Introducti on: Tenia Cruris is the commonest dermatophyte infecti on which is common in men and aggravated by warm humid conditi on Teniarubrum is the main species for the disease 1,2 . Itraconazole and Terbinafi ne are the bett er newer drugs for the therapeuti c opti on due to their effi cacy, convenient and less side eff ect. Itraconazole is a wider spectrum Thiazole group of fungistati c drugs which inhibit sterol 14 α demethylase impairing biosynthesis of fungal ergosterol. Similarly Terbinafi ne is broad specturmallylamine group of fungicidal acti vity which inhibits squalene 2, 3 epoxidase enzyme thus inhibit fungal biosynsthesis of ergosterol [3][4][5] . These two drugs have been needed conventi onally as a pulse and conti nuous therapy. The main aim of this study is to compare the effi cacy of both drugs and to recommend the eff ecti ve treatment in case of Teniacruris. Methods:In this randomized comparati ve study, the effi cacy and safety of oral itraconazole (n=35) and terbinafi ne (n=35), each given for 2weeks, was compared in pati ents with ti neacruris within the period of 1 year study. Results:The fi nal evaluati on at week 4 showed a cure rate of 91.4% for itraconazole and 82.9% for terbinafi ne. No defi nite adverse eff ect was noted. Conclusions:Itraconazolehas high cure rate and less failure rate without side eff ects in comparision toTerbinafi ne.

Introduction: Dermatological conditions make up a significant burden of hospital visits. This study aims to calculate the prevalence of different dermatological conditions among OPD visits in a tertiary care hospital in Kathmandu, and describe the variation of those conditions with demographic variables and seasons. Methods: This study was performed retrospectively using the data collected in the OPD register of a tertiary level hospital from 14th April 2017 to 13th April 2018. Analysis was conducted using MS Excel 2016 and Statistical Package for the Social Sciences (SPSS) v25. Results: A total number of 24,332 OPD visits were recorded in the year. 54.3% of the visits were made by males and 45.7% by females and most common age group seeking dermatological consultation was 25 to 34 years. Noninfectious dermatoses were more common than infections. The most common noninfectious dermatoses were dermatitis/eczema, urticaria, angioedema and hypersensitivity, and pigmentary disorders in descending order of frequency. The common infectious dermatoses in decreasing order of frequency were fungal, viral, and parasitic/protozoal conditions. The infectious dermatoses were found to be significantly higher in males (p<0.05) while pigmentary disorders, urticaria and angioedema, autoimmune cutaneous disorders, disorders of pilosebaceous units and xerosis were significantly higher in females (p<0.05). Bacterial, fungal and viral infections, eczemas, urticarial/angioedema, papulosquamous disorders, xerosis, neoplasms and vasculitis showed significant seasonal variation. Conclusions: Eczemas and fungal infections are the most common dermatoses. Infectious dermatoses and several non-infectious dermatoses vary significantly with seasons.

Introducti on: Approximately 90% pregnant women are associated with skin changes. The skin undergoes profound alterati ons during pregnancy as a result of endocrine, metabolic and immunologic changes. Some of these are trivial and chiefl y cosmeti c, producing no or minor symptoms, others can be distressing and/or of major medical importance. For the necessity of proper and complex care of the pregnant woman,the knowledge about the changes are crucial. The ability of precise diagnosis of physiological skin changes allows specifying the suspected cases of pathologic eti ology and referring them to the dermatological referral centers for in-depth diagnosis and eventual treatment. The aim of this study was to identi fy the incidence and types of dermatological changes in our populati on.Methods: Pregnant pati ents att ending the antenatal clinic of the Gynecology department in Shree Birendra Hospital, and presenti ng to the outpati ent clinic of the Department of Dermatology, Bir Hospital, for any dermatologic problem, were enrolled. The study spanned a period of 10months (January 2008 to October 2008). We evaluated 150 pregnant women to determine the patt ern of pregnancy-induced physiologic skin changes in Nepalese community.Results: Majority of pati ent developed dermatological changes in second and third trimester. The commonest sign was hyper pigmentati on of the skin followed by striae and edema. Fungal infecti ons were the commonest infecti ons observed,Tineacorporis accounti ng for 10 (6.66%) and ti neaversicolarwas seen in Eight (5.33%) pati ents. Three (2%) pati ents hadScabies. A total of 3 pati ents had sexually transmitt ed disease. 2 (1.3%) had Condyloma acuminate and 1 (.006%) had syphilis. Conclusions:Hyperpigmentati on was the commonest sign (87.33%) followed by striae (82%), edema (45.3%), vascular changes (17.3%) and melasma (8%). Varicositi es of veins, spider nevi and palmar erythema are relati vely less frequent in our populati on.

