Browsing by Author "Kumar, Ajay"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
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 Comorbidities in Psoriasis, Cross-Sectional Study in Western Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Basnet, Binamra; Kumar, Ajay; Khadka, ShreyashaAbstract: Introduction: Psoriasis is an immune mediated chronic inflammatory disorder with a worldwide prevalence of 0.5 to 11%. Prevalence of psoriasis in Nepal is around 3%. Psoriasis has many associated systemic diseases and conditions such as diabetes, hypertension, metabolic syndrome, hypothyroidism, of which the commonly associated condition is Metabolic syndrome. The objective of this study is to find the degree of association between psoriasis and other diseases such as hypothyroidism metabolic syndrome etc. Materials and Methods: For this study, total number of fifty-two patients with equal number of age and sex matched controls were recruited with a total duration of study being six months. This is an observational cross sectional prospective study. For the qualitative data, Chi-square test was used and for quantitative data analysis Student’s t test was used. Results: Out of the eight parameters [BMI, smoking, alcohol use, hypothyroidism, hypertension, fasting blood sugar(FBS),fasting triglyceride(TG), fasting high density lipoprotein] considering the p value of <0.05 to be significant, FBS & fasting TG were found to be significant. When the means of FBS and fasting TG were compared between the cases and controls, there was notable relationship between the difference of means and the standard errors of means (p value=0.01 for FBS and p value=0.017 for fasting TG) as calculated by Student’s t Test. Conclusion: In this study, there was a statistical significance between the fasting blood sugar(FBS) levels of the cases and controls (p value=0.01) and also between the fasting triglyceride levels of cases and controls (p value=0.017).Publication Dermatological Practice in Nepal during COVID-19 Crisis: Recommendations of National Panel of Experts(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Parajuli, Sudip; Pokhrel, Dinesh Binod; Agrawal, Sudha; Kumar, Ajay; Pokhrel, Kumar; Bastola, Anup; Bhattarai, Sabeena; Shrestha, Shristi; Shrestha, Manisha; KC, Shekhar; Joshi, Smita; Das, Anil Kumar; Shah, Mahesh; Joshi, Shambhu Dutta; Paudel, Sushil; Hirachan, Shashi; Paudel, Upama; Neupane, SaraswotiAbstract: Introduction: Novel Coronavirus disease has caused a substantial halt to the ongoing world in every aspect. There are medical and social implications of the disease. Cutaneous manifestations have been reported to be a part of the disease as well. Dermatologists globally are in dilemma with the clinical practice because of the fear of acquiring the disease. Objectives: This article aims to recommend best practice measures that can be followed in local scenario for re-opening up of dermatological services in the context of Nepal. Materials and Methods: A preliminary draft for guidance on Dermatological services based on recommendations of American Academy of Dermatology, International league of Dermatological societies, National recommendations from Ministry of Health, Nepal was sent to a panel of national experts to determine the level of consensus in first week of April, 2020. A preliminary survey was sent to all the members of Society of Dermatologists, Venereologists, and leprologists of Nepal on first week of June and a second draft was subsequently formed which was sent again to experts and revised based on the opinions of national experts. Results: A total of 19 experts participated in the preparation of draft and reached a national consensus after a series of revisions in preliminary draft. Conclusion: Agreements regarding the opening of practice in dermatology discipline have been summarized. Recommendations have been made for opening of dermatological services – opening of outpatient department, performing dermatosurgical and cosmetic procedures as well as strategies on triage of patients and use of masks. Keywords: Coronavirus, Dermatology, Disease, NepalPublication 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.Publication Non-Veneral Genital Dermatoses: A Study from Western Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Kumar, Ajay; Pun, Jenny; Neupane, Deepika; Subedi, Saujan; Mohammad, Asim; Sathian, BrijeshAbstract: Introduction: The etiology of dermatoses involving genital areas could be venereal or on-venereal. These disorders are responsible for mental distress and guilt which can be minimized by appropriate diagnosis and information to the patients. Objectives: To assess the clinical pattern and prevalence of various non venereal genital dermatoses in a referral center. Materials and Methods: This was a hospital-based descriptive study involving patients with non-venereal diseases visiting outpatient clinics of Department of Dermatology. After informed consent, all the parameters were recorded in a proforma and analyzed. Results: Total of 70 patients with non-venereal genital dermatoses were included. Mean age of the patients was 33 years. Majority were male, married and had history of irregular use of contraceptives. Duration of symptoms ranged from one to 36 months with mean of four months. Total 19 types of non-venereal skin diseases were noted with major complaint of itching in genitalia in 22 (31.4%). Primary site of involvement/complaint was vulva in 19 (27.1%), scrotum in 17 (24.3%), groin in 18 (25.7%) and penile area in 14 (20.0%). The most common final dermatological diagnosis in majority was fungal infections and neurodermatitis in 12.9% each. Extramarital relationship was reported by 37 out of 70 patients (52.9%), while 31 patients correlated their symptoms with sexual exposure. Conclusions: Itching was the most common presenting complaint with infective etiology. The current study highlighted the relevance of addressing non-venereal genital dermatoses in order to avoid the general misconception that all genital lesions are sexually transmitted. Keywords: Neurodermatitis, Sexually Transmitted Diseases, Dermatitis, Allergic ContactPublication Study of Cutaneous Manifestations in End Stage Kidney Disease Undergoing Hemodialysis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Maskey, Abhishek; Kumar, Ajay; Shrestha, RoshanAbstract: Introduction: The prevalence of cutaneous manifestations in hemodialysis patients is increasing. Objectives: The aim of this study was to determine the prevalence and pattern of various cutaneous manifestations in patients undergoing maintenance hemodialysis. Material and Methods: A hospital based cross sectional study was conducted in patient undergoing maintenance hemodialysis at least for three months in dialysis unit of Manipal Teaching Hospital Pokhara, Nepal during the period from August 2018 to January 2019. A demographic questionnaire and a checklist about cutaneous disorders were used for data collection. Patients with cholestatic liver disease or acute hepatitis, active infection, active malignancy, patient with acute kidney injury, patient undergoing peritoneal dialysis and renal transplant recipient were excluded from study. Results: Total 80 patients undergoing maintenance hemodialysis were included. Among them, 52 (65%) patients were male. The mean age of study population was 51.95±14.96 years. The mean duration of dialysis was 40.28±11.09 months. The most common cause of end stage kidney disease was diabetic nephropathy. The most common cutaneous manifestations were pigmentation (82.5%), nail changes (75%), xerosis (70%) and pruritis (50%). Conclusions: The results of this study revealed that patients on hemodialysis were associated with multiple cutaneous symptoms, the most prevalent of which were pigmentation and nail disorders. Therefore, early diagnosis of these problems is a major step in improving the quality of life in these patients. Keywords: Diabetic Nephropathies, Kidney Failure, Chronic, Pruritus, Renal Dialysis