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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Berkala Ilmu Kesehatan Kulit dan Kelamin Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan JOURNAL LA MEDIHEALTICO eJournal Kedokteran Indonesia Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia Jurnal Kedokteran Meditek Indonesian Journal of Biomedicine and Clinical Sciences
Shannaz Nadia Yusharyahya
Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Herpes Zoster dengan Manifestasi Eritema Multiforme Bulosa pada Pasien Geriatri Imunokompromais: Laporan Kasus Halim, Dionisius Ivan Yonathan; Legiawati, Lili; Yusharyahya, Shannaz Nadia; Astriningrum, Rinadewi
Media Dermato-Venereologica Indonesiana Vol 52 No 2 (2025): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v52i2.531

Abstract

   Pendahuluan: Herpes zoster (HZ) merupakan sekumpulan gejala dan manifestasi klinis yang disebabkan oleh reaktivasi varicella-zoster virus (VZV). Faktor predisposisinya antara lain: usia lanjut, keadaan imunokompromi, obat imunosupresif, keganasan, stres psikologis, trauma, dan tindakan pembedahan. Manifestasinya bervariasi, namun manifestasi eritema multiforme (EM) bulosa jarang dilaporkan. Kasus: Seorang perempuan berusia 65 tahun mengeluhkan bercak gatal pada kedua lengan dan tungkai sejak 3 hari yang lalu. Pasien sedang menjalani kemoterapi atas indikasi kanker payudara metastasis tulang dengan multikomorbid. Pada pemeriksaan ditemukan lesi target tipikal EM yang beberapa berkembang menjadi EM bulosa. Terdapat riwayat demam. Pasien ditatalaksana dengan kortikosteroid serta terapi simptomatik. Satu minggu kemudian ditemukan lenting berkelompok di lengan kiri atas sampai ke leher kiri sesuai dermatom C4 dan C7 yang disertai rasa nyeri dan terbakar. Kortikosteroid dihentikan dan diobati dengan valasiklovir 3 x 1000 mg selama 10 hari dan terapi simptomatik. Setelah 2 minggu terdapat perbaikan klinis dan gejala. Diskusi: Kasus HZ aberans dengan manifestasi EM bulosa dapat terjadi pada individu dengan komorbid dan keadaan imunokompromi. Pada pasien ini terdapat usia lanjut riwayat kanker payudara, obat kemoterapi, serta komplikasi infeksi sekunder pasca tindakan pembedahan. Manifestasi HZ mirip dengan EM minor karena ditemukannya lesi target tipikal pada kedua ekstremitas tanpa lesi mukosa. Perubahan perjalanan penyakit menjadi vesikel berkelompok sesuai dermatom, kemungkinan HZ aberans lebih dipertimbangkan. Kesimpulan: Herpes zoster dapat menimbulkan manifestasi EM. Terapi dengan obat antiviral menunjukkan perbaikan baik klinis maupun gejala. Kemungkinan manifestasi EM pada HZ harus dipertimbangkan untuk diagnosis dini dan tatalaksana efektif.
Characteristics of pressure injuries among geriatric patients at an Indonesian tertiary hospital: a cross-sectional study Yusharyahya, Shannaz Nadia; Legiawati, Lili; Astriningrum, Rinadewi; Jonlean, Reganedgary; Andhira, Vega
Medical Journal of Indonesia Vol. 32 No. 3 (2023): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.237092

