Berkala Ilmu Kesehatan Kulit dan Kelamin

A Rare Self-Limiting Adamantiades Behcet Diseasen in A Woman: A Case Report

Farah Meriana Fajrin — 2024-03-31

Background: Adamantiades–Behçet is a genetically determined disorder with a probable environmental triggering factor and is an inflammatory disease representing vasculitis. Chronic relapsing progressive course, Dapson prevents problems in other organs. Case Report: A 31-year-old woman with chief complaints of a progressive painful ulcer on her genitalia in the last month, covered by pus and with a bad odor, and also recurrent tongue sores that healed spontaneously. Multiple partner sexual intercourse, joint pain, and an eye complaint were denied. Her husband has no history of previous sexually transmitted diseases. The labia majora region showed a solitary ulcer, sharply marginated, and covered with pus. The Haemophilus ducreyi, pathergy, VDRL, TPHA, and rapid test HIV all came back negative. Enterococcus faecalis, found in bacterial culture, is sensitive to Penicillin and glycopeptide. Histopathologically recited vasculitis with thrombus in the blood vessel marks Behcet disease. The patient was given Mefenamic Acid (3x500mg), doxycicline (2x100 mg), and a wet dressing. The ulcer decreased in size after 3 weeks of treatment. Discussion: Adamantiades-Behçett disease is characterized by chronic, recurrent oral aphthous ulcers, genital ulcers, skin lesions, ocular lesions, and arthritis or arthropathy. Viral and bacterial infections have been implicated in initiating immunopathologic pathways. The pathergy test is pathognomonic, but it is not specific and often gives a negative result. Histopathological examination is still the best option to establish the diagnosis.

Epigenetic Alterations in Keloid a Possible Method to Find Novel Agents for Keloid Treatment

Arief Budiyanto Budiyanto — 2024-03-31

Background: Keloids are dermal fibro-proliferative disorders due to prolonged wound healing processes with excessive collagen depositions, which produce symptoms of itching and pain, cosmetic disfigurement, and limitation of joint motion. Standard treatment for keloid has not been accepted yet. It may be due to the complexities and poorly understood keloid development that are driven by various factors from systemic to local, genetic to epigenetic. Since genetic factors are difficult to manipulate, an approach to epigenetic factors may be hopeful. Purpose: To review various related reports on epigenetic factors such as DNA methylations, histone modifications, and micro-RNAs, which have significant roles in keloid development and can be used as targets for novel agents in keloid treatment. Review: Various genes in keloid fibroblasts (KFs) are repressed by DNA methylation, and one of them can inhibit the regulation of TGF-β1/Smad signaling, whereas another gene may influence anti-fibrotic events. Either inhibitor of methyl-transferase, inhibitor of histone-acetyltransferase, or histone-deacetylase can reduce TGF-β1/Smad signaling in KFs. Abnormal expressions of pro-fibrotic miRNAs have been identified in KFs and transfection KFs with anti-fibrotic miRNAs such as miRNA-205 and miRNA- 31, evidently can inhibit VEGF signaling. Furthermore, transfection of miRNA-637 into KFs can inhibit KFs in proliferation, migration, and collagen synthesis through TGF-β1/Smad signaling. Apoptosis and cellular senescence in KFs can also be stimulated by miRA-34 and miRNA-30. Conclusion: In the future, targets in epigenetic events such as inhibitors of methyl-transferase, histone-acetyltransferases, and histone-deacetylases, together with various miRNA, may be applied as novel agents for the treatment of keloid.

Zoliflodacin, A Novel Antimirobial Agent Against neisseria Gonorhoeae: A Systematic Rreview of Quasi-Experimental Studies

