Browsing by Author "Khadka, Anupa"
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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 Clinical Profile and Treatment Outcome of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Hospital of Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Khadka, Anupa; Mishra, Punam; Chapagain, Laxman; Gartaula, Manisha; Gupta, Pooja; Shrestha, Dwarika PrasadAbstract: Introduction: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe forms of severe cutaneous adverse reactions (SCAR) with high morbidity and mortality. Due to its rarity and severe acute nature, there is limited data from controlled trials. This study seeks to contribute to the existing knowledge on the etiology and treatment outcomes of SJS/TEN. Objectives: To assess the clinical profile and treatment outcomes of SJS and TEN patients. Materials and Methods: A retrospective analysis of patients’ admissions and discharge records was done from April 2020 to November 2024. The variables analyzed included the clinical types (SJS, TEN, SJS/TEN overlap), causative drugs, treatment undertaken, mean duration of hospital stay, and treatment outcome. Results: Among 27 patients, SJS accounted for 81.48% (n=22), TEN 14.8% (n=4), and SJS/TEN overlapped 3.70% (n=1) of the cases. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most commonly implicated culprit drugs, followed by amoxicillin. The mean time of appearance of the lesion after the medication was 29.14±22.93 days. All the patients received steroids-hydrocortisone 81.48% (n=22); hydrocortisone and dexamethasone 7.40% (n=2) and methylprednisolone 7.40% (n=2) with supportive management. The mean duration of hospital stay was 12.03±10.52 days, and the recovery rate without complication was 88.89% (n=24). Conclusion: SJS is the most common clinical type in the SJS-TEN spectrum. NSAIDs and antibiotics were the common causes of SJS/TEN. Corticosteroids proved beneficial in managing SJS/TEN in our patients.Publication Effect of Low dose Isotretinoin on Lipid Profile and Liver enzymes in Acne Patients: A Cross Sectional Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Jha, Ayush; Shrestha, Rima; Khadka, Anupa; Wagle, AshmitaAbstract: Introduction: Oral isotretinoin remains the most clinically effective anti-acne therapy. However, a myriad of adverse effects are associated with isotretinoin use. Elevated liver enzymes and an altered lipid profile are well documented side effects of prolonged oral isotretinoin usage. Objectives: To assess the alteration in liver enzymes and lipid profiles of acne patients on isotretinoin therapy. Materials and Methods: The current prospective hospital based study, was carried out from September 2022 to December 2023, and included 150 patients with acne vulgaris on isotretinoin therapy. All consenting patients were then subjected to a detailed history and clinical examination. Subsequently, baseline Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Triglyceride (TG), Low density Lipoprotein (LDL), and High density Lipoprotein levels (HDL) levels were measured. Patients were then started on oral isotretinoin therapy at conventional dosages. Levels of ALT, AST, TG, LDL and HDL were repeated at 3- month and 6- month follow-up visits. A self-designed proforma was used to collect all relevant data. The collected data was analyzed as per standard statistical protocol. Repeated measures analysis of variance was used to compare means between 3 groups (baseline, 3-month, and 6-month values). Results with a p<.05 were considered statistically significant. Results: The mean age of patients was 22.31(±SD 4.44) years. Females comprised the majority of our study subjects (n = 95; 63.33%). Levels of Alanine (F2,226=30.73, p<.0005) and Aspartate transaminase (F2,232=13.13, p<.0005) were increased significantly at 3 and 6 month follow up visits. Levels of TG were, also, increased significantly at follow up visits (F2,239=14.45, p<.0005). Similarly, levels of low density lipoprotein increased significantly when compared to baseline levels (F1,215=38.43, p<.0005). High density lipoprotein levels were decreased significantly when compared to baseline levels (F1,209=105.83, p<.0005). Conclusion: Our study has highlighted the significant alterations that occur in liver function tests and lipid profiles in patients on isotretinoin therapy.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.Publication Pseudoxanthoma Elasticum a Rare Genetic Disorder : A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Pandit, Shashwata Raj; Khadka, Anupa; Jha, Ayush; Shrestha, Rima; Shrestha, Ravina BadeAbstract: Pseudoxanthoma elasticum (PXE) is a rare hereditary condition marked by the accumulation of fragmented and calcified elastic fibers in the body's tissues, leading to skin, vascular, and ocular involvement. In clinical practice, the most prevalent and typically earliest indication of PXE is observed through skin manifestations, which include laxity and the presence of yellowish papules and plaques. Here we report a case of a 40-year-old woman from Nepal presenting with yellowish multiple papules and plaque around the neck and axilla for 20 years, slowly increasing in size and number. A skin biopsy revealed fragmented eosinophilic elastic fibers in the dermis, consistent with PXE. Echocardiography, slit lamp, and indirect ophthalmoscopic examination were done.