Journal Issue: Volume: 19 No. 2 (2021)
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Volume
Number
Issue Date
2021
Journal Title
Journal ISSN
ISSN 2091-0231 eISSN 2091-167X
Journal Volume
Articles
COVID-19 and Dermatologist: A Scenario from Nepal
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Thapa, Deeptara Pathak; Paudel, Vikash
Abstract:
Corona virus disease-2019 (COVID-19) had impacted the healthcare sector severely. The impact of pandemic had a foothold even on dermatology practice and dermatology residency teaching programs. Patients with dermatological diseases, few diseases arising due to COVID-19 and patients with immunosuppressive for chronic dermatological conditions were affected. In the midst of this pandemic, all dermatologist should learn and contribute to the mankind with precaution at all level either in healthcare or society.
Melatonin - A Cutaneous Perspective
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Dhali, Tapan; Sharma, Mona; Hemrajani, Priyanka
Abstract:
Melatonin (MLT) is an endogenous hormone secreted from the pineal gland, located deep in the brain in the epithalamus associated with numerous biological activities. The primary function of melatonin is to regulate sleep-wake cycles. However, research over the last few years has enlightened a range of functions associated with this molecule, including anti-inflammatory, direct and indirect antioxidant activity, regenerative tissue benefits, and preservation of mitochondrial function. Melatonin’s anti-inflammatory and antioxidant support, coupled with its mitochondrial modulation, makes it a vital molecule to use for skin health homeostasis. The cutaneous melatoninergic system’s widespread expression and pleiotropic activity provides for a high level of cell-specific selectivity. Several skin cells, including normal and malignant keratinocytes, melanocytes, fibroblasts and hair follicles, express melatonin receptors. Melatonin also has receptor-independent effects that protect against oxidative stress and can reduce ultraviolet radiation-induced damage. Several functions of melatonin in the skin have been experimentally implicated such as hair growth cycling, fur pigmentation, melanoma control, suppression of ultraviolet-induced damage to the skin cell. Melatonin may play a role in treating several dermatoses e.g., atopic eczema, psoriasis, melasma, ulcer healing, and malignant melanoma. There is a plethora of functional melatonin properties, which still await to be fully appreciated by dermatologists. The current review emphasizes few of the established uses and few emerging potentialities that render melatonin a promising candidate for managing several diseases.
Efficacy of Intense Pulse Light with Triple Combination Cream Versus Triple Combination Cream alone in the Treatment of Melasma
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Verma, Anshul; Agrawal, Sudha
Abstract
Introduction: Various studies explored the use of intense pulse light (IPL) therapy in treating melasma, but only a few randomized clinical trials have evaluated the combination of triple combination cream (TCC) with IPL so far.
Objective: This study compared the efficacy and safety of the combination of IPL and triple combination cream with triple combination cream alone in treating melasma.
Material and Methods: Sixty patients with melasma were enrolled in this assessor-blinded, parallel-group randomized controlled study. Thirty patients were treated with IPL (15J/cm2, two sessions at 2-week intervals) and TCC (Hydroquinone 2%, tretinoin 0.025%, fluocinolone acetonide 0.01%) at night and broad-spectrum sunscreen during day time whereas other groups received only TCC and broad-spectrum sunscreen. The median percentage reduction in melasma area and severity index (MASI) and physician’s global assessment scale was assessed at 12-week to determine the efficacy of the treatment. The incidence of adverse effects at each follow-up and relapse at 16-week were also noted during the study period as the secondary outcome measure.
Results: The median reduction in MASI achieved at 12 weeks was 48% in the IPL+TCC group and 13.1% in the TCC group from the baseline. The incidence of relapse was seen in 7.14% and 13.04% patients in the IPL+TCC group and TCC alone group respectively at 16 weeks however, this difference was not statistically significant (p<0.05).
Conclusion: Our study supports that IPL and TCC are more effective than TCC therapy alone in treating melasma.
Keywords: Intense Pulse Light, Melasma, Triple Combination Cream
Severity of Stress in Acne Patients Attending Dermatology Outpatient Department of Tertiary Hospital in Kathmandu
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Shrestha, Amrita; Pokhrel, Dinesh Binod; Parajuli, Sudip; Chapagain, Manisha; Shrestha, Rabina
Abstract:
Introduction: Stress persists when a person is unable to cope with the situations of the past, present or future. Stress may be associated with physical and psychological abnormalities. Acne vulgaris is a chronic inflammatory disease of the pilo-sebaceous units with prevalence of more than 85% in adolescent age group.
Materials and Methods: Three hundred one patients were recruited in the study. Inclusion criteria included new acne patients of age 16 years and above as well as those who were using but not improving with topical or oral acne therapies. Exclusion criteria included patients receiving sedatives, antidepressants, or glucocorticoids, patient suffering from chronic illnesses like diabetes, hypothyroidism, chronic kidney disease, migraine and other diseases. This questionnaire included biodata of the patients, clinical history and their perceived stress scale. Global Acne Grading System (GAGS) was used to assess acne severity in relation to stress using the Perceived Stress Scale (PSS).
Results: The results indicated an increase in stress severity positively correlated with an increase in acne severity, which was statistically significant (p<0.01). Most of the patients were students. Subjects with higher stress scores, determined using the PSS, had higher acne severity when examined and graded using the GAGS.
Conclusions: The results showed that there is a positive correlation between severity of stress and grade of acne. Stress management should be a part of acne management.
Keywords: Acne, Severity, Stress
Clinicoepidemiolgic Profile of Dermatophytosis in the Elderly: A Hospital Based Study
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Gahalaut, Pratik; Mehra, Mriganka; Mishra, Nitin; Rastogi, Madhur Kant; Bery, Vasudha
Abstract:
Introduction
Superficial tinea infections are some of the most common dermatological conditions in the elderly. Recently, few studies done showed an abrupt increase in dermatophytic infection in adults; however, similar recent studies describing dermatophytosis in the elderly are lacking. The aims and objectives of this study were to identify the epidemiological profile of dermatophytoses among the elderly population.
Materials and Methods
This was a single centre, observational cross-sectional study conducted at a tertiary care Medical College Hospital in North India over 12 months including patients of dermatophytosis (KOH confirmed) aged 60 years or more.
Results
A total of 192 patients were enrolled, among which 68.7% were males. The extensive disease was present in 56.2%. History of topical steroid usage was present in 79.2%. The mean duration of disease was 23.8 weeks among which chronic disease was seen in 25%. Various other demographic characteristics were identified. Various risk factors for extensive disease, like gender, topical steroids use, urban residence, higher socioeconomic status, longer duration of disease, positive family history, diabetics, regular alcohol and tobacco consumption, were also noted in the present study.
Conclusion
The present concludes increased prevalence in women, delay in seeking treatment among them, a rising proportion of chronic and extensive dermatophytosis, rising atypical clinical presentation and higher predilection for tinea cruris and onychomycosis.