Browsing by Author "Rijal, Arpana"
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Publication Comparison of Efficacy of Localized Narrow-Band UVB Therapy Versus Localized PUVA Therapy in Chronic Hand Eczema(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Khadka, Dhan Keshar; Agrawal, Sudha; Rijal, Arpana; Shrestha, SamirAbstract: Introduction: Hand eczema is a type of dermatitis largely confined to the hands. Narrowband UVB (NBUVB) appears to be as effective as topical PUVA therapy in the treatment of chronic hand dermatitis. However, the risks of phototoxicity and dyspigmentation associated with local PUVA therapy make NBUVB therapy a preferable initial therapeutic option. Methods and Methodology: A total of 40 patients with chronic hand eczema were randomly divided into two groups: Group A (20) receiving localized NBUVB and Group B (20) receiving localized PUVA therapy. They were administered the designated treatment modality for the period of 8 weeks. They were evaluated every 2 weeks to see for the clinical response and any side effects. Results: In group A, there was around 47% and 85% improvement in Clinical Assessment Score (CAS) at weeks 4 and 8 respectively. Similarly, in group B, there was around 52% and 86% improvement in CAS at weeks 4 and 8 respectively. The improvement in terms of the mean of CAS in cases of group B was more compared to group A. (p=0.636 at week 4 and 0.578 at week 8). Conclusion: Light-based modalities of treatment in the form of localized NBUVB and PUVA can be considered as an alternative treatment of choice in cases of hand eczema as they have been shown effective by the reduction in the clinical assessment score. However, there was no statistically significant difference in the reduction in the mean clinical assessment score among the patients treated with either localized NBUVB or PUVA.Publication Cutaneous Manifestations of Thyroid Hormone Disorder(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Sijapati, Karuna Singh; Rijal, Arpana; Agrawal, Sudha; Khadka, Dhan Keshar; Maskey, RobinAbstract: Introduction: Thyroid hormone disorder (THD), a major health problem, is associated with a wide range of diseases. One of the organs, which shows this wide range of clinical signs is the skin. Some dermatological findings may be the first symptoms of THD. Therefore, this study was planned to determine various cutaneous manifestations of THD that can be used as a diagnostic marker for THD. In Nepal due to lack of awareness, thyroid diseases may go unnoticed .So, cutaneous manifestations help in early diagnosis and treatment of THD. Objectives: To identify cutaneous manifestations of THD and to evaluate dermatological manifestations specific for THD. Materials and methods: Seventy six patients with diagnosis of THD attending endocrine clinic of Internal Medicine Department in BPKIHS, Dharan were consecutively assessed for cutaneous changes by detailed history and clinical examination. As a control group, 26 age and sex matched individuals without THD were included to assess frequency of cutaneous manifestation in normal individuals. Results: Fifty five (72.3%) cases and 4(15.4%) control had skin changes. This observation was statistically significant with OR-14.4(95% CI4.43 – 46.78) and p<0.001.Hair changes (OR-2.100, 95% CI 0.647-6.821 and p=0.210) and nail changes (OR-1.818, 95% CI 0.371-8.902 and p=0.726) had no statistically significant association with THD. Conclusion: THD may present as or be associated with many changes in skin, hair and nails. Keywords: Cutaneous changes, Hypothyroidism, HyperthyroidismPublication Paraneoplastic Pemphigus: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2018) Shah, Nidhi; Paudel, Rosina; Rijal, ArpanaAbstract: Paraneoplastic pemphigus (PNP) is a rare autoimmune bullous disease associated with underlying neoplasms. Targetoid lesions, intractable stomatitis and refractory course of disease are some of the characteristic features of paraneoplastic pemphigus. It is usually associated with lymphoproliferative disorders, and rarely with solid tumors. We present a case of a 35 years old female with a six-months history of recurrent, severe, recalcitrant stomatitis and widespread blistering and erosions with involvement of palms and soles. A provisional diagnosis of PNP was made based on clinical features. Investigations for an underlying neoplasm revealed presence of solid lesion of size 6.7 x 6.4 cm in left adnexa, likely an ovarian tumor. PNP should be considered in the differential diagnoses in severe atypical mucocutaneous manifestations of pemphigus vulgaris and diagnostic screening for search for an underlying tumor should be performed. Keywords: Acantholysis, autoantibodies, erythema multiforme, paraneoplastic pemphigus