Browsing by Author "Mishra, Punam"
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Publication 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 Skin Manifestations in Dengue Patients of a Tertiary Hospital during Dengue Epidemic in Kathmandu: A Retrospective Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Sitaula, Seema; Shrestha, Suraj; Mishra, Punam; Subba, Mamata; Poddar, ElishaAbstract: Introduction: With a wide range of clinical manifestations and a drastic shift in epidemiology, dengue infection is a life-threatening condition. Studies of skin manifestations in dengue fever are scarce, and hence, it is prudent to explore the skin manifestations of dengue in Nepal for prompt diagnosis and to reduce associated complications. Methods: We conducted a single-center retrospective cross-sectional study from August 1, 2022, to December 1, 2022. Information on demographics, clinical characteristics of rash, and laboratory investigations were gathered in a pre-formed proforma from patients’ charts, which were organized and analyzed using the statistical software SPSS 21. Continuous data were presented as mean, and standard deviation and categorical data were presented as frequency and percentage. Results: There were 98 dengue cases with a mean age of 39.47 years. Among 43 patients, maculopapular (72.1%), erythematous macules (23.3%), purpuric (20.9%), both macules and maculopapular (11.6%) and ecchymotic (4.6%) rashes with no mucosal involvement were found. There was no statistically significant association between platelet count and rashes. Conclusion: Patients with dengue had varied cutaneous features. Maculopapular and erythematic rashes were the most commonly observed dermatological manifestations.