BackgroundLeprosy remains a major stigmatizing condition. Stigma is a dynamic process resulting from the interaction between physical attributes caused by leprosy and the existing stereotypes in a community. Leprosy has pervasive impacts on all areas of life including psychosocial burden to an individual, social interaction, marriage, and employment. These impacts vary and are largely dependent on a particular culture and community. The main objective of this study was to explore the perceived stigma of leprosy amongst community members and health care providers in Lalitpur district of Nepal.MethodsA total of six focused group discussions (FGDs) with 43 participants from a community living close to Anandaban Leprosy Hospital and ten semi structured interviews (SSIs) with health care providers were conducted between October and December 2016. An interview guide was used for the FGDs and SSIs. All qualitative data were transcribed and translated into English and were thematically analyzed using Atlas.ti software.ResultsVisible deformities due to leprosy was one of the major contributing factors for stigma. Stigma was further exacerbated by an attitude to conceal the disease due to perceived fear of potential discrimination. While over the years, stigma was felt to be decreasing, various aspects of life were still affected by leprosy stigma including marriage, employment and social interaction. This was largely attributed to leprosy and its consequences, specifically the disability and deformity caused by leprosy.ConclusionLeprosy was still perceived to be feared and concealed because of potential discrimination, even within the community that was close to a long established leprosy hospital. Various aspects such as marriage, employment and social interaction were still affected by the stigma which was strongly associated with visible deformities. In addition to ongoing rehabilitation and stigma reduction programs, integrating strategies such as community engagement wherein community and leprosy affected person jointly take a role in stigma reduction programs can be helpful.

Introduction. Alopecia areata is one of the commonest causes of nonscarring alopecia. Since hair is a vital part with very high cosmetic concern, hair loss might have a significant negative impact on patient’s life. Hence, we aimed this to investigate depression and anxiety in patients with alopecia areata. Methods. In this cross-sectional study, a total of 75 consecutive eligible patients of alopecia areata were interviewed over one-year period in the dermatology outpatient department. We recorded the relevant history and examination details in the present proforma. Nepali versions of Beck Depression Inventory and Beck Anxiety Inventory were used for the assessment of depression and anxiety, respectively. Data analysis was done with Statistical Package for the Social Sciences version 11.5. Results. Among 75 patients, the prevalence of depression and anxiety were 66.7% and 73.3%, respectively, with median depression score = 5 (IQR = 0.0–10.0) and median anxiety score = 5 (IQR = 0.0–11.0). Out of all depressed patients, 82.0% had minimal and 18.0% had moderate depression. However, none of them had severe depression. Likewise, out of all patients with anxiety, 89.0% had mild and 11.0% had moderate anxiety, but none of them had severe anxiety. Conclusion. Anxiety and depression are common psychological problems in patients with alopecia areata. Because of their direct impact on treatment outcome, we, treating dermatologist, must be aware of them, and we should counsel our patients for consultation with the psychiatrist on time for their maximum benefit.

Because pediatric leprosy strongly indicates continuous disease transmission in the community, knowing the profiles of pediatric leprosy is of great value for a leprosy-free world. We conducted this study to assess the clinical profiles of pediatric leprosy in Nepal. This retrospective study analyzed the 7-year record from 2011 to 2017. There were a total of 68 pediatric leprosy cases. Male (63.2%) cases outnumbered female cases. The minimum age of the leprosyaffected children was 6 years, with the mean age 12.17 (±1.95) years. Contact history was present in 26 (38.2%) children. Most of them (83.8%) had positive slit-skin smear. Lepra reaction was present in 14.7%. Nine had disability, with 4/9 (44.4%) of them having grade 2 disability. More than two-thirds (70.6%) were multi-bacillary cases. Some (2.9%) even had lepromatous leprosy. Leprosy continues to be a disease of concern in the post-elimination era even in the pediatric population.

Background: Alopecia areata is the commonest cause of non-scarring alopecia. Few previous studies have found correlation between AA and vitamin D deficiency, suggesting that vitamin D deficiency can be a risk factor for Alopecia areata. To compare serum vitamin D level between Alopecia areata patients and healthy controls; and to assess the relation between serum vitamin D levels and AA disease severity.Methods: This case control study included 30 newly diagnosed Alopecia areata patients. Thorough history was taken, detail examination was done and relevant findings were recorded in the standardized pro-forma. Their serum vitamin D (25-hydroxyvitamin D) levels were determined by competitive chemiluminescence methods; and were compared with that of age and sex matched healthy controls. Chi square test and Spearman’s rho correlation test were used for the inferential statistics using SPSS version 11.5. Results: There were 30 AA patients with mean age 28.37+10.07 years. Mean Severity of Alopecia Tool score was 3.56+3.50. Prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency was significantly higher in AA group (83.3%) compared to the control group (53.3%) (P=0.01). Similarly, serum 25(OH)D level was reduced more in Alopecia areata group (12.84, IQR=8.87-20.47) than the control group (29.5, IQR=19.85-41.27) (P=0.06). There was inverse co-relation between serum 25(OH)D level and SALT score.Conclusions: Prevalence of serum 25(OH)D deficiency was significantly higher in Alopecia areata group compared to the control, with inverse co-relation between its level and Alopecia areata disease severity. Keywords: Alopecia areata; Nepal; SALT Score; Vitamin D.

Leprosy, an infectious disease, is a highly stigmatized disease. It directly affects patients' physical, psychological, social and economical well-being. To know the stigma faced by the patients in the family and community. The study was carried out at Netherlands Leprosy Relief, Biratnagar, Nepal. Verbal consent was taken from each patient. A total number of 34 patients who were diagnosed to have leprosy were interviewed. Data were collected using structured interview schedule that included questions seeking information about all aspects of objective. Although both men and women faced the social stigma of the disease, women suffered more rejection by the family members (50%), neighborhood (75%) and work places (62.5%) in comparison to male patients, who are affected maximum at work places (39%) and minimum in family (7.69%). Illiterate were avoided by family members (25%) and co-workers (75%) whereas literate were not. All unemployed patients were neglected in community whereas only 21.42% of employed were neglected. Leprosy is a highly stigmatized disease. Patients are neglected by their family and society. Therefore community education component of Leprosy Control Program needs to be strengthened.