Fitz-Hugh-Curtis syndrome (FCHS), also known as acute perihepatitis, is a rare disorder characterised by inflammation of the peritoneum and the tissues surrounding the liver. This syndrome can arise as a potential complication from a pelvic inflammatory disease caused by Neisseria gonorrhoeae or Chlamydia trachomatis. This is a case of 26 years’ healthy asymptomatic woman with primary infertility where this syndrome was diagnosed incidentally during laproscopy.

Introduction: Acne vulgaris is one of the most common skin disorders. It mainly affects adolescent, though may present at any age. It differs from patient to patient. Thus, the treatment should be differing from individual patients. Methods: The comparative study between the efficacy of isotretinoin and pulse dose azithromycin was carried for one year. Sixty patients of moderate to severe acne were enrolled among 15 – 30 years’ group divided into two equal groups. Isotretinoin 0.5-1mg/kg body weight given to Group A and azithromycin 500mg was given to Group B three days a week for 3 months according to severity of the disease. The severity of acne was done according to Global Acne Grading Score, GAGS. Results: Maximum number of patients were having moderate type of acne i.e., 20 (66.7%) in group A and 25 (83.3%) in group B. In group A, all cases responded and the clinical response was rated as excellent in 24 (80%), good in 5 (16.67%) and fair in 1 (3.33%) case. In group B, 24 (80%) cases responded and the response was categorized as excellent in 6 (20%), good in 9 (30%), fair in 3 (10%) and poor in 6 (20%) cases. There was no response in 6 (20%) cases. The response of isotretinoin in Group A is better than azithromycin in group B [p<0.01]. Conclusions: Isotretinoin appears to be the superior than to weekly pulse dose of azithromycin in moderate to severe case of acne.

Introduction: The COVID-19 pandemic has become a major health care issue worldwide. The surge in cases was seen in the second wave, with more people getting hospital admissions. An accurate and rapid identification of cutaneous manifestations is vital to early diagnosis and better prognosis. The aim of the study was to determine cutaneous manifestations in patients with COVID-19. Materials and Methods: This prospective observational cross-sectional hospital-based study was conducted from June 2021 to September 2021.  Patients admitted to the hospital were examined by the dermatologists. All inpatients diagnosed with COVID-19 with RT PCR were included. Types, patterns and how the skin lesions changed its course during illness were recorded. Ethical clearance was taken from IRC. Statistical analysis was done with SPSS Version 20.0. Results: A total of 452 COVID-19 RT-PCR-positive patients were enrolled out of which 97(21.5%) had skin lesions. Out of 131 comorbid patients, 40(30.5%) had skin lesions. Urticarial wheals and erythema nodosum were seen in 21(4.6%) each and were the most common manifestation, followed by exanthema in 17(3.8%). Conclusion: Study showed maximum patients with COVID-19 had urticaria and erythema nodosum. It is important to know the types of skin lesions for early diagnosis. In order to prevent the spread patient can be sent for investigations on time. More elaborate studies with multicenter involvement are recommended.

Introduction: Teledermatology provides virtual consultation to patients using telecommunication technology. Using this method dermatologists can diagnose a condition with the help of pictures of the lesions and short history. During the COVID-19 pandemic, practicing this method has become more relevant. Providing teleconsultations to patients with fungal skin infections can prevent inadvertent use of topical corticosteroids. The objective of this study was to find the prevalence of fungal infections among teledermatology consultations done in a tertiary care hospital. Methods: It was a descriptive cross-sectional study where the store and forward and real-time methods were used between February 2020 to July 2020. Ethical clearance was taken from the institutional review board (reference number: 245). Data of those patients who wanted consultations from this department were sent by medical officers deployed in military hospitals that are under the central army hospital located in Kathmandu. Convenient sampling was used. The collected data was entered and analyzed in the Statistical Package of Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: A total of 451 (33.45%) (30.93-35.97 at 95% Confidence Interval) were diagnosed with fungal infections out of 1348 patients who were enrolled for the study. About 361 (80%) of the patients suffering from fungal infections belonged to the Terai region and 90 (20%) belonged to mountainous areas. Conclusions: The prevalence of fungal infection among teledermatology consultation was lower than the findings from a similar international study.