Berkala Ilmu Kesehatan Kulit dan Kelamin

Dermoscopic Examination in Malassezia folliculitis

zahruddin ahmad, Evy Ervianti — Sun, 31 Jul 2022 00:00:00 +0700

Background: Malassezia folliculitis (MF) is the most common fungal folliculitis, and it is caused by yeast of the genus Malassezia. MF may be difficult to be distinguished clinically from acne and other types of folliculitis, causing misdiagnosis and improper treatment. Dermoscopy has been very useful to support the diagnosis of several types of folliculitis, including MF. Purpose: To know the role of dermoscopic examination in MF. Review: The diagnosis of MF can be identified by usual clinical presentation with direct microscopy and culture of the specimen, Wood's light examination, histopathological examination, and rapid efficacy of oral antifungal treatments. Several studies reported that dermoscopy provides a deeper level of the image that links the clinical morphology and the underlying histopathology. Some dermoscopic patterns are observed consistently with certain diseases, including MF, so these could be used for establishing their diagnosis. The dermoscopic features of MF seem to correlate with the current understanding of its etiopathogenesis. Conclusion: Dermoscopic examination in MF will reveal dermoscopic patterns including folliculocentric papule and pustules with surrounding erythema, dirty white perilesional scales, coiled/looped hairs with perifollicular erythema and scaling, hypopigmentation of involved hair follicles, and dotted vessels.

A Retrospective Study of Verruca

Sun, 31 Jul 2022 00:00:00 +0700

Background: Verruca (non genital warts) is a quite common public health problem caused by viral infection of low risk Human Papilloma Virus (HPV) types, risking patients of all backgrounds. There is still no ideal treatment for verruca with little knowledge regarding the effectiveness of the available therapies, which results in the lack of therapeutic standard for patients. Purpose: To evaluate the incidence, management, and effectiveness of verruca treatment. Methods: This was a descriptive, retrospective study with a cross-sectional design. All patients diagnosed with verruca in Tumor and Skin Surgery Division of the Dermatology and Venereology Outpatient Unit at Dr. Soetomo General Academic Hospital Surabaya between January 2016 and December 2020 were included in the study. Result: The results of this study obtained a total of 113 verruca patients, consisting of 61 (53.98%) male patients and 52 (46.01%) female patients, mostly aged 20-60 years old (45 patients [39.82%]). The upper extremity was the most common location where the lesion was found (39 patients [34.5%]). Electrosurgery was the most performed method (38 patients [33.6%]). Thirty-one patients who were treated and returned to the clinic at least once during the month were evaluated for the resolution of the lesion after undergoing therapy. Among 31 patients, resolution was reported in 35.5% of cases. Conclusion: Verruca is a common condition in general practice with many treatment options available yet often neglected. Knowing the available evidence for efficacy of those treatments is critical for dermatologist when considering treatment and educate patients.

Age and Nutritional Status as Factors Supporting Incidence of Atopic Dermatitis with Complications in Children: A Retrospective and Cross-Sectional Study

Khansa Raihani Rosmalika, Damayanti Damayanti, Azwin Mengindra Putera — Sun, 31 Jul 2022 00:00:00 +0700

Background: AD is a chronic, pruritic inflammatory skin disease that frequently occurs and common in infants and children. Purpose: This study aims to analyze the correlation of age, sex, nutritional status, and family history of atopy with the occurrence of AD complications in children. Methods: This study used a cross-sectional study design in pediatric AD patients aged 0-18 years. Data were collected from electronic medical records (EMR) of pediatric AD patients at the Dermatology Outpatient Clinic of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January to December 2019. The bivariate analysis in this study used the Chi-square test. The statistical test was significant, as indicated by p-value (p < 0.05). Result: Out of 80 eligible participants, a total of 53.75% of the participants were children aged 1-60 months, and 55% of total were female. In this study, 28.75% of participants had normal nutritional status. A total of 67.5% of patients had no family history of atopy. There was a significant relationship between age and nutritional status with the incidence of AD with complications (p=0.006 and 0.040), but no relation was found between sex and family history of atopy (p=0.444 and 0.644). Conclusion: Age and nutritional status have a correlation with the incidence of AD with complications.

