Berkala Ilmu Kesehatan Kulit dan Kelamin

Periungual Pyogenic Granuloma in Multiple Nails due to Isotretinoin

2024-04-22T12:41:30+07:00

Background: Isotretinoin, a first-generation nonaromatic retinoid approved in 1973 for severe nodulocystic acne treatment in the United States, has historically been associated with mucocutaneous adverse events. Case: The case involves a 22-year-old male with chronic plaque psoriasis who, after eight weeks of isotretinoin use, experienced swelling, pain, and bleeding in the periungual area of multiple fingers. Dermoscopic examination and follow-up assessments, including images, demonstrate the progression and eventual complete resolution of the periungual pyogenic granuloma following discontinuation of isotretinoin and topical application of fusidic acid and betamethasone combination. Discussion: The discussion delves into potential mechanisms linking isotretinoin to increased skin fragility and granulation tissue development, drawing on insights from experts like Baran and Piraccini. Additionally, we explore the role of angiogenic factors, particularly vascular endothelial growth factor (VEGF), in the context of psoriasis and its potential contribution to the development of pyogenic granuloma, with the aim of providing a comprehensive understanding of the underlying processes leading to this unique adverse event. Conclusion: In conclusion, this case report underscores the importance of recognizing and promptly addressing rare adverse events associated with medication errors. The successful resolution of the periungual pyogenic granuloma highlights the significance of timely intervention and appropriate management strategies in mitigating adverse outcomes.

Secondary Syphilis with Multiple Co-Infections of Human Immunodeficiency Virus (HIV), Tuberculosis (TB), and Oral Candidiasis in a 19-Year-Old Men Who Have Sex with Men (MSM): A Case Report

2024-09-24T10:56:12+07:00

Background: Syphilis is an infection of the Treponema pallidum bacteria that often occurs along with conditions such as Human Immunodeficiency Virus (HIV) infection, tuberculosis (TB), and oral candidiasis. A weakened immune system affects the complex interactions between these conditions and the clinical presentation as well as the therapeutic management provided to patients. Case: A 19-year-old male with a history of HIV complained of lesions on the skin and mouth. Anamnesis, physical examination, and serological test results establish the diagnosis of secondary syphilis and pulmonary tuberculosis, characterized by a one-month history of phlegm coughing and weight loss, was confirmed via sputum testing. Additionally, oral candidiasis was identified based on clinical examination. Discussion: The patient exhibited complex complications from secondary syphilis, HIV infection, TB, and oral candidiasis. In cases of syphilis with HIV, the appropriate treatment is three doses of Benzathine Penicillin G. Anti-Tuberculosis Drugs administration for TB was adjusted based on HIV status and therapy response, and antifungal fluconazole for oral candidiasis. Conclusions: This case highlights the importance of proper management and close monitoring of patients with multiple infectious conditions, including treatment of syphilis patients that has a higher incidence in men who have MSM, HIV, TB, and oral candidiasis. Timely and appropriate therapy strategies are essential to minimize complications and improve clinical outcomes.

Update Management of Atopic Dermatitis

2024-01-16T08:25:26+07:00

Background: Atopic dermatitis (AD) is a chronic recurrent skin disease that is very complex due to impaired skin barrier function in the form of xerosis, chronic eczematous lesions, and itching, commonly found in infants and children. Pathogenesis is thought to be the interaction of genetic factors, immune dysfunction, epidermal barrier dysfunction, and the role of the environment and infectious agents. Approach the disease by performing etiopathogenesis algorithms, clinical manifestations, diagnosis, and treatment. Based on the 2013 Asia-Pacific consensus, AD management guidelines using the 5-pillar principle have long been used. Currently, the European consensus in 2018 has developed new guidelines for AD management. Purpose: To provide an updated treatment for AD. Review: The ethiopathogenesis of AD is influenced by genetics, skin barrier disorders, and immune response disorders. Updated management of the European consensus in 2018 includes education, avoidance of precipitating factors, psychosomatic counseling, optimization of skin barrier function with moisturizers, anti-inflammatory and antimicrobial administration, allergen-specific immunotherapy, complementary and alternative drugs, phototherapy, and controlling the itch-scratch cycle with anti-itch in pediatric and adult AD patients. AD may affect patients’ quality of self-esteem. In general, patients expect higher. Conclusion: AD affects the psychosocial aspects of patients. Updated management of AD adequately improves the quality of life.