Franklind Matthew — 2024-03-31

Background: The gram-negative bacteria Neisseria gonorrhoeae is the source of the STI known as gonorrhea. N. gonorrhoeae can adapt well to humans as a host and become a pathogen with sophisticated mechanisms to avoid the innate immune response as well as suppress the adaptive immune response. Lately, zoliflodacin was shown to have antibacterial activity against N. gonorrhoeae. Purpose: The aim of this study is to evaluate the antibacterial activity of zoliflodacin against N. gonorrhoeae. Methods: We followed the PRISMA 2020 guidelines to systematically search and collect literature in the following databases: ProQuest, EBSCOhost, PubMed, ScienceDirect, Taylor&Francis, SAGE, JSTOR, and Wiley, without time limitation (until October 9^th, 2022). Titles and abstracts were reviewed for relevance. The inclusion criteria were original article written in English that investigated the effects of zoliflodacin in patients with gonorrhea. From 177 studies, we retrieved five studies for this study, published between 2015 and 2021. Results: Zoliflodacin was highly active in vitro against N. gonorrhoeae isolates from European countries, China, Thailand, and South Africa, and also showed potent antimicrobial activity against multi-resistant N. gonorrhoeae isolates in South Korea. There were three different kinds of minimum inhibitory concentration (MIC) evaluated, with the following results: modal MIC (0.064-0.25 μg/mL), MIC50 (0.03-0.125 μg/mL), and MIC90 (0.06-0.25 μg/mL). There was no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment. This MIC range could be used for further studies.

Comparison of Acne Degree among Users of Disposable and KN95 Masks

Andi Nur Asrinawaty — 2024-03-31

Background: Maskne is a variant of acne that arises from wearing a mask. One factor that influences the incidence of maskne is the type of mask. Purpose: To compare the degree of acne vulgaris in disposable and KN95 mask wearers. Methods: This research was a cross-sectional descriptive study. The sample used was 444 people with acne vulgaris due to the use of disposable and KN95 masks. Acne vulgaris is classified based on the degree of acne. Data were analyzed bivariately using the Chi-square test. Result: This study shows no significant difference between the type of mask and the incidence of acne vulgaris (p = 0.70,p> 0.05). Conclusion: There is no difference in the degree of acne vulgaris in the incidence of maskne in individuals wearing disposable and KN95 masks.

Concordance Test Between Dermoscopic and Histopathological Parameteres in Basal Cell Carcinoma

Felix Hartanto — 2024-03-31

Background: Basal cell carcinoma (BCC) is the most common skin cancer and can cause local tissue damage. BCC can occur in all populations, regardless of skin color. Dermoscopy has compatibility with histopathology in determining the benign or malignant nature of a lesion. Dermoscopy can improve the diagnostic accuracy of BCC by >90%, with 7 parameters that can be found: arborizing vessels, blue-gray ovoid nests, blue-gray dots/globules, maple leaf-like areas, spoke-wheel areas, ulceration, and hiny white areas. Purpose: To assess the compatibility of each dermoscopy parameter with its corresponding histopathological parameters. Methods: Observational analytic study with a cross-sectional approach was performed. Dermoscopy parameters were obtained by reassessing all photographs, while histopathological parameters were obtained from pre-existing slide reviews. Cohen's Kappa test was performed to analyze both variables. Result: A Total of 26 samples met the inclusion criteria. Most BCCs were found in female sex (65.4%), age >50 years (80.8%), and facial location (88.5%). Cohen's Kappa test was significant in 2 out of 7 dermoscopy parameters: "blue-gray ovoid nests" (p = 0.0019; r = 0.458) and "spoke wheel areas" (p = 0.037; r = 0.371). The “shiny white areas” parameter could not be analyzed because there was no negative variation in the examination. The possibility of false positives and negatives could not be ruled out. Conclusion: Significance between the two variables is found in 28.6% of the 7 parameters analyzed...

Clinical Manifestations and Distribution of Treatment for Pyoderma at a Tertiary Hospital in Surabaya, Indonesia

Arsya Auliya — 2024-03-31

Background: Pyoderma is a skin disease caused by infection with Gram-positive bacteria. In Indonesia, this disease has a high prevalence due to inadequate sanitation, climate condition, humidity, and high population density. Patients with pyoderma present in diverse range of symptoms, in the form of clinical manifestation or systemic symptoms. Inadequate management of pyoderma can lead to an escalation in morbidity rates. Therefore, it is important to conducting comprehensive research about clinical profile of pyoderma patients. Purpose: To describe the profile of pyoderma patients in Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Acdemic Hospital Surabaya in January 2016 to December 2018. Methods: This study is a retrospective descriptive analysis using secondary data derived from medical records at Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Academic Hospital Surabaya. Result: The analysis of pyoderma patient at Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Academic Hospital Surabaya in January 2016 to December 2018 reveals a total of 407 patients, predominantly male and the most age category were toddlers. Most clinical diagnosis were furuncles and carbuncles. Among the clinical manifestations, macula was the most frequent primary skin lesion, while erosion predominated among secondary lesions. The most commonly administered therapies were systemic and topical antibiotics. Conclusion: In the period from January 2016 to December 2018, clinical manifestations of pyoderma patients at the Dermatology and Venereology Outpatient Unit of Dr. Soeto...

