Journal Issue: Volume: 20, No. 2 (2022)
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Volume
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Issue Date
2022
Journal Title
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ISSN 2091-0231 eISSN 2091-167X
Journal Volume
Articles
Aesthetic Dermatology Training During Residency: Do we Need to Revise the Postgraduate Curriculum?
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Marahatta, Suchana; Thapa, Deeptara Pathak
Abstract:
Aesthetic Dermatology (AD) is a growing sub-unit of dermatology. Appearance plays a vital role in enhancing and boosting self-confidence. Reports are showing a growing demand for AD throughout the world. To converge this increasing demand, we must pivot on engendering certified competent dermatologists and hence include this sub-specialty in the dermatology residency program.
Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Bhatia, Saurabh
Abstract:
Introduction: Apremilast, an oral phosphodiesterase-4 inhibitor, decreases the production of pro-inflammatory cytokines including tumour necrosis factor-α, interleukin-12/23, IL-12, IL-2, and interferon-γ; while upregulating the anti-inflammatory cytokine IL-10. Its pan-immunomodulatory nature has led to its use in managing various immune-mediated dermatoses for non-FDA-approved indications.
Objectives: To review and analyze the use of Apremilast in Non-FDA-approved indications in current available literature.
Materials and methods: PubMed, EMBASE, SCOPUS, and Google scholar databases were searched with the parameters “Apremilast”, “Apremilast NOT Psoriasis*”, “Apremilast NOT Behçet’s*”, and “Apremilast NOT arthritis*”. A total of 45 relevant articles were chosen for review.
Results: We found 22 indications in dermatology where apremilast has been used without FDA approval. The best evidence was for treatment in Atopic Dermatitis, Alopecia Areata, and Hidradenitis Suppurativa, with randomized controlled trials. Prospective open-label trials were found for Cutaneous Sarcoidosis, Lichen Planus, Rosacea, and Vitiligo. Individual case series and reports were found for Acrodermatitis Continua of Hallopeau, Dermatomyositis, Disseminated Granuloma Annulare, Erythema Nodosum Leprosum, Morphea, Pityriasis Rubra Pilaris, Hailey-Hailey Disease, Recurrent Erythema Multiforme, and Folliculitis Decalvans, Prurigo Nodularis, Perforating Dermatoses, Chronic Actinic Dermatitis, and Hand Eczema, and Epidermolysis Bullosa Simplex-Generalised Severe Type. Apremilast has shown varied efficacy despite a better safety profile and tolerability over a long duration compared to conventional immunosuppressant drugs and placebo.
Conclusion: Apremilast has been used for varied non-FDA-approved indications in dermatology with variable efficacy. Better controlled, randomized studies with adequate sample size and drug comparisons are needed for better analyses.
Effectivity of Uniform Multidrug Therapy on the Success of Paucibacillary and Multibacillary Leprosy Treatment
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Susanto, Prayogi Miura; Esti, Prima Kartika; Komarasari, Eka
Abstract:
Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) that involves the integumentary and peripheral nervous system, causing neuropathy, deformity, and disability. Early detection and appropriate treatment are the ways to break the chain of transmission and prevent disability in leprosy patients. The first line of treatment for leprosy is the standard Multidrug Therapy (MDT) regiment consisting of rifampicin, dapsone, and clofazimine. Standard MDT treatment is given based on the leprosy classification of paucibacillary (PB) and multibacillary (MB). The utilization of the standard MDT regiment has some limitations, particularly where there is a limited supporting test facility, causing difficulty in determining the leprosy classification accurately. An alternative regiment proposed to substitute the standard MDT is the Uniform-MDT (U-MDT). Several studies have been conducted on the use of U-MDT and have produced promising results for the treatment of PB and MB leprosy.
Better Disease Control by Multidrug Regimen in Scabies: A Randomized Controlled Trial
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Pandey, Prajwal; Agrawal, Sudha
Abstract:
Introduction: Scabies is a highly resilient condition with varying morbidity worldwide. The treatment options widely used for the disease include topical permethrin 5% and oral Ivermectin with similar efficacy. Treatment failure due to non-compliance is a major problem with the current treatment modalities.
Objectives: This study was designed to compare the efficacy of combination to the gold standard treatment regimen of scabies.
Materials and Methods: A randomized controlled trial was done with 212 patients, divided randomly into two groups Group 1 and Group 2. Group 1 were treated with two-time application of 5% permethrin one week apart while Group 2 were treated with a combination of 5% permethrin and oral ivermectin (200μg/kg) on a single day. Patients were followed up every week for 4 weeks to assess the efficacy and adverse events.
Results: The treatment efficacy in group 2 was more compared to group 1 after 2 weeks of follow up (72.6% vs 65.1% after 1 week; 89.6% vs 80.2% after 2 week) however it was not statistically significant. After 4 weeks of follow up, the treatment efficacy in both the groups was similar. The reduction in intensity of itching was almost similar in both the groups at every follow up.
Conclusion: The combination of 5% topical permethrin and oral ivermectin showed earlier resolution of clinical symptoms compared to 5% topical permethrin alone repeated in 1 week. The reduction in intensity of itch was similar in both the groups.
Quality of life in Patients with Melasma: A Hospital-Based Study
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Mainali, Priyanka; Jha, Anil Kumar; Shrestha, Shristi; Thapa, Deeptara Pathak; Joshi, Smita; Amatya, Bibush
Abstract:
Introduction: Melasma is the most common cause of facial melanosis and one of the most common diseases presenting to the Dermatology department. It can lead to psychological and emotional distress for the patients and can hamper their quality of life. So, this study was done to assess the quality of life among patients with melasma so that the need for couseling of these patients could be assessed along with medical treatment.
Materials and Methods: This was a hospital based cross sectional study with 205 clinically diagnosed cases of melasma during the study period of one year. Melasma area severity index (MASI) score was recorded for each patient. Melasma quality of life was evaluated using the Melasma related Quality of Life (MELASQOL) score. MASI score and MELASQOL score were correlated using the Chi square test and socio-demographic details were also recorded.
Results: The mean MASI score in our study was 14.39 and the mean MELASQOL score was 34.98. The correlation of the MASI score with the MELASQOL score was found to be statistically significant (p value = 0.000).
Conclusion: MELASQOL score can be used to assess the quality of life in patients with melasma and the impairment in quality of life depends upon the MASI score.