Anti-Retroviral Treatment in dr. Sardjito Central General Hospital Yogyakarta

2024-07-12T06:19:58+07:00

Background: Adverse cutaneous drug reactions (ACDRs) affect 2-3% of hospitalized patients globally, wherein approximately 2% (1 in 1,000 cases) accounted for a severe form of cutaneous drug reactions. Out of all dermatologic diagnoses recorded by HIV patients, eight-point twenty-five percent of patients feature ACDRs, indicating that these patients are 100 times more inclined to develop unfortunate, severe reactions to anti-retroviral treatment. Therefore, there is an urgency in identifying the prevalence of ACDRs in HIV patients taking anti-retroviral treatment. Purpose: The aim of this study is to calculate the prevalence of anti-retroviral drug-induced ACDRs in HIV-positive patients in Central General Hospital, in the time period of January 2015 to December 2017. Methods: This study analyzed inpatient and outpatient medical records from January 2015 to December 2017 in the Dermatology and Venereology Department of dr. Sardjito Central General Hospital, which recorded ART-induced ACDRs manifestations. Result: This study revealed a prevalence of 0.095% of ACDRs as a result of ART administration, with 1.5% HIV-positive patients affected by ACDRs in response to ART medication. A m sex ratio of 2:1 with an average age of 30.4 ± 5.94 years old was found. The most predominant type of ACDR found in HIV-positive patients receiving ART was maculopapular rash (46.7%), while the most common type of drug within the ART regimen to cause such ACDR was Nevirapine (25.8%). Discussion: Nevirapine was the most common type of causative drug, for monotherapy (22.6%) and polytherapy (25.8%).

Scabies Risk Factor Analysis in Students at Islamic Boarding School

2024-06-14T11:06:55+07:00

Background: Scabies is a highly contagious skin disease that often occurs in densely populated settings, especially among children, including those in boarding schools. Purpose: We aimed to investigate the risk factors for scabies infestation in boarding schools. Methods: This crosssectional analytic research was conducted at the Imam Syuhodo Modern Islamic Boarding School. This study consisted of four main steps: survey questionnaires, a pre-test, one-on-one doctor examination, and a brief discussion. The collected data was analyzed using the ChiSquare test and bivariate analysis. Additional multivariate analysis was performed to determine the most influential risk factors. Result: The total sample for the study was 490 students (242 males and 248 females). The overall prevalence of scabies in the boarding school was 16.12%. Bivariate analysis showed a significant relationship between male sex, age (<14 years), history of itchiness, and sharing belongings. In the multivariate analysis, sex (OR 5.56, 95% CI 2.5911.93) and age (OR 2.09, 95% CI 1.23-3.56) turned out to be the most significant factor for scabies. Dermatology specific quality of life index assessment showed more severe negative effects on students with scabies (p<0.001). Discussion: Scabies prevalence was more common in younger males patients. The prevalence of male students was very disproportionate, which needs further attention when designing an intervention model. Students in boarding schools dealing with scabies have worse impacts on their daily lives, which could impede their academic progress.

The Effectiveness of 20% Moringa Leaf (Moringa oleifera Lam) peel-off Mask on Facial Skin Moisture

