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All Journal International Journal of Science and Society (IJSOC)
Redha Cipta Utama
Regional General Hospital of Gunung Tua, North Sumatera, Indonesia
Materials Science & Nanotechnology Social Sciences

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Self-Medication-Induced Exanthematous Drug Eruption in A 19-Year-Old Male with Uncomplicated Gonococcal Urethritis Ersi Dwi Utami Siregar; Redha Cipta Utama
International Journal of Science and Society Vol 8 No 1 (2026): International Journal of Science and Society (IJSOC)
Publisher : GoAcademica Research & Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54783/ijsoc.v8i1.1631

Abstract

Improper self-medication, especially with antibiotics, continues to be a major cause of skin reactions to drugs. Unprotected sexual activity in young adults elevates the risk of sexually transmitted infections, including gonococcal urethritis, which may be exacerbated by inappropriate antibiotic usage. A 19-year-old male presented with a two-day history of pruritic erythematous eruptions involving the trunk. The patient had self-administered cotrimoxazole 480 mg for purulent urethral discharge and dysuria prior to presentation. He reported his first sexual encounter with a commercial sex worker following peer influence, without condom, and disclosed a background of family instability. Dermatological examination revealed multiple erythematous macules on the chest, abdomen, and back. Venereological examination demonstrated mild erythema of the external urethral meatus with mucopurulent discharge. Microscopic examination of urethral secretions identified intracellular gram-negative diplococci. A diagnosis of exanthematous-type allergic drug eruption secondary to cotrimoxazole and non-complicated gonococcal urethritis was established. The patient was treated with a single intramuscular dose of ceftriaxone 250 mg, a single oral dose of azithromycin 1 g, and intravenous dexamethasone 5 mg three times daily for three days. Marked clinical improvement was observed after four days of hospitalization, with resolution of cutaneous lesions and negative follow-up urethral smear. This case underscores the dermatological and venereological consequences of antibiotic misuse in young adults and highlights the importance of early recognition of drug eruptions, appropriate antimicrobial therapy, and comprehensive sexual history assessment.
When Psoriasis Is Not Psoriasis: Tinea Incognito Induced by Long-Term Steroid Abuse Ersi Dwi Utami; Redha Cipta Utama
International Journal of Science and Society Vol 8 No 1 (2026): International Journal of Science and Society (IJSOC)
Publisher : GoAcademica Research & Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54783/ijsoc.v8i1.1644

Abstract

Background: Tinea incognito is a dermatophyte infection with atypical clinical features caused by inappropriate use of topical or systemic corticosteroids. It often mimics other dermatoses, particularly psoriasis, leading to delayed diagnosis and inappropriate management. Misuse of steroids may mask inflammation while allowing fungal proliferation and dissemination. Case Presentation: A 60-year-old male farmer presented with a two-week history of pruritic, thick, scaly erythematous plaques involving the chest, abdomen, back, and upper arms, accompanied by fever, myalgia, and malaise. Initially, the patient noticed mildly pruritic erythematous patches one month prior and self-treated with topical dexamethasone, resulting in temporary relief but progressive worsening. He also reported long-term oral dexamethasone use (0.5 mg daily for 10 years). Lesions evolved into widespread plaques with thick scales and pustules, clinically resembling pustular psoriasis. KOH examination of skin scrapings revealed long septate hyphae, confirming dermatophytosis, while Gram staining was negative for bacteria. Laboratory findings were unremarkable. The diagnosis of extensive tinea incognito with concurrent viral infection was established. The patient was treated with oral itraconazole (200 mg/day) and topical ketoconazole for four weeks, showing significant clinical improvement by the third week. Conclusion: This case highlights the importance of considering tinea incognito in steroid-modified dermatoses mimicking psoriasis. Early mycological examination is essential to avoid misdiagnosis and inappropriate steroid use. Rational antifungal therapy leads to favorable outcomes. Keywords: tinea incognito; corticosteroid abuse; psoriasis mimicry; dermatophytosis
Co-Authors Ersi Dwi Utami Ersi Dwi Utami Siregar