Browsing by Author "Gurung, Tsering Dolma"
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Publication Clinico-Histopathological Consistency in Dermatological Disorders in a Tertiary Care Hospital of Kathmandu(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Shrestha, Akankshya; Gurung, Tsering Dolma; Joshi, Deepak Raj; Shrestha, Dwarika PrasadAbstract Introduction: A skin biopsy for histopathological examination is one of the most reliable investigations for confirming clinical diagnosis. When there is alignment of clinical and histopathological diagnosis, it demonstrates clinico-histopathological consistency. There is limited reported data on clinico-histopathological concordance in the context of Nepal. Objectives: To determine the consistency of clinical and histopathological diagnosis of dermatological disorders. Materials and Methods: A retrospective study was conducted on 551 patients who underwent skin biopsy at the Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital, for a period of 1 year. Both inpatients and outpatients who had undergone a skin biopsy were included in the study. Demographic data, clinical and histopathological diagnoses were noted on a proforma sheet. Histopathological diagnoses, both definitive and descriptive, were deemed consistent when they aligned with the clinical diagnoses. Conversely, if either definitive or descriptive histopathological diagnoses were not concordant with the clinical diagnoses, they were categorized as inconsistent. Results: The mean age of patients was 41.42 (±18.42) years. The male to female ratio was 1:1.5. Out of 551 cases who underwent skin biopsy, clinico-histopathological consistency was found in 64.43% of cases (355), whereas clinico-histopathological inconsistency was present in 35.57% (196). The maximum concordance was present in eczematous disorders (58.06%), followed by immunobullous disorders (47.22%), and vasculitis (45.45%). Conclusion: The overall clinico-histopathological consistency was 64.43%. Both experienced dermatologists and pathologists need to assist each other in providing a better understanding of the diagnostic process. This study emphasizes need for this cooperation and will aid in evaluating clinico-histopathological consistency.Publication Management of Telogen Effluvium: A Survey among Dermatologists and Dermatology Residents of Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Sharma, Ashu; Khadka, Anupa; Gurung, Tsering Dolma; Shrestha, Dwarika PrasadAbstract: Introduction: Telogen effluvium (TE) is a common form of non-cicatricial alopecia, marked by excessive shedding of hairs in the telogen phase. Despite its prevalence, there is no consensus on the best approach to diagnosing, investigating, and managing TE, leading to varying practices among dermatologists. This study aims to understand current practices in Nepal regarding the diagnosis and treatment of TE. Objectives: To explore the management modalities of TE among the dermatologists and dermatology residents of Nepal Materials and Methods: An online, questionnaire-based survey was conducted among Nepalese dermatologists and dermatology residents. The questionnaire consisted of twelve multiple-choice questions related to TE. The responses were recorded and analyzed. Results: A total of 150 responses were recorded, with 53.33% attending 5-10 hair loss patients weekly. Most (94%) diagnosed TE based on history and clinical examination, and 82% commonly ordered thyroid function tests. Iron and vitamin deficiency was identified as the leading cause by 78%, and 53.33% felt no treatment was necessary. Counseling (92.66%) and iron/vitamin supplements (88%) were the most frequent management strategies. TE was reported to have a "moderate" impact on Quality of Life (QoL) by 69.33%, and 50.67% of participants reported a “good level” of satisfaction among patients with the outcomes of their treatments. Conclusions: Telogen Effluvium is one of the most common causes of hair fall, with a moderate impact on the quality of life. Most dermatologists agree on many aspects of TE management. A consensus management guideline of TE would be handy.