2024-04-30T13:45:58+07:00

Background: Indonesia’s tropical climate creates a variety of skin problems, including dry skin. The ingredients for making masks can come from nature such as moringahich have high antioxidants n moisturize facial skin. Purpose: To determine the effectiveness of 20% Moringa leaf (Moringa oleifera) peel-off mask on facial skin moisture. Methods: This research is a double-blind quasi-experimental method with a pre-post design. The sample used in this research is workers and students in the Tadulako University area. Result: Based on the Friedman test, the use of 20% concentration moringa leaf extract peel-off mask for improving skin moisture was not significantthe positive control and treatment, and dercreasing insignificantly in negative control groups (with p values of 0.484, 0.538 and 0.981, respectively). Based on the Wilcoxon test, it was found that thesults of skin moisture were not significant in the positive control, treatment and negative control groups from week 0 to week 2 (p= 0.301, p= 0.675, 0.916), week 2 to week 4 (p= 0.806, p= 0.53, p= 0.441), and week 0 to week 4 (p= 0.889, p= 0.529, p= 0.694). Conclusion: The 20% moringa leaf extract peel-off facial mask has potential effect to improve facial skin moisture, but not significant. The effect of 20% moringa leaf extract peel-off facial mask on facial moisture is still need to be investigated more.

The Impact of Xerosis Cutis Severity on Quality of Life of Elderly

2024-08-15T03:56:37+07:00

Background: Xerosis cutis occurs more frequently in elderly. This disease is associated with reduced quality of life. This study aimed to determine the impact of xerosis cutis severity on elderly patients' quality of life. Methods: The goal of this cross-sectional observational analytical study was to analyze the impact of xerosis cutis severity on the quality of life of elderly patients. The study was conducted at the outpatient unit clinic of Dermatovenereology Department, Dr. Soetomo General Hospital, Surabaya, Indonesia. This study included a total of 36 elderly patients. We assessed the severity of Xerosis cutis using the Xerosimeter score, and evaluated the quality of life using the Dermatology Life Quality Index (DLQI). Result: The majority of elderly patients with xerosis cutis had moderate severity with 22 patients (61.10%) and reported a moderate impact on quality of life with 17 patients (47.20%). The severity of xerosis cutis was also significantly correlated with quality of life (P<0.000). Conclusion: There is a significant, directly proportional relationship between the severity of xerosis cutis and quality of life, with the severity having a greater impact on quality of life.

The Role of Health Education on the Level of Knowledge of Contact Dermatitis in the Elderly

2024-09-12T13:26:38+07:00

Background: Contact dermatitis is a skin condition resulting from exposure to external substances that provoke allergic or irritant reactions. Individuals aged 60 and older are particularly susceptible to this condition due to the physiological changes in their skin accompanying aging. Purpose: To analyze the role of education regarding contact dermatitis in the elderly. Methods: The sampling technique used in this study is a total sampling technique using the pre-experimental one-group method, and presented the results in an analytical descriptive format. Result: The study demonstrated a significant impact of the educational intervention on contact dermatitis regarding the knowledge levels of the research subjects. Analysis using the Wilcoxon test revealed a significance value of 0.001 (p < 0.05). This finding indicates that the educational intervention resulted in a notable improvement in knowledge from before to after it. Conclusion: There is a significant impact of the educational intervention on the knowledge levels of the elderly, as observed before and after the intervention.

The Relationship of Over the Counter (OTC) Facial Soap Usage and Acne Risk in Sebelas Maret University Medical Students

2024-09-19T14:56:53+07:00

Background: Acne vulgaris (AV) is a common inflammatory skin disorder among young adults. The use of over-the-counter (OTC) facial soap is a common practice for managing AV, but the impact of its frequency on acne severity remains unclear. Purpose: This study aims to determine the relationship between the frequency of OTC facial soap usage and the severity of acne vulgaris among medical students at Sebelas Maret University. Methods: This observational analytical study utilized a cross-sectional approach and involved 57 medical students at Sebelas Maret University. The questionnaire focused on the frequency of OTC face wash usage among participants. Data were analyzed using Chi-square tests and Spearman-Pearson correlation methods. Result: There is a significant relationship (p = 0.089) between the frequency of OTC face wash usage and the risk of acne vulgaris, with a weak negative correlation (r = -0.226, p = 0.092). This study set a significance level of 0.1, higher than the conventional 0.05, which limits the generalizability of the results. This decision was made to balance the accuracy of the findings with the available resource constraints. Conclusion: There’s a significant correlation between OTC facial soap usage and acne risk in Sebelas Maret University medical students, with more frequent use linked to reduced acne severity.