Clinical and Cure Profile of Tinea Capitis Patients

Farah Ayu Noviannisa, Linda Astari, Lindawati Alimsardjono — Sun, 31 Jul 2022 00:00:00 +0700

Background: Tinea capitis (TC) is a superficial mycoses infection of hair follicles and hair shaft caused by dermatophytes of the genus Trichophyton and Microsporum. Tinea capitis can cause hair loss and scales with varying degrees of inflammatory response. The incidence varies depending on geographical location and factors that affect the incidence rate. It is important to know the incidence also the clinical and cure profile of tinea capitis to provide benefits in the prevention, diagnosis, and treatment. Purpose: To evaluate the clinical and cure profile of TC patients at the Dermatology and Venereology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya from January 2019 to January 2020. Methods: A retrospective descriptive study based on medical records with a total sampling technique. Result: Of the 10 TC patients, who were the research subjects, TC predominantly affected males and at 5–11 years age group. The highest risk factor was a history of contact with cats. Scales were the most common clinical feature. Microsporum canis was the most common causative species, ectothrix arthrospores was revealed during the direct microscopic examination, Wood lamp's fluorescence was mostly yellow-green, and cigarette-shaped hair was the most common dermoscopic finding. Eighty percent of subjects were diagnosed with gray patch type. Conclusion: The diagnosis of TC was established based on the patient's history, clinical examination, and supporting examination.

Hand Eczema in Nurses in COVID-19 Treatment Room: Frequency of Handwashing, Hand Sanitizer, Moisturizer, and Duration of Latex Gloves Use

Sun, 31 Jul 2022 00:00:00 +0700

Background: The COVID-19 pandemic causes health workers to use level 2 and level 3 personal protective equipment. Hand washing and the use of latex gloves are important in limiting the spread of COVID-19, but they can potentially induce hand eczema and skin pH disturbance if used too frequently. Purpose: Determine the correlation between the frequency of handwashing and duration of using hand sanitizer and moisturizer as well as skin pH level on the incidence of hand eczema in nurses in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta. Methods: This cross-sectional study was conducted in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta with 90 nurses as subjects. A validated questionnaire carried out the frequency of handwashing, hand sanitizer, moisturizer, duration of using latex gloves, and hand eczema complaints. The subject's pH assessment was conducted after 4-5 hours in the COVID-19 treatment room. Data were analyzed bivariately with a Spearman rank correlation test. Result: There was a significant correlation with the incidence of hand eczema with the frequency of handwashing with soap (r=0.305 and p=0.003) and the duration of using latex gloves (r=0.328 and p=0.002) with a weak category correlation (r=0.200-0.399). The frequency of using hand sanitizer, moisturizer, and skin pH did not correlate with the incidence of hand eczema. Conclusion: Frequency of handwashing and the duration of using latex gloves correlated with the incidence of hand eczema, meanwhile frequency of using hand sanitizer, using moisturizer, and skin pH didn't correlate with the incidence of hand eczema.

Narrowband Ultraviolet B (NB-UVB) Phototherapy in Psoriasis: A Retrospective Study

Faida Ufaira Prameswari, Cita Rosita Sigit Prakoeswa, Widiana Ferriastuti — Sun, 31 Jul 2022 00:00:00 +0700

Background: Psoriasis with higher Psoriasis Area and Severity Index (PASI) scores correlate with impaired quality of life. Assessing narrowband ultraviolet B (NB-UVB) phototherapy as a new therapy option in Indonesia is necessary to find the most effective treatment for psoriasis patients. Purpose: To determine the usage of NB-UVB phototherapy and the therapy response in psoriasis patients. Methods: This retrospective descriptive observational study was conducted at Dr. Soetomo General Academic Hospital Surabaya in March 2019-November 2020. The variables were collected through medical records. Result: A total of 28 patients were obtained at this study. Psoriasis type plaque/vulgaris were found in 92.9% of the patients. The patients mostly started with PASI score >10 with the initial dose of NB-UVB phototherapy is 260 mJ/cm². The most common initial phototherapy frequency is 3 times per week (53.6%). The latest dose and frequency distribution was varied in each subject. The mean total number of sessions was 31.54 ± 20.549. Patients were also administered various combination therapy. The majority of patients had missed NB-UVB phototherapy sessions and the phototherapy dose needed to be reduced (57.1%). The achievement of PASI-75 (treatment success) was mostly achieved by subjects that went through 40-60 sessions of phototherapy and subjects with psoriasis type plaque/vulgaris. Conclusion: The achievement of PASI-75 was found to be low (17.5%), influenced by multiple factors such as the total number of NB-UVB phototherapy sessions, combination therapy, dose of NB-UVB phototherapy, frequency of NB-UVB phototherapy, and the level of patient compliance to therapy.

