Skin can show various manifestations in patients suffering with malignancy, which may be specific or non specific. In absence of any available literature on this issue, we conducted this study to know the dermatological conditions affecting Nepalese patients with malignancy. A total of 62 patients who were referred for dermatological consultation both from out-patient department and in-patient department of Nepal Cancer Hospital were included in this study. Data including demographic variables, type of malignancy, duration since diagnosis, chemotherapeutic agents administered and dermatological manifestation were recorded. The frequency of Dermatological manifestation in cancer patients was found to be 0.41%. There were 56% females and 44% males. Mean age of presentation was 44 years. These patients had primary malignancy as carcinoma breast in 31%, lung carcinoma 21%, carcinoma colon 16%, carcinoma rectum 8%, carcinoma pancreas 7% and 3% each had carcinoma prostate, carcinoma stomach, carcinoma ovary and oral carcinoma and Ewing sarcoma. The mean duration of presentation of primary carcinoma was 8 months. The most frequent dermatoses was eczema in 39%, followed by infection 25%, pruritus 14%, insect bite hypersensitivity 3.2%, disorder of pilosebaceous unit 3.2%, urticaria 3.2%, pigmentary changes 3.2%, nail involvement 3.2%, drug rash 2%, vesiculo-blistering disorder 2% and cutaneous metastasis in 2%. In absence of screening program, we found a very low frequency of cutaneous manifestation in patients with malignancy in our study. We recommend a prospective long term follow-up study with institution of screening and awareness program.

INTRODUCTION: Seasonal variation in disease frequency has been observed for centuries. The direct effects of climate on the skin play a small but significant role in determining the geographical and seasonal variation of many skin disorders also in pediatric age group. In our country Nepal where there is a wide range of climates and where pediatric population of 0 to 14 years constitutes 34.19% of the total population there is a need for studying the seasonal variation of pediatric dermatoses separately. MATERIAL AND METHODS: A retrospective study was conducted in the outpatient department of dermatology of Nepal Medical College and Teaching Hospital for a period of 1 year. The total patients were divided according to 4 seasons spring, summer, autumn and winter and analyzed with Chi square test. RESULTS: Out of total 2032 patients 52% was male and 48% was female. Majority of the visits was in the winter season, followed by summer, spring and autumn. The five most common dermatological problems in the pediatric age group were impetigo, lichen urticatus, scabies, seborrheic eczema and milaria. lichen urticatus, seborrheic eczema and milaria showed statistically very significant seasonal variation but impetigo and scabies did not. The age wise variation of these common dermatoses was also statistically highly significant. CONCLUSION: Many common dermatoses in the pediatric age group show seasonal variation and age wise variation. DOI: http://dx.doi.org/10.3126/jucms.v2i1.10483 Journal of Universal College of Medical Sciences (2014) Vol.2(1): 7-11

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Hailey-Hailey disease is a rare autosomal dominant acantholytic disorder, previously not reported from Nepal. We report a case of 30 years old female who presented with pruritic hyperkeratotic papules and plaques on vulva, perianal area and inner left thigh for a period of one year. Biopsy from the lesion showed suprabasal acantholysis with loss of intercellular bridges resulting in a dilapidated brick-wall appearance; characteristic of Hailey-Hailey disease. Treatment of this disease till date is far from satisfactory.

Cosmetic Dermatology has garnered tremendous interest all over the world. With the advent of modern technologies and developments, demand for non-surgical aesthetic procedures is on a rise. The purpose of the study is to know the types of cosmetic consultations and procedures being done in a General Dermatology setup. Patients who visited outpatient dermatology department of a multi-specialty, Nidan Hospital, Lalitpur, between May 2017 to April 2018 were included. Details of patients’ demographic profile were filled in a preset performa. Other information related to cosmetic consultation including dermatological diagnosis, awareness of cosmetic procedures and cosmetic procedures etc were also included. 160 patients attended the dermatology outpatient during the study period. Seventy four percent of them were females. Thirty six percent of the cases were between 26years and 35 years. Forty three percent of the cohort were working. Majority of them had Bachelors degree (57%). Twenty six patients who attended the OPD wanted cosmetic consultation. The type of cosmetic consultation, majority sought for was wrinkles (37%). Among the cosmetic procedures performed, chemical peeling was done in 59%, mesotherapy in 16%, mole removal in 12% and remaining 13% underwent topical treatment. Statistical significance was seen between Cosmetic consultation and economic status (p=0.000) and between cosmetic consultation and employment status (p=0.007). Almost a quarter of patients attending a general dermatology OPD sought cosmetic consultation. Females, young adults who are employed, well-educated and from good socio-economic status seek cosmetic services.

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Background: Cryosurgery is the well-aimed and controlled destruction of diseased tissue by application of cold. It has been shown to be effective and efficient in various skin diseases. We studied the indications and outcome of this modality of treatment in our set up. Materials and Method: All patients who were subjected to cryosurgery for different clinical indications were included in the study. Results: There were total of 133 patients. Commonest age group presentation (between 16 to 25 years) constituted about 42%. 52% of patients were students. There were total of 91% who were from Kathmandu remaining 9% were from outside of Kathmandu Valley. Cryosurgery was indicated commonly in warts for 82% patients followed by 12% for keloid & hypertrophic scar, benign conditions in 4% and in premalignant conditions for 2% patients. Number to treatment (or sessions) for indicated disease with resolution of disease was single in 81% patients followed by between 2 to 5 treatment session in 14% and more than 5 treatments was necessary in 5%. Side effects like pain was seen in 64% patients, erythema in 8% and blistering 4%. 24% patients did not have any side effect. Conclusion: Cryotherapy is considered as one of the effective modality of treatment for various skin conditions with various limitations. Further prospective clinical trial with large population group should be carried out.

Objective: Lupus Erythematosus Profundus (LEP) is a rare subset of Lupus erythematosus and clinically presents as indurated subcutaneous painful nodules and plaques. The objective of the study was to evaluate clinical, histopathological and supplementary laboratory parameters to diagnose Lupus erythematous profundus. Methods and materials:This was a retrospective study, a clinical series of histo-pathologically proven cases of 11 patients. Data were collected from clinic records from 1996 to 2010. A detailed history including onset of disease, age, sex, residence, hospital ID number and clinical examination, association with Discoid lupus erythematosus (DLE) or Systemic lupus erythematosus (SLE), laboratory workup, histopathological evaluation and Direct Immunofluorescence data was taken from the records.Result: There were total of 11 patients, with mean years of presentation of 26 years. Male to female ratio was 3:8. Face was the commonest site of distribution. Exclusively LEP presentation was seen in 83% and in 18% associated with DLE and 9% with SLE. Clinically lesions varied from nodules, indurated plaques, atrophy and ulcer. In laboratory work up ANA was positive in 9% of the cases, others baseline investigations were within normal limits. On histopathological evaluation, lobular panniculitis and hyaline fat necrosis was seen in all patients. The infiltrates were predominantly lymphohistiocytic. Direct immunofluorescence (DIF) could be done in 3 out of 11 cases. Lupus band at basement membrane zone was seen in all the 3 cases. Deposition of predominantly IgG followed by IgM, IgA and C3 were seen. Two of the three cases with positive DIF findings had no interface pathology. Conclusion:Diagnosis of LEP is based on clinico-pathological correlation. An early diagnosis and prompt treatment may help prevent disfigurement.