Browsing by Author "Aryal, Eliz"
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Publication Benign Migratory Glossitis in Toddlers: Report of Two Cases and Review(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Khadka, Anupa; Aryal, ElizAbstract: Benign migratory glossitis is an often asymptomatic, characteristically migratory, recurrent, inflammatory condition involving, mostly dorsum of tongue or any other part, with a typical “map like appearance”. It is a condition frequently encountered in adults, with a controversial etiology. Despite being benign and self-resolving, owing to its relative uncommon occurrence in children, it can be a matter of significant concern for parents. Here we report 2 cases of asymptomatic geographic tongue in children below two years of age. Keywords: Child, Preschool, Glossitis, Benign Migratory, TonguePublication Dengue Fever among Patients Visiting the Outpatient Department of Dermatology in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Aryal, Eliz; Bista, Raunak; Shrestha, Prashanna Raj; Regmi, GarimaAbstract Introduction: Dengue is in an increasing trend in our part of the world mostly due to global warming, It can present with various manifestations including cutaneous manifestations. The main objective of our study was to find out the prevalence of dengue fever among patients visiting the Outpatient Department of Dermatology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department of Dermatology in a tertiary care centre after taking ethical approval from the Institutional Review Committee (Reference number: 09092022\04). Data from 1 June 2022 to 8 September 2022 were collected between 1 December 2022 to 20 February 2023 from the hospital records. The laboratory data of individuals were analyzed to find out the prevalence of dengue fever. A Visual Analogue Scale was used to assess the severity of pruritus. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 7442 patients, dengue fever was found to be in 202 (2.71%) (2.34-3.08, 95% Confidence Interval) patients. The mean duration of fever was 3.02±2.960 days. The mean duration of onset of rash after having a fever was 2.56±2.032 days. The most common cutaneous manifestation was maculopapular rash 70 (34.65%). Conclusions: The prevalence of dengue fever was found to be lower than in the studies done in similar settings.Publication Extracutaneous Manifestation of Ulcerative Colitis: Pyoderma Gangrenosum, A Case Report Authors(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Sapkota, Rohan; Aryal, Eliz; Shrestha, Prashanna Raj; Bhari, Jyoti; Shrestha, SunnyAbstract: Pyoderma gangrenosum (PG) is a rare, ulcerative skin condition often associated with systemic diseases such as inflammatory bowel disease (IBD), including ulcerative colitis (UC). This case report describes a 79-year-old male patient with a history of ulcerative colitis who presented with increased passages of blood-mixed stools and a solitary ulcer on the left lower shin following minor trauma. The ulcer, measuring 10 cm by 4 cm, exhibited a violaceous border with purulent necrotic tissue. Histopathological examination revealed neutrophilic exudate, dense inflammatory cell infiltrate, perivascular neutrophilic infiltration, extravasated red blood cells, congested blood vessels, and hemosiderin-laden macrophages. The clinical presentation, along with the biopsy findings, confirmed the diagnosis of PG associated with UC. The patient was managed with systemic corticosteroids and antineutrophilic therapy, emphasizing the importance of early diagnosis and treatment to prevent disease progression. This case underscores the need for vigilance in identifying PG in patients with IBD, as prompt intervention can significantly improve outcomes.Publication Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Bhusal, Mohan; Aryal, Eliz; Bhattarai, Sabina; Shrestha, Sanju Babu; Rajouria, AlarkAbstract: Corticosteroids are over the counter and cheaper drugs available in every medical stores in Nepal. Iatrogenic Cushing syndrome due to topical steroids application is a very rare phenomenon in adults.A 32 year female from Janakpur presented with complaints of swelling of face, weight gain, excessive facial hair and fatigue since two years that gradually increased over last one year. She had a past medical history of on and off application of multiple potent topical corticosteroids for disseminated Tinea infection. She was obese with moon facies, buffalo hump and multiple striae over her abdomen. Her blood pressure was raised and her blood sugar was in pre-diabetic range. Laboratory studies were consistent with iatrogenic Cushing syndrome. Patient recovered after discontinuation of topical corticosteroids and treatment with antifungals.Although iatrogenic Cushing syndrome following application of topical