Profile of Disability in Leprosy Patients: A Retrospective Study

Sun, 31 Jul 2022 00:00:00 +0700

Background: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that affects peripheral nerves and skin. The interaction between M. leprae and Schwann cells causes irreversible damage to peripheral nervous tissue afterward disability occurs. Involvement of the major nervous trunks of the extremities can produce sensory-motor deficits. The risk factors are delay in diagnosis, gender, age, type of leprosy, duration of disease, number of affected nerves, leprosy reaction, type of treatment, socioeconomic factors, education, ethnicity, and occupation. Purpose: The aim was to study the profile of leprosy patients with disability who seek treatment in Leprosy Division Dermatovenerology Outpatient Clinic RSUD Dr. Soetomo Surabaya. Methods: This was a descriptive retrospective study of leprosy patients with disability from January 2017 to December 2019. Result: The results of this study obtained a total of 275 leprosy patients with disabilities, which consisted of 76 patients (27.6%) with grade-1 disability and 199 patients (72.4%) with grade-2 disability. The majority were male (73.4%) and aged 25-44 years old (42.2%). Other dominant risk factors were MB type leprosy (92%), duration of disease more than 12 months (52.3%), no leprosy reaction (68%), and had received multidrug therapy (45.5%). Conclusion: Knowledge of disability risk factors can assist in improving management and education to prevent disability in leprosy patients.

Risk Factors of Syphilis and HIV/AIDS Coinfection

Sun, 31 Jul 2022 00:00:00 +0700

Background: Syphilis infection and HIV are major health problems worldwide. Both of these diseases can be transmitted through sexual contact, so often a person suffers from both diseases at the same time. Purpose: To describe the risk factors of syphilis and HIV/AIDS coinfection in the Infectious Disease Intermediate Treatment Unit (UPIPI) inpatient and outpatient ward of Dr. Soetomo General Academic Hospital in 2019. Methods: The study design used in this study is a retrospective descriptive study aimed at evaluating sexual and non-sexual factors that cause syphilis and HIV coinfection. The research population was patients in the inpatient and outpatient rooms of UPIPI RSUD Dr. Soetomo Surabaya for the January-December 2019 period. The sampling technique was sourced from secondary data, namely medical record data from the inpatient and outpatient rooms of UPIPI RSUD Dr. Soetomo Surabaya for the period January-December 2019. The data in this study were obtained from medical records and patient biodata. Result: Based on the calculation results, it is known that age group (P=0.022>0.05), and gender (P=0.024>0.05) had no effect on the risk of syphilis and HIV coinfection, while marital status (P=0.048<0.05), sexual orientation (P=0.048<0.05), transmission model (P=0.044<0.05), and type of work (P=0.046<0.05fected the risk of syphilis and HIV coinfection. Conclusion: People with HIV/AIDS are expected to be active in participating in programs that are needed by patients, such as antiretroviral (ARV) therapy assistance programs and counseling that will prolong the quality of life in various aspects of life, both physical, psychological and social aspects.

The Epidemiologic and Sociodemographic Features of Superficial Fungal Infection Among Children in East Java Suburban Public Hospital

Flora Ramona Sigit Prakoeswa, Ratih Pramuningtyas, Rully Setia Agus Dimawan — Sun, 31 Jul 2022 00:00:00 +0700

Background: Superficial fungal infection is a common skin disease among children, causing morbidity and reducing quality of life. The disease's prevalence and etiological agents change with geographic area, age, humidity, and sex. The data on this matter is still limited in Indonesia. Purpose: To determine the current epidemiologic and sociodemographic features of superficial fungal infection among children. Methods: This descriptive study examined all the pediatric inpatients and outpatients at the Department of Dermatology and Venerology of East Java suburban Public Hospital in Indonesia from 2016 to 2020 who met the inclusion criteria. Result: From 2016 to 2020, the number of fungal infection patients was 12.3% (n = 175) among 1,427 dermatology patients. Pityriasis versicolor (PVC) is the most common fungal skin disease (4.1%), followed by tinea capitis (2.2%), tinea cruris (1.6%), and tinea corporis (1.4%). Subjects aged 6 to 12 years old were the most likely to be infected with a fungus. Boys were more likely to develop this infection. Conclusion: From 2017 to 2020, there was a downward trend in children's superficial fungal infections. Pityriasis versicolor (PVC) is a fungal skin ailment that cause the most cases compared to other fungal infections. Boys and children between the ages of 6 to 12 years old were the most susceptible to fungal infection.

