Browsing by Author "Adhikari, Bishnu Prasad"
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Publication Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Neupane, Bidhan; Jwarchan, Jayanti; Adhikari, Bishnu Prasad; Kumar, Ajay; Sapkota, Surendra; Paudel, Subash; Oli, AshmitaAbstract: Acquired epidermodysplasia verruciformis (EV) is a rare dermatologic disorder linked to increased susceptibility to specific HPV infections in immunosuppressed states. We report a 43-year-old renal transplant recipient on prolonged immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and corticosteroids who developed multiple asymptomatic wart-like papules and plaques on extremities, hypopigmented pityriasis versicolor-like macules on the trunk, and seborrheic keratosis-like lesions on the face. Histopathology confirmed EV, showing acanthosis, hyperkeratosis, and keratinocytes with pale blue cytoplasm, perinuclear halos, and mild nuclear dysplastic changes. Due to malignancy risk in sun-exposed areas, strict sun protection and follow-up were advised. With acitretin and imiquimod unavailable, lesions were managed with intralesional measles, mumps, rubella (MMR) vaccine, and topical keratolytic, resulting in partial regression. This case highlights the need for early recognition, vigilant monitoring, and tailored management of EV in immunosuppressed patients, emphasizing further research to refine therapeutic strategies in resource-limited settings.Publication Lues Maligna in Immunocompetent Individuals: Two Case Reports(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Adhikari, Bishnu Prasad; Basnet, Binamra; Neupane, Bidhan; Kumar, Ajay; Sapkota, Surendra; Joshi, Mandeep Dutta; Subedi, KamalaAbstract: Lues maligna, also termed malignant syphilis or rupioid syphilis, is a rare and severe form of secondary syphilis. Clinically, the condition is characterized by unusual nodules and necrotic and ulcerated skin lesions covered by thick, lamellated crusts associated with severe constitutional symptoms. Most of the lues maligna cases have been observed in immunocompromised individuals, including Human Immunodeficiency Virus (HIV) co-infected patients, alcoholics, malnourished individuals, and patients with debilitating illnesses. However, immunocompetent individuals can also develop this form of illness. Herein, we present 2 cases of lues maligna in immunocompetent patients. The first case is a 38-year-old immunocompetent married female, while the second case is a 34-old married male, both presenting with multiple diffuse noduloulcerative lesions with rupioid crusts. Serological tests for syphilis were positive in both patients and a biopsy of both patients showed forms consistent with secondary syphilis.