Description of Hanifin-Rajka Criteria and Skin Hydration in Adult Patients with Mild-Moderate Atopic Dermatitis at Tertiary Hospital

Menul Ayu Umborowati — 2024-03-31

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that typically manifests in childhood and has a diverse etiology. In the United States, the prevalence of AD among adults was 4.9%, while in Japan it was 2.1%. The majority of people with AD have dry skin. Hanifin-Rajka criteria were the first to be established and are frequently used as diagnostic standards in research. Purpose: The purpose of this study is to determine the Hanifin-Rajka criteria and skin hydration in adult patients with mild-moderate atopic dermatitis at Dr. Soetomo General Academic Hospital, Surabaya March-May 2022. Methods: This cross-sectional descriptive study included adult patients with mild to moderate AD according to Hanifin-Rajka aged 18-64 years who visited the Dermatology and Venereology Outpatient Dr. Soetomo General Academic Hospital Surabaya between March and May 2022. Skin hydration was measured using a corneometer on the volar side of the left forearm in the skin area. Result: Based on the major criteria, all participants had pruritus, typical morphology and distribution, and chronic or chronically recurrent dermatitis. As for the minor criteria, more varied results were obtained, one of which was xerosis, which was experienced by all participants. The skin hydration shows that the mean value for skin hydration was 39.8 ± 12.1. The lowest skin hydration was 21.4 and the highest was 87.4, both found in subjects with mild AD. Conclusion: ..

Profile of Mild Acne Vulgaris Patients at Tertiary Hospital at Surabaya, Indonesia

Alvian Arifin Saiboo — 2024-03-31

Background: One of the most prevalent skin conditions worldwide is acne vulgaris (AV). Even mild forms of AV could have an adverse impact on psychological wellbeing. Purpose: To explore the profile of mild AV patients in a tertiary care facility in Surabaya, Indonesia. Method: This was a descriptive study conducted for eight weeks. Data regarding the patient's identity, history, skin type, and complaints related to AV or other complaints that arose were noted on the sample’s medical record and collected for analysis. The Lehmann classification was used to assess the AV degree. Result: A total of 34 patients were included. Gender equality was similar in our study, and late adolescence (17-25 years) is the most dominant age group (73.5%). Genetics plays the biggest precipitating factor (73.5%), followed by stress (70.6%). Most patients had an oily skin type (91.2%) with Fitzpatrick’s phototype 4 (85.3%). Comedone is the most prevalent lesion in our study (median = 10, range = 4-20). Conclusion: Most patients with mild AV had an oily skin type, and late adolescent is most dominant age group.

Profile of Atopic Dermatitis at Dermatovenereology Outpatient Clinic at Tertiary Hospital in Surabaya, Indonesia

Alisha Princessa Brahmana — 2024-03-31

Background: Atopic dermatitis (AD) is a pruritic skin condition with erythema, lichenified patches, and excoriations from scratching the skin and often affect the patient's quality of life. Patient history and clinical manifestations are key elements in various diagnostic criteria. Therefore, it is important to know clinical profile of AD patients. Purpose: To describe profile of patients with AD at Dermatovenereology Outpatient Clinic Dr. Soetomo General Academic Hospital Surabaya in 2019-2021. Methods: This study is a retrospective descriptive study using secondary data from the patients' medical records at Dermatovenereology Outpatient Clinic Dr. Soetomo General Academic Hospital Surabaya in 2019-2021. Result: New AD patients in total were 89 patients, dominated by female (53.9%) in age group 2-12 years (37.1%). The most common complaint was itching (83.1%) and trigger factor was unknown (43.8%). Most patients had previous history of atopy (52.8%) and did not know about their family history of atopy (37%). The most common lesion efflorescence was erythematous macule (59.6%) and located on inferior extremity (43.8%). The most frequent systemic therapy was Cetirizine (71.9%) and topical therapy was hypoallergenic emollient (42.7%). Conclusion: Most of AD patients are female in the 2-12 year age group, come with the complaint of itching and do not know the trigger factor, they mostly had previous history of atopy, but they mostly do not know about their family history of atopy, the most common lesion efflorescence are erythematous macules and the location on inferior extremity with the most given therapy are Cetirizine and hypoallergenic emollient.