Abstract

BACKGROUND Pressure injury develops due to sustained pressure at the bony prominence of the skin and tissues. Geriatric patients often have multiple comorbidities, predisposing them to pressure injury. Data on the characteristics of the geriatric with pressure injuries are still limited. This study aimed to report the characteristics of geriatric patients with pressure injuries admitted at a tertiary hospital in Indonesia. METHODS This cross-sectional study used medical records of geriatric patients admitted with all stages of pressure injuries consulted to the Department of Dermatology and Venereology at a tertiary hospital in Indonesia between January 2017 and April 2021. Pressure injuries were classified based on the 2019 National Pressure Injury Advisory Panel guideline. RESULTS 39 patients presented with varied pressure injury characteristics. The sacral region was the most reported site (36%), with stage 2 pressure injury being the most commonly found stage in the patients (74%). Interestingly, 22% of the patients had pressure injuries found on the atypical sites due to prolonged surgery or the pressure of medical devices. More than half of the patients used conventional dressings (51.3%). Immobility was found in 35.9% of the patients due to being bedridden. CONCLUSIONS No characteristics were found as a significant risk factor for pressure injury formation during or outside the admission period. However, a history of surgery might be related to pressure injury formation during admission.
Herpes Zoster Reactivation Following COVID-19 mRNA Vaccination in an Elderly Patient: A Case Report Sarah, Ratu Siti Khadijah; Hapsari, Yari Castiliani; Yusharyahya, Shannaz Nadia; Miranda, Eliza; Edwar, Sarah Qanita
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Latent varicella-zoster virus (VZV) in nerve ganglia may reactivate into herpes zoster infection. The coronavirus disease (COVID-19) vaccine is suspected of triggering VZV reactivation, although the exact cause is unclear. This case report aims to raise awareness of the potential complications induced by the COVID-19 mRNA vaccine, particularly in elderly patients. Case Illustration: A 62-year-old woman complained of itchy and painful unilateral dermatomal herpetiform blisters six days after mRNA COVID-19 vaccination. The vesicle first appeared on the left breast, spreading to the back. The patient has a history of hypertension. After the administration of 800 mg of acyclovir five times a day for seven days, the vesicles dried up, and no new vesicles emerged. Discussion: The incidence of herpes zoster has been widely reported to occur within 5-7 days after the COVID-19 vaccination, mostly due to the mRNA vaccine. The dysregulated cell-mediated immune system may trigger VZV reactivation. The vaccines have been shown to induce a cellular response with increased CD8+ T-cells and T-helper type 1 CD4+ T cells. The VZV-specific CD8+ cells cannot control VZV after the massive shift of naïve CD8+ T-cells in the setting of COVID-19 vaccination. Hypertension is also allegedly the main comorbid factor for herpes zoster reactivation after COVID-19 vaccination. Conclusion: Increased awareness and early recognition of potential COVID-19 vaccine-related complications, especially in elderly individuals with comorbidities, are important for timely management and prevention of further issues.
Narrowband ultraviolet B phototherapy combined with topical treatment for vitiligo in 2 geriatric patients Astriningrum, Rinadewi; Legiawati, Lili; Chandrakesuma, Vivianne; Nadia, Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia – Dr. Ci
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Narrowband ultraviolet B (NB-UVB) become the mainstay of widespread vitiligo therapy due to its great efficacy and safety compared with other modalities. The use of NB-UVB for vitiligo has been widely studied in adult patients, while studies on geriatric patients specifically are still very limited. This report aims to show the immediate response after the initial treatment, side effects of therapy, and other problems that were encountered during therapy in two geriatric patients with vitiligo who have been followed up for more than 12 months. Case Illustration: We reported two geriatric patients with vitiligo treated with NB-UVB phototherapy combined with topical treatment for more than 12 months. The first patient was 68-year-old woman, with Fitzpatrick skin type IV, who had vitiligo on her face, both lower arms and hands, and both legs and feet. The second patient was a 61-year-old man with Fitzpatrick skin type IV who had generalized vitiligo. The first repigmentation occurred on the 5th session in the first patient and on the 6th session in the second patient, using a cumulative dose of 1223 mJ/cm2 and 1541 mJ/cm2, respectively. Discussion: After NB-UVB phototherapy, there was a great improvement on the face in both patients, followed by the trunk and legs. However, the duration of treatment needed to achieve homogeneous repigmentation is longer in geriatric patients than in the general population. Conclusion: NB-UVB was well tolerated and showed good clinical response to treat vitiligo in the elderly. However, little is known about the safety and efficacy of phototherapy in elderly patients with vitiligo.
Effectiveness and safety of moisturizing wash and cream in the treatment of elderly xerosis cutis Legiawati, Lili; Yusharyahya, Shannaz Nadia; Astriningrum, Rinadewi; Puteri, Fathirah Rahmatiah; Ilyas, Nabila Chalisya
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: The skin undergoes degenerative and metabolic changes with aging, increasing susceptibility to dermatological conditions. Xerosis cutis, characterized by rough, scaly skin on the lower legs, is the most common cause of pruritus in elderly patients, with a prevalence of 38–85%. Treating xerosis cutis is challenging due to its multifactorial causes, especially in the elderly. Moisturizers remain the primary and most effective treatment, providing convenience and efficacy. This study aimed to evaluate the effects of QV Intensive Moisturizing Cleanser™️ and QV Intensive Cream™️ (Ego Pharmaceuticals, Australia), which contain humectants, emollients, and occlusives. Case Illustration: This observational case series involved six elderly subjects (>60 years) with xerosis cutis. Exclusion criteria included medications that cause dry skin, use of topical moisturizers within 2 weeks, or oral supplements (hyaluronic acid, vitamin C, and ceramide) within 4 weeks before the study. Over four weeks, subjects used only the specified cleanser and moisturizer on affected skin. Improvement was assessed subjectively using the Smoothness, Redness, Roughness, Cracking (SRRC) score, the Dermatology Life Quality Index (DLQI), and the 5D Pruritus Scale. Objective measures included transepidermal water loss (TEWL) via Tewameter® TM300 and skin capacitance (SCap) via Corneometer® CM825 (Courage+Khazaka Electronic GmbH, Germany). Discussion: All subjects showed improvement in SRRC, 5D Pruritus Scale, DLQI, TEWL, and SCap after four weeks of cleanser and moisturizer use, with no side effects or irritation observed. Conclusion: Cleansers and moisturizers containing humectants, emollients, and occlusives were found to be safe and effective for treating xerosis cutis in geriatric patients.
Sunscreen Use in Populations of Colour: A Comprehensive Review of Barriers, Efficacy, and Clinical Recommendations Sarah Qanita Edwar; Devi Arofah; Irma Bernadette; Lili Legiawati; Sondang P. Sirait; Ika Anggraini; Shannaz Nadia Yusharyahya
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 19 No 1 (2025): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan (In Press)
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v19i1.13868