corticosteroid is a rare phenomenon in adults, this can happen in a setup like ours where corticosteroids are prescribed as over the counters and patients have very little knowledge about their use. Therefore, we emphasize that patients and pharmacist should be well educated about the consequences of their prolong application and their side effects. Keywords: Adrenocorticotropic hormone, Clobetasol, Pituitary-adrenal systemPublication Immunotherapy with Intralesional Vit D injection in Recalcitrant wart at a Tertiary Care Center: A Descriptive Cross sectional Study(Nepal Medical Association, 2024) Aryal, Eliz; Bhari, Jyoti; Shrestha, Prashanna RajAbstract Introduction: Recalcirant warts are resistant to conventional therapeutic option with high recurrence rate. In recent year, treatment of warts with different immunotherapeutic agent has shown good results, as it regulate epidermal cell proliferation and are involved in the formation of anti microbial peptides. Hence, this study was undertaken to evaluate the efficacy of immunotherapy with intralesional vitamin D in wart. Methods: A descriptive cross-sectional study was conducted from 1 January 2021 to 2 February 2023 at Kathmandu Medical College after approval from the Institutional Review Committee (Reference number: 0110202002). Ninety - two patients with recalcitrant wart of varying sizes and duration were included in the study. Injection vitamin D ( 600000 IU, 15mg/ ml) was injected about (0.2-0.5 ml) to the base of the wart. Maximum of five warts were injected per month, and was repeated after 4 weeks for 3 sessions. Results: Among 92 patient, complete response was seen in 70 patient (76.08%), partial response was seen in 17 patients ( 18.47%) and 5 patient(5.43%)showed no response. Mild pain as observed at the time of injection. Signs of hypervitaminosis D was not observed. Conclusions: Intralesional administration of Vitamin D is an effective treatment option for reclacitrant warts and is, highly effective, cost-efficient, with minimal adverse effects, and can be perfomed in our clinical set upPublication Lansoprazole – Induce Black Hairy Tongue- A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Aryal, Eliz; Rajbhandari, M; Bhattarai, SabinaAbstract: Lansoprazole induced black hairy tongue has been rarely reported. The purpose of this paper is to report a case of lansoprazole induce black hairy tongue and review the literature. A 75 year man from eastern part of Kathmandu presented with black hairy fine growth from tongue along with discomfort, burning and halitosis from oral cavity after taking lansoprazole for acute peptic disease(APD) from over the counter and after discontinuation of lansoprazole, black hairy tongue was resolving. Clinically and histopathologically: lansoprazole induced black hairy tongue was confirmed. Black hairy tongue is characterized by abnormal hypertrophy and elongation of filliform papillae. Lansoprazole is a proton-pump inhibitor (PPI) with a racemic 1:1 mixture of the enantiomers dexlansoprazole which inhibits the stomach’s production of gastric acids. Keywords: lansoprazole, induce black hairy tonguePublication Low Dose Oxybutin in Primary Hyperhydrosis: A Prospective Study from a Tertiary Care Center in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Aryal, Eliz; Shrestha, Prashanna Raj; Gautam, SujanAbstract: Introduction: Hyperhydrosis is a clinical condition where there is excessive sweating beyond the physiological need of the patient’s body. This can directly or indirectly affect the quality of patients life. Oxybutin is widely used in urology as anticholinergic medication for bladder urge incontinence. It can be used safely at a high doses (over 15 mg/day) to treat urological disorder. It also acts against excessive sweating and can be used in cases of hyperhidrosis. Objectives: To evaluate effectiveness of oxybutin at low dose and to assess the Hyperhidrosis Disease Severity Scale (HDSS) . Materials and Methods: This is a hospital based cross-sectional study in primary hyperhydrosis. Oxybutin was prescribed to all patients of primary hyperhydrosis with gradual increment of dosage of 2.5 mg orally once a day to 5 mg twice a day. Patients were evaluated at zero wk (baseline), 4 wk, 8 wk, 12 wk and follow-up in 16 wks with Hyperhidrosis Disease Severity Scale (HDSS) along with adverse effects were noted. Results: There was a significant difference in HDSS at zero wk (baseline) and 4th wk (p=0.001) at a dose of 2.5 mg once a day of oxybutynin. Also, a significant difference was noted (p=0.022) in HDSS between zero wk (baseline) and 12 wk. Similarly, a significant difference between HDSS at zero wk (baseline) versus the 16th wk was also noted. Conclusion: Oxybutin is an anticholinergic drug with an emerging role in hyperhydrosis. Low doses have shown significant results