Browsing by Author "Lamichhane, Ramesh"
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Publication Delayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report(Nepal Medical Association, 2022) Lamichhane, Ramesh; Chaudhary, SarojAbstract Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer.Publication Terbinafine-induced Toxic Epidermal Necrolysis in Pregnancy: A Case Report(Nepal Medical Association, 2023) Lamichhane, Ramesh; Pandey, Mahendra Raj; Dhungana, Ayushma; Lamsal, AnjanaAbstract Toxic epidermal necrolysis in pregnancy is a rare disease that can have an adverse effect on Toxic epidermal necrolysis in pregnancy is a rare disease that can have an adverse effect on pregnancy outcomes. Common etiology of the condition includes medication triggered followed by mycoplasma infection. Almost one-third of cases are idiopathic. Despite the rarity of data, terbinafine causing toxic epidermal necrolysis has been reported. Toxic epidermal necrolysis manifests as a macule, erythema followed by a blister in the chest and spreading to other parts of the body. Removal of the offending agent and supportive management is the cornerstone of management. Here we report 22-year-old primipara pregnant women presenting with toxic epidermal necrolysis after 3 weeks of oral terbinafine use with good pregnancy outcomes.