Giant Arcuate Lupus Vulgaris with Rapid Progression:A Case Report

Lupus vulgaris is the commonest form of cutaneous tuberculosis. It is a chronic and slowly progressive disease. It can be transmitted either through hematogenous or lymphatic spread but most commonly through contiguous extension.There are many reports on different form of lupus vulgaris but there are only a few reports on large sized lupus vulgaris. Here, we report a case of 75-year-old man with a giant lupus vulgaris rapidly progressing in just two year's duration

Cutaneous Tuberculosis among Patients Presenting to Dermatology Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Cutaneous tuberculosis is an uncommon form of extrapulmonary tuberculosis. It can present in various morphological presentations leading to a late diagnosis in many cases. It is mainly associated with significant scarring and morbidity. It is classified as paucibacillary or multibacillary depending on the bacillary load. Similarly, it can be acquired through either an endogenous or an exogenous source. The mainstay of treatment is anti-tubercular medications. The objective of the study was to find out the prevalence of cutaneous tuberculosis among patients presenting to the dermatology outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was done among the patient presenting to the outpatient department of dermatology and venerology in a tertiary care centre where all patients data from medical records were taken from April 2016 to March 2021 after taking ethical approval from the Institutional Review Committee (Reference number: 503/2078/79). Demographic details of the patients including age, sex, site and duration of the lesion were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1,30,924 cases, 40 (0.03%) (0.02-0.04, at 95% Confidence Interval) cutaneous tuberculosis was seen. Conclusions: The prevalence of cutaneous tuberculosis was similar to the studies done in similar settings

Porphyria Cutanea Tarda Presenting as Erythema-multiforme Like Lesions

Porphyria cutaneatarda, is the most common type of porphyria.It is characterized by defective uroporphyrinogen III decarboxylase enzyme.It presents with erosion, bulla with milia formation and sometimes with hypertrichosis and abnormal pigmentation mostly on the photo-exposed sites. A urine fluorescence of coral red color helps in the diagnosis. Here, we present a rare case of porphyria cutanea tarda in a 15 years old male who presented with multiple targetoid plaques. Keywords: Erythema-multiforme; porphyria cutanea tarda; targetoid

Chronic Urticaria and Its Impact on the Quality of Life of Nepalese Patients

Chronic urticaria (CU) is a skin condition characterized by sudden and recurrent episodes of wheals, angioedema, or both and commonly associated with itching for a duration of more than six weeks. The available data indicate that urticaria markedly affects both objective functioning and subjective well-being of patients. A review of patients’ records with chronic urticaria attending Civil Service Hospital from January 2018 to December 2019 was done. A detailed demographic data of all patients with chronic urticaria was also retrieved. Dermatology Life Quality Index questionnaire (DLQI) Nepalese version was used for the assessment of the impact of disease on life quality. Mann–Whitney U-test was applied to compare means, and principle component analysis for factor analysis was used. A total of 149 patients were included, with a male-to-female ratio of 1 : 1.9. The mean age of the study population was 32.86 ± 12.837 years. The mean DLQI score was 8.30 ± 6.73 with men having a significantly greater score than women (p<0.02). DLQI scores negatively correlated with age (p<0.01). There was a high internal consistency among items (Cronbach’s alpha 0.89), and all items had satisfactory correlation with each other as well. Principle component extraction revealed that there were two underlying factors in the DLQI questionnaire on measuring quality of life in chronic urticaria. Males had a greater impairment in quality of life than females due to chronic urticaria. Most severe impairment was seen in symptoms/feelings subdomain. It also revealed that there were two different underlying factors in DLQI questionnaire

Multibacillary Leprosy Presenting as Anetoderma in a Young Teenager

Anetoderma presents as a circumscribed area of slack skin. It can present as either primary or secondary, if associated with other conditions. Leprosy is one of the causes of secondary anetoderma, but it is not commonly reported, especially in multibacillary leprosy. Here, we report a case of a 16-year-old young girl who presented with fever, joint pain, and only three anetodermic plaques. A slit skin smear from the lesion showed multiple acid-fast bacilli with a bacillary index of 3+, thus confirming the diagnosis of leprosy. This case is unique since multibacillary leprosy presented with only few anetoderma lesions in a young teenager girl from a leprosy-eliminated country

Metabolome Mining of <i>Curcuma longa</i> L. Using HPLC-MS/MS and Molecular Networking

Turmeric, Curcuma longa L., is a type of medicinal plant characterized by its perennial nature and rhizomatous growth. It is a member of the Zingiberaceae family and is distributed across the world’s tropical and subtropical climates, especially in South Asia. Its rhizomes have been highly valued for food supplements, spices, flavoring agents, and yellow dye in South Asia since ancient times. It exhibits a diverse array of therapeutic qualities that encompass its ability to combat diabetes, reduce inflammation, act as an antioxidant, exhibit anticancer properties, and promote anti-aging effects. In this study, organic extracts of C. longa rhizomes were subjected to HPLC separation followed by ESI-MS and low-energy tandem mass spectrometry analyses. The Global Natural Product Social Molecular Networking (GNPS) approach was utilized for the first time in this ethnobotanically important species to conduct an in-depth analysis of its metabolomes based on their fragments. To sum it up, a total of 30 metabolites including 16 diarylheptanoids, 1 diarylpentanoid, 3 bisabolocurcumin ethers, 4 sesquiterpenoids, 4 cinnamic acid derivatives, and 2 fatty acid derivatives were identified. Among the 16 diarylheptanoids identified in this study, 5 of them are reported for the first time in this species

Antidiabetic, Antimicrobial, and Molecular Profiling of Selected Medicinal Plants

Natural products have been the center of attraction ever since they were discovered. Among them, plant-based natural products were popular as analgesics, anti-inflammatory, antidiabetic, and cosmetics and possess widespread biotechnological applications. The use of plant products as cosmetics and therapeutics is deep-rooted in Nepalese society. Although there are few ethnobotanical studies conducted, extensive research of these valuable medicinal plants has not been a priority due to the limitation of technology and infrastructure. Here, we selected 4 traditionally used medicinal plants to examine their bioactive properties and their enzyme inhibition potential. α-Glucosidase and α-amylase inhibitory activities were investigated using an in vitro model followed up by antioxidant and antimicrobial activities. The present study shows that ethyl acetate fraction of Melastoma melabathrium (IC50 9.1 ± 0.3 µg/mL) and water fraction Acacia catechu (IC50 9.0 ± 0.6 µg/mL) exhibit strong α-glucosidase inhibition. Likewise, the highest α-amylase inhibition was shown by crude extracts of Ficus religiosa (IC50 29.2 ± 1.2 µg/mL) and ethyl acetate fractions of Shorea robusta (IC50 69.3 ± 1.1 µg/mL), and the highest radical scavenging activity was shown by F. religiosa with an IC50 67.4 ± 0.6 µg/mL. Furthermore, to identify the metabolites within the fractions, we employed high-resolution mass spectrometry (LC-HRMS) and annotated 17 known metabolites which justify our assumption on activity. Of 4 medicinal plants examined, ethyl acetate fraction of S. robusta, ethyl acetate fraction of M. melabathrium, and water or ethyl acetate fraction of A. catechu extracts illustrated the best activities. With our study, we set up a foundation that provides authentic evidence to the community for use of these traditional plants. The annotated metabolites in this study support earlier experimental evidence towards the inhibition of enzymes. Further study is necessary to explore the clinical efficacy of these secondary molecules, which might be alternatives for the treatment of diabetes and pathogens