Abstract

Populations with skin of colour (Fitzpatrick types IV–VI) have higher melanin levels, providing intrinsic photoprotection equivalent to SPF ~13.4 versus ~3.3 in lighter skin. Despite this advantage, darker skin remains susceptible to UV-related harm, including post-inflammatory hyperpigmentation (PIH), photoaging, and delayed skin cancer diagnosis. This review synthesizes evidence on sunscreen use in populations of colour, focusing on formulation efficacy, clinical outcomes, adoption barriers, and best-practice recommendations. Evidence consistently supports broad-spectrum sunscreens with SPF ≥30 for all skin types. Tinted sunscreens containing iron oxides are particularly effective against visible light–induced pigmentation, reducing blue light exposure by up to 86% and preventing PIH in 98–100% of cases. However, adoption is limited by higher costs (tinted products averaging $24.59/oz vs. $6.85/oz), restricted shade ranges, and cultural misconceptions about skin cancer risk. Only 15.79% of African American individuals report regular sunscreen use, and 76% perceive their risk as low or none. Emerging data also indicate increased photoaging risk in high–sun exposure coastal settings, including Jakarta. Optimal photoprotection for Fitzpatrick V–VI includes SPF 30 sunscreen, antioxidants, emollients, and iron oxide formulations. Effective interventions must address educational, cultural, and structural barriers while improving affordability and shade inclusivity.
Co-Authors Adhi Harmoko Saputro Adhika Ayu Lestari Adistri, Kara Aldri Frinaldi Andhira, Vega Barros, Terlinda Chandrakesuma, Vivianne Christine Lieana Devi Arofah Edwar, Sarah Qanita Eliza Miranda Endi Novianto Erdina Pusponegoro Evita Halim Effendi Evita Halim Effendi Eyleny Meisyah Fitri Fauziah, Siti Nurani Fifi Mifta Huda Githa Rahmayunita Halim, Dionisius Ivan Yonathan Hanny Nilasari Hapsari, Yari Castiliani Hartanto, David Dwiadiputra Huda, Fifi Mifta Ika Anggraini Ilyas, Nabila Chalisya Imelda Wihadi Inadia Putri Chairista Indah Widyasari Irawan, Yudo Irene Darmawan Irene Dorthy Santoso Irma Bernadette Irwan Saputra Batubara Jonlean, Reganedgary Kusmarinah Bramono Kusumawardhani, Dina Larisa Paramitha Lili Legiawati Lusiana Lusiana Lusiana Lusiana Marsha Bianti Martinus Tarina Martinus, Martinus Melody Febriana Andardewi Menaldi, Sri Linuwih Susetyo Wardhani Mutiara Ramadhiani Natalia Rania Sutanto Natalia Rania Sutanto Nugraheni Pasaribu, Uly Aanda Maria Prayogo, Rizky Lendi Priyanto, Mufqi Handaru Puteri, Fathirah Rahmatiah Putu Martha Gerynda Sukma Putu Siska Virgayanti Rahadi Rihatmadja Rahadi Rihatmadja Ratu Siti Khadijah Sarah Rheza, Agung Mohamad Rhida Sarly Amalia Rinadewi Astriningrum Rizky Lendl Prayogo Roro Inge Ade Krisanti Sampurna, Adhimukti T. Sandra Widaty Santoso, Irene Dorthy Sarah Qanita Edwar Sirait, Sondang Panjaitan Siti Nurani Fauziah Sitohang, Irma Bernadette S. Sondang P Sirait Sondang P. Sirait Sri Adi Sularsito Sri Adi Sularsito Sri Adi Sularsito Terlinda Barros Tiara Aninditha Valdi Ven Japranata Vivianne Chandrakesuma Widyasari, Indah Wihadi, Imelda Windy Keumala Budianti Wresti Indriatmi B. Makes Yudo Irawan Yudo Irawan