Browsing by Author "Paudel, V"
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Publication Cutaneous Leishmaniasis in Natives of Central Region of Nepal(Kathmandu University, 2019) Paudel, U; Parajuli, S; Poudel, AS; Paudel, V; Pokhrel, DBABSTRACT We report two cases of cutaneous leishmaniasis in natives of central region of Nepal. The first patient in our series, an adult female, presented with a small nodule on the philtrum of upper lip and the second case, a male child, presented with two crusted plaques on forehead. The final diagnosis was based on histopathological findings; however, species characterization was not possible because of its unavailability in the country. These patients responded well to the treatment with Miltefosine (First case) and Fluconazole (second case). Moreover, these cases sparks a question about the origin of diseases in this region and calls for further research in future to find out the cause and prevalence of this disease in Nepal. This case report also emphasizes to consider cutaneous leishmaniasis as differential diagnosis for granulomatous presentations in our context. KEY WORDS Cutaneous leishmaniasis, Fluconazole, MiltefosinePublication Publication Epithelioid sarcoma: A rare cause of non-healing ulcer(Institute of Medicine, 2017) Paudel, V; Das, AKAbstract Epithelioid sarcoma, first described by Enzinger in 1970, is a rare slow-growing soft tissue malignancy, associated with a high incidence of regional recurrence and distant metastases. It is characterized by a proliferation of epithelium-like cells and the absence of a granuloma-like pattern with positivity for vimentin, cytokeratin. The recommended treatment is a wide resection with adequate margins, lymph node dissection. We report a 37-year-old male with chronic,non healing ulcer in lower leg of seven years duration who was treated conservatively leading to recurrence of the lesion with metastasis up to left inguinal region resulting lymphedema of the penis. Keywords: Epithelioidsarcoma, Soft tissue sarcoma, Vimentin, CytokeratinPublication Isolated Leprosy of Bilateral Ear Lobes, A Rare Presentation of Leprosy(Kathmandu University, 2021) Paudel, V; Chudal, DABSTRACT Hansen disease is a chronic infectious disease caused by Mycobacterium leprae. It can present with a variety of clinical manifestations depending on the immune status. Ear lobes are commonly involved in leprosy. However, isolated earlobe involvement of both ear lobes is rare. We present a case of a 25-year-old man who presented with isolated swelling of both pinna, which on slit skin smear turned to be multi-bacillary leprosy. The bilateral pinna swelling started as asymptomatic, multiple skin colored shiny papules which progressively became lobular over a period of a year. Isolated involvement of the pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment. KEY WORDS Hansen’s disease, Leprosy, Mycobacterium leprae