Browsing by Author "Pokhrel, Sudarshan"
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Publication Linear Atrophoderma of Moulin: A Case Report(Nepal Medical Association, 2024) Duwal, Anu; Timisina, Sunil; Pokhrel, SudarshanAbstract Linear Atrophoderma of Moulin is a rare skin condition that is characterized by the development of one or more atrophic patches or depressions in the skin. These patches are usually located on the trunk, but they can also occur on the arms, legs, and neck. We here present a case of 33-year Nepalese male with brown to black color lesions over the left upper back, abdomen and thigh for the last 7 years. Clinical and dermatopathological findings were similar to the Linear Atrophoderma of Moulin. To our knowledge, this is the first case of LAM from Nepal. This case emphasizes the necessity of diagnosing Atrophoderma of Moulin and separating it from linear scleroderma due to differences in therapy and prognosis.Publication Mucocutaneous Adverse Effects of Methotrexate Toxicity: A Case Series(Nepal Medical Association, 2025) Subedi, Bibek; Neupane, Saraswoti; Bhandari, Sajana; Timilsina, Sunil; Pokhrel, SudarshanAbstract Methotrexate is a widely used medication in dermatology, rheumatology, and oncology. However, patient misunderstandings or attempts to expedite symptom relief can lead to overuse, resulting in severe toxicity. This case series presents five instances of methotrexate toxicity due to daily dosing and excessive use for underlying disorders. All patients exhibited fever, skin, and mucosal lesions, alongside abnormal hematological parameters. Management involved immediate cessation of methotrexate, administration of leucovorin rescue therapy, and supportive care. Three patients fully recovered with the resolution of lesions and improved hematological profiles, while two succumbed to the illness. These cases underscore the critical need for early recognition of methotrexate toxicity symptoms and comprehensive patient counseling on proper dosing schedules to prevent such adverse outcomes.