with minimal side effects. The dose requirement varies among authors. Studies with long-term follow-ups with ideal protocol need to be established in the future.Publication Psychological Impact of Acne Vulgaris in Basic Science Medical Students in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2018) Aryal, Eliz; Shrestha, Sanju; Shrestha, Prashanna; Pokhrel, Govind; Bhattaria, Sabina SabinaKeywords: Acne vulgaris, health education, sebaceous gland, students, medical, surveys and questionnaires Abstract Introduction: Acne vulgaris is a disorder of the sebaceous gland affecting mostly the adolescent age. Although acne does not cause direct physical impairment, it can produce significant psychosocial stress. Due to the paucity of data, there is a poor understanding of etiopathogenesis, treatment and psycho-social impact of acne in the Nepalese population. This study is the first of its kind in Nepal. Objectives: To determine the beliefs, knowledge, misconceptions, myth, psycho-social impact about acne in recently joined undergraduate medical students attending basic science. Materials and Methods: A cross- sectional study was conducted in two medical colleges in Kathmandu affiliated to Kathmandu University (KU), which followed the same curriculum. Medical students of basic science were enrolled in the study. Self-administered questionnaire was used to collect the data regarding their belief and perception about acne. Results: A total of 247 students constituted the study population and female to male ratio was 1:1.62. Stress, oily skin, poor hygiene were the most common causative factors for acne. Belief and perception of acne included bad blood, menstrual cycle, eve teasing, evil eye. According to them, the best way to treat acne was herbal remedies. They liked to explain acne as being related to puberty, followed by dirty face. Psychological impact of acne was embarrassment followed by lack of confidence and impaired social contact. Suicidal tendency due to acne was found in 3.6%. Conclusion: Misconception about acne are widespread and enduring among basic science medical students. Health education program on acne is needed to improve their condition.Publication Vitamin D and Skin: An Review and Update Authors(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Aryal, Eliz; Bhari, JyotiAbstract: Vitamin D was recognized for its pivotal role in bone formation, but it is now recognized for its impact on the optimal functioning of various tissues throughout the body, including the brain, heart, muscles, immune system, and skin. Vitamin D is a fat-soluble prohormone steroid with endocrine, paracrine, and autocrine functions. Vitamin D receptors and the enzymes that can convert 25-hydroxyvitamin D [25(OH)D] into the active form, 1,25-hydroxyvitamin D [1,25(OH)D], have been identified in numerous cells throughout the body, including the skin. Vitamin D analogs are widely acknowledged for effective treatment of psoriasis vulgaris due to their anti-proliferative and pro-differentiating impact on keratinocytes. Beyond this, emerging roles for vitamin D in skin health include immunomodulatory and anti-apoptotic effects, suggesting potential applications in conditions like atopic dermatitis and infections including verucca vulgaris. Epidemiological studies have linked low vitamin D levels to autoimmune diseases like vitiligo, leading to the use of topical vitamin D in its treatment. Recent evidence also suggests that cutaneous vitamin D synthesis may contribute to preventing skin malignancies, and oral supplementation may reduce cancer mortality. Its role in the pathogenesis of various dermatological diseases has not been an exception and has been extensively studied in recent years. In this review, we will shed light on roles of vitamin D in various skin disorders.Publication Zinc Therapy in Dermatology: A Review and Update(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Aryal, Eliz; Bhattarai, Elisa; Bhattarai, SabinaAbstract: Zinc is a micronutrient used over the years for many dermatological conditions such as infections, inflammatory dermatoses, pigmentary disorders, neoplasias etc. It is used in both elemental as well as salt form, either in topical or in oral form as a therapy. An average adult weighing 70 kg has a body zinc content of 1.4–2.3 gm. The role of zinc in deficiency disorder like acrodermatitis enteropathica is already established and used widely as treatment. Zinc has been identified as effective in the treatment of various disorders but it cannot be used as the replacement for proven first line treatment. Zinc can be used as adjuvant therapy in many dermatological disorders. This is a narrative review where various use of zinc as therapy in dermatological disorders is highlighted. Keywords: Acrodermatitis enteropathica, Micronutrients, Zinc