The Relationship between Hygiene Behaviour and Acne Vulgaris Incidence in Medical Students Sebelas Maret University

Jasmine Rahmi Hapsari, Alamanda Murasmita, Suci Widhiati, Arie Kusumawardani — Sun, 31 Jul 2022 00:00:00 +0700

Background: Hygiene behaviour is a person's actions in maintaining cleanliness to prevent the spread of infectious disease by cutting off the transmission of microorganisms that cause infection both in the community and in the health service. Various diseases caused by poor hygiene behaviour are diarrhea, dengue fever, leptospirosis, acute respiratory tract infections, typhoid fever, and various skin infections. One of the infectious skin diseases that affects almost the entire population is acne vulgaris. It is the highest disease prevalence worldwide and ranked 8th with 645.499.139 sufferers. Purpose: To determine the relationship between hygiene behaviour and acne vulgaris incidence in medical students at Sebelas Maret University. Methods: This study was an observational analytical study with a cross-sectional approach. This study was conducted on 45 male medical students at Sebelas Maret University. The questionnaire used was Hygiene Inventory (HI23). Data were analyzed using Fisher's Exact correlation test. Result: There is no relationship (p = 0.720) between hygiene behaviour and acne vulgaris incidence in medical students of the Sebelas Maret University. Conclusion: Hygiene behaviour has no relationship with acne vulgaris incidence in medical students at Sebelas Maret University.

A Rare Case of Orbital Cellulitis with Tolosa-Hunt Syndrome Caused by Methicillin-Resistant Staphylococcus aureus (MRSA): a Case Report

Sun, 31 Jul 2022 00:00:00 +0700

Background: Orbital cellulitis is an active infection of the orbital soft tissue posterior to the orbital septum, which can cause Tolosa-Hunt Syndrome (THS) complication. Purpose: We reported a child with orbital cellulitis with THS complication caused by methicillin-resistant Staphylococcus aureus (MRSA). Case: A two-year-old girl complained of swelling and pain in the left eye accompanied by fever. In nasal region and left eye showed multiple erythema patches with geographic shape, size 1x2cm - 4x5cm, unclear border, erosion with sizes 0.5x1cm - 1x1.5 cm size covered with blackish crusts. After several days of hospitalization, she complained of proptosis and pain in moving her eye. We did the magnetic resonance imaging (MRI) scan examination, which showed a mass size of 2.2 x1.1 x 0.9 cm in a left intraconal orbital and dilation of the left-sided cavernous sinus. The blood culture showed MRSA bacteria. She was diagnosed with orbital cellulitis with THS complication and showed a good response with Meropenem, Methylprednisolone, cendo lyteers eye drops, levofloxacin eye drops, and gentamicin eye ointment. Discussion: Orbital cellulitis presents as ill-defined erythema, edema, warmth, and pain around the nasal and the orbital region and is more often found in children. The THS complication is characterized by ophthalmoplegia, unilateral orbital or periorbital pain, unilateral headache, and leukocytosis. Orbital cellulitis management includes antibiotic intravenous, corticosteroid, and eye care. Conclusion: THS is a rare complication of orbital cellulitis. Early diagnosis and management of orbital cellulitis are essential to prevent THS complication.

Mid-Borderline Leprosy with Mild Type 1 Reaction in Children: A Case Report

Anindia Indraswari, Muhammad Yulianto Listiawan — Sun, 31 Jul 2022 00:00:00 +0700

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Cases of leprosy in children are rarely found because of the long incubation period of Mycobacterium leprae. Purpose: To report a case of mid-borderline leprosy with a mild type 1 reaction in a seven-years-old girl patient. Case: A 7-years-old girl patient presented with multiple red and white patches on her face, body, arms, legs, and buttocks since 6 months before. There was no itching, numbness, painr fever. There was no thickening of peripheral nerves and no nerve function impairment. Her grandmother was suspected to have leprosy, but she had never been treated and had already passed away. From the acid fast bacilli (AFB) examination, the bacterial index (BI) was 1+ and the morphological index (MI) was 2%. A serologic test examination was also performed and the result were Immunoglobulin (Ig) G 3716 u/ml and IgG 284 u/ml. The patient got multidrugs therapy for 12 months and after 9 months of treatment, the pre-existing patches became erythematous, thickened, and felt pain when touched, but there was no fever. In the presence of pain, oral ibuprofen was then administered and the patches began to improveDiscussion: Due to the possibility of leprosy reaction, it is important to immediately give prompt treatment to children with type 1 leprosy reaction that is associated with neuritis and leads to deformities. Conclusion: Early diagnosis and therapy for a type 1 leprosy reaction are very important to prevent deformities.