melanoma often has a protracted disease course, in which patients have a disease-free period following surgical excision of the primary tumor, only to discover visceral metastases—months, years, or even decades later. Melanoma metastasis is an ominous sign as it generally predicts a poor prognosis. This case is an unusual presentation of metastatic melanoma where, with the elaboration of history and proper examination of lesion, the diagnosis of metastatic melanoma was made. Conclusion: Metastatic MM has a very poor prognosis and an early diagnosis with clinical presentation is very essential in a country where health facilities are not well developed. Knowing the unusual variants of MM is important to allow application of the most appropriate treatment strategies before something wrong happens.

DermatoFibroSarcoma Protuberans (DFSP) is a rare recurrent fibrohistiocytic tumor. Given the limitation of available diagnostic modalities in a resource poor setting, diagnosis can be confusing. As most of the tumors recur with time, our case of complete cure was interesting phenomenon observed in our case.

INTRODUCTION:  Psoriasis is a chronic inflammatory condition of skin which can be associated with other ailments including dyslipidemia which is an abnormal serum lipid profile. OBJECTIVE: The aim of present study was to determine correlation between dyslipidemia and Psoriasis of patients visiting the Out-patient Department of Patan Hospital METHODS: Ninety patients were selected for study. Among them 30 patients with psoriasis were taken as cases and 60 patients that matched for age and sex with Psoriasis patients were taken as controls. The lipid profile that comprised four parameters: serum High-density Lipoprotein, Low-density Lipoprotein, Total Cholesterol and Triglyceride were determined and compared for both case and control groups. RESULTS: More than 95% of the psoriatic patients had dyslipidemia. The odds of dyslipidemia among Psoriatic patients were 1.709 times higher compared to control group (p <0.001). Among the parameters, results showed High-density lipoprotein was significantly lower while Triglyceride was significantly higher among the cases compared to controls with p value of 0.012 and 0.001 respectively. The risk factors like smoking and alcohol were present in higher proportions among the patients with dyslipidemia but it failed to reach statistical significance. With increase in duration of Psoriasis and PASI scores, lipid parameters i.e., Total cholesterol, triglyceride and Low-density lipoprotein increased while High density lipoprotein decreased but this correlation was insignificant. CONCLUSION: This study showed Dyslipidemia is significantly higher among patients with Psoriasis especially lipid profile parameters Triglyceride and total cholesterol. Thus, timely screening and management of dyslipidemia among Psoriatic patients might be helpful in prevention of future cardiovascular events.