The Burden of Leprosy Reaction in the Post-Elimination Era: A Study from Gresik City, Indonesia

Hapsari Kinanti — 2024-03-31

Background: The attention of leprosy management has shifted to reduce the burden of leprosy complications, including leprosy reactions. Leprosy reaction is the predominant cause of nerve impairment that leads to disability and lowers the quality of life of the affected. Purpose: The aim of this study was to provide primary data about leprosy reaction epidemiology, risk factor, and outcomes in the post-elimination era. Methods: A cross-sectional study was held in a general hospital in Gresik City, Indonesia, to give clinical demography, risk factors, and outcomes of leprosy reaction. Result: New leprosy reaction cases remain detected each year. There were 57 (58.8%) out of 97 leprosy patients who had a reactional episode. The incidence of leprosy reactions has been increasing in the last three years. The multibacillary (MB) group and type 2 reactions dominated leprosy reactions, which mostly occurred in the young adult population. Some of the leprosy reaction patients had developed a complication due to prolonged steroid usage. Conclusion: Leprosy cases in a young population with a high risk of developing reaction episodes need collaboration in the management to prevent deformity in youth.

The Association of Keloid Site with its Histopathological Features: an Analytical Observational Study

Wibisono Nugraha — 2024-03-31

Background: Keloid is a growth of fibrous tissue in the wound tissue of susceptible individuals. This tissue extends beyond the boundaries of the previous wound. The site of keloids commonly appears on a high-tension area, such as the chest, shoulders, and neck. Histopathologically keloids show thickened the epidermis and the vascularization and infiltration of inflammatory cells in the dermis. Purpose: This study aims to determine the relationship between the site of keloids and the histopathological appearance of keloids. Methods: An analytical observational study was conducted on keloid patients visiting the Dermatovenereology outpatient clinic of Dr.Moewardi Hospital. The sample collection used consecutive sampling techniques Result: The majority of keloid patients are >30 years old (46.4%). Most patients with keloids were female (53.6%). Keloids were mostly found on the chest (25.0%). Tounge-like appearance of the epidermis at the edges of the lesions was mostly on the shoulders and chest (33.3% each, p=0.048); flattened appearance was found on the middle epidermis of the lesions, which were mostly on the ears, shoulders, and upper extremities (22.7% each, p=0.011). Increased vascularity was found in the dermis at the edges of the lesions, especially in the ear and chest areas (31.3% each, p=0.046). Moderate-severe inflammatory infiltrates in the dermis at the edges of the lesions were commonly found on the chest (p=0.04). Conclusion: There is a significant relationship between the site of the lesion and the histopathological appearance of the keloid in epidermal as well as dermal layers.

The Association between Gender, Personal Hygiene Indicators, and Occupancy Density with the Incidence of Pediculosis Capitis at Madrasah Tsanawiyah Pondok Pesantren (Ponpes) Nurus Sunnah Semarang

Yusuf Ari Mashuri — 2024-03-31

Background: Pediculosis capitis is one of the neglected tropical diseases (NTDs) caused by Pediculus humanus capitis, an obligate ectoparasite that lives parasitically on human skin. This disease is most common in women, in people with poor personal hygiene, and in densely populated areas. Boarding schools are densely populated and pose a risk for transmission of pediculosis capitis due to the many interactions among residents. Purpose: This study aims to investigate the association between gender, personal hygiene indicators, and occupancy density with the incidence of pediculosis capitis at Madrasah Tsanawiyah Pondok Pesantren Nurus Sunnah Semarang. Methods: In this cross-sectional observational study, all the junior high school students at Ponpes Nurus Sunnah were included in a total of 49 subjects. The data were collected by filling out questionnaires, doing a direct examination of the hair, and counting the measurements of the room area. Data analysis was performed using SPSS 23.0 for Windows. Result: Pediculosis capitis infestation was found among 13 (26.5%) students, with a higher incidence in females (46.4%) than males (0%), in respondents with the habit of combing hair using a personal comb (37.1%), and in non-densely populated areas (58.8%). There was an association between gender (p=0.000), the habit of combing hair using a personal comb (p=0.006), and occupancy density (p=0.000) and the incidence of pediculosis capitis. Conclusion: Gender, the habit of combing hair using a personal comb, and occupancy density are associated with the incidence of pediculosis capitis...