Browsing by Author "Bhari, Jyoti"
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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 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 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.