The Relationship between The Level of Knowledge and Stigma Towards Leprosy Patients among Healthcare Workers

2024-07-09T03:36:21+07:00

Background: Leprosy is currently one of the most common health problems in the world. Because leprosy is contagious and chronic, most people fear those who suffer from it, and leading to mindless creation of various negative stigmas. Purpose: This research aimed to determine the relationship between the level of knowledge and the stigma towards leprosy. Methods: This study used an analytical observational design with a cross-sectional approach, conducted from January to March 2024 at Pungging Health Community Center, Mojokerto Regency, East Java, Indonesia, using the total sampling method. We collected the data for this study using a questionnaire that included questions relevant to the variables under investigation. Processing and analyzing data used Microsoft Office Word 2019, Microsoft Office Excel 2019, and IBM SPSS Statistic 26. We used bivariate analysis the Spearman statistical test to determine the relationship between the dependent and independent variables. Result: Health workers with sufficient knowledge had the highest good stigma presentation (14%), and there is a significant relationship between the level of healthcare workers' knowledge of leprosy and stigma towards leprosy patients (p=0.025). Conclusion: A significant correlation exists between healthcare workers' understanding of the stigma associated with leprosy. To reach the program's target, health workers need additional training about leprosy to eliminate the negative stigma of healthcare workers towards leprosy.

The Relationship between the Severity of Atopic Dermatitis and Sleep Quality in Widya Mandala Surabaya Catholic University Teaching Hospital Patients

2024-07-01T08:23:00+07:00

Background: Atopic dermatitis is a chronic inflammatory skin disease that commonly begins during childhood. Most atopic dermatitis patients may experience symptoms that continue into adulthood. Itching is the characteristic symptom of atopic dermatitis. Over time, patients’ itching can lead to sleep disturbances. In fact, every human being requires sleep to maintain the balance of metabolism, calories, temperature, and immunity. If a person often lacks sleep, the risk of obesity, type 2 diabetes mellitus, hypertension, heart disease, stroke, deterioration of mental health, and premature death will increase. Purpose: To analyze the relationship between the severity of atopic dermatitis and sleep quality in Widya Mandala Surabaya Catholic University (WMSCU) teaching hospital patients. Methods: This is an analytic study with a cross-sectional research design. This study used the purposive sampling technique as its sampling method. A dermatologist used the Eczema Area and Severity Index (EASI) instrument, to assess the severity of atopic dermatitis in the samples, and Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess their sleep quality. Result: The Mann-Whitney test showed a p value of 0.348 (p> 0.05). Conclusion: There is no significant relationship between the severity of atopic dermatitis and sleep quality in WMSCU teaching hospital patients.

Water Maceration of Black Mahlab Effectively Inhibits the Growth of Staphylococcus aureus Associated with Skin Infections

2024-07-09T05:13:36+07:00

Background: With the rising risk of antibiotic resistance, our ability to combat Staphylococcus aureus (S. aureus) in skin and soft tissue infections (SSTIs) is being compromised. Purpose: This study aimed to determine the activity of several aqueous extracts of black mahlab seeds (maceration, infusion, and decoction) against S. aureus-associated SSTIs. Methods: We employed the disc diffusion Kirby-Bauer method to evaluate the anti-staphylococcal activity of the extracts. Furthermore, we used various extract concentrations to calculate each extract's minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) against S. aureus. Result: The results revealed enhanced anti-staphylococcal activity, with inhibition zones measuring 11.5, 22.5, and 26.5 mm at concentrations of 25, 50, and 100 mg/ml, respectively. These effects were similar to ampicillin against S. aureus and significantly higher (p 0.05) than gentamicin. The extracts showed antibacterial activity with MICs and MBCs ranging from 12.5 to 25 mg/ml. Conclusion: Overall, compared to the clinically prescribed antibiotics, ampicillin, and gentamicin, black mahlab seed extract obtained by water maceration exhibits increased anti-staphylococcal activity associated with SSTIs.