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All Journal E-Jurnal Medika Udayana Berkala Ilmu Kesehatan Kulit dan Kelamin Al Qalam: Jurnal Ilmiah Keagamaan dan Kemasyarakatan ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Bali Dermatology and Venereology Journal JOURNAL LA MEDIHEALTICO MAHESA : Malahayati Health Student Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Bali Dermatology Venereology and Aesthetic Journal Indonesian Journal of Biomedicine and Clinical Sciences
Ni Made Dwi Puspawati
Departemen Dermatologi And Venereologi, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Karakteristik kanker kulit di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2015-2018 Made Wardhana; I Gusti Nyoman Darmaputra; I Gde Nengah Adhilaksman; Nyoman Yoga Maya Pramita; Ricky Fernando Maharis; Made Dwi Puspawati; I Gusti Ayu Agung Dwi Karmila; I Gusti Agung Ayu Praharsini; I Gusti Ayu Agung Elis Indira; Nyoman Suryawati
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.084 KB) | DOI: 10.15562/ism.v10i1.438

Abstract

Latar belakang: Prevalesi kanker kulit semakin meningkat di seluruh dunia. Walaupun insiden tertinggi pada kelompok berkulit putih, namun mengetahui epidemiologi dan tren penyakit dari kanker kulit diperlukan agar dapat menentukan pencegahan dan penanganan yang tepat.Tujuan: Untuk mengetahui karakteristik kanker kulit pada pasien yang telah dilakukan skin flap di Departemen Dermatologi dan Venereologi RSUP Sanglah.Metode: Penelitian ini merupakan studi deskriptif retrospektif dari catatan medis semua penderita kanker kulit yang memperoleh tindakan skin flap sejak Januari 2015 sampai dengan Desember 2019. Sampel diambil melalui total sampling. Karakteristik yang tercatat meliputi jenis kanker, jenis kelamin, umur, tipe kulit, pekerjaan, dan jenis flap yang dilakukan. Data yang terkumpul dianalisis secara deskriptif dengan program SPSS Ver21.Hasil: Terdapat 41 pasien kanker kulit yang memperoleh tindakan skin flap, terdiri dari 43,9% (n=16) BCC, 54,6% (n=10) melanoma, 21,9% (n=9) SCC, 9,8% (n=4) jenis kanker lain. Jenis flap yang umum digunakan yaitu simple advancement. Lokasi kanker paling umum ditemukan pada wajah dan kejadian kanker paling tinggi terjadi pada usia ≥50 tahun dan bekerja di luar ruangan.Simpulan: Kasus kanker tertinggi yaitu BCC dengan usia lebih dari 50 tahun dan bekerja di luar ruangan sebagai karakteristik paling umum pada semua kasus kanker.
Skin flap pattern in skin cancer at Sanglah General Hospital Denpasar, Bali-Indonesia Made Wardhana; IGN Darmaputra; I Gde Nengah Adhilaksman Sunyamurti Wirawan; Nyoman Yoga Maya Pramita; Rikcy Fernando Maharis; Ni Made Dwi Puspawati; IGAA Dwi Karmila; IGAA Praharsini
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (917.309 KB) | DOI: 10.15562/ism.v10i3.518

Abstract

Background: The prevalence of skin cancer is consistently increasing recently, an hence a more comprehensive management is necessary for patients’ satisfaction. Generally, skin cancer is categorized into several histological types, including melanoma, basalioma, squamous cell carcinoma (SCC), and several other less common types such as keratoacanthoma, pyogenic granuloma, and Bechet disease. In dermatology, the intervention is limited which only consists of infiltrative anesthesia, no involvement of other organs, and no attachment to the underlying tissue. Therefore, random skin flap frequently becomes the preferred option that involves advancement, rotation, transposition, and interpolation flap. This study aims to investigate the profile of skin cancer and flap pattern among patients undergoing skin flaps procedure at Dermatology and Venereology Department of Sanglah General Hospital, Denpasar. Method: This study included all skin cancer patients who underwent skin flap surgery. Samples collection was performed retrospectively using patients’ medical records from January 2015 - December 2018. Results: Over the study period, there were a total of 41 skin cancer patients who underwent skin flap surgery of whom 10 (54.6%) patients were diagnosed with melanoma, 16 patients with basalioma, 9 patients with SCC and the remaining included 3 cases of acanthoma and 1 Bechet disease. Regarding the flap types, simple advancement and its variances were performed in 6 melanoma, 11 basaliomas, 5 SCC and 4 keratoacanthoma cases. Transposition flap was performed in 2 melanoma, 3 basalioma, and 3 SCC cases; whereas rotation flap was performed in 2 melanoma and 2 basaliomas and SCC cases.Conclusion: From 41 skin cancer patients discovered, basalioma was the most frequent cases and advancement techniques were the most frequently performed flap surgery. Only 1 post-surgical infection was found after rotational flap procedure.   
Profil dermatitis kontak akibat kerja pada pekerja garmen di Kota Denpasar Made Wardhana; Made Martina Windari; I Gusti Ayu Agung Dwi Karmila; Ni Luh Putu Ratih Vibriyanti Karna; Ni Made Dwi Puspawati; I Gusti Ayu Agung Praharsisni; Luh Made Mas Rusyati; Nyoman Suryawati
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.159 KB) | DOI: 10.15562/ism.v11i2.649

Abstract

Background: The development of the garment industry in Bali is increasing as a tourism supporting industry. As a consequence the number of garment and textile companies is growing in quantity and quality. According to data in the Denpasar City, there were around 125 large garment companies employing at least 100 workers. A small garment company as a home industry is almost five hundred. The impact of the development of the garment industry requires a lot of human resources by recruiting, opening jobs both for trained and untrained workers, most of whom are casual workers, without getting attention in terms of health. This research was conducted to collect data about the pattern of skin lesions (work-related contact dermatitis) in garment workers in Denpasar City because they do not have complete and accurate data.Methods: The method used in this study was a survey on three large garment companies in Denpasar with interviews and examinations of their skin disease patterns.Results: Total 288 workers included in this study consisted of 105 (36.5%) men and 183 (63.5%) women. From 288 respondents, 74 workers (25.7%) suffer from skin disorders related to their work. The occupational category that suffered the most was colouring workers of 30 people.Conclusion: The pattern of skin disease in garment workers by 25.7% suffering from DKAK. Disease categories are often workers who come into contact with colour materials. Latar Belakang: Perkembangan industri garment di Bali semakin meningkat sebagai salah satu industri penunjang pariwisata. Sebagai konsekuensi jumlah perusahan garmen dan tekstil semakin banyak secara kuantitas dan kualitas. Menurut data di kodya Denpasar, tercatat sekitar 125 perusahan garmen yang besar dengan memperkerjakan sedikitnya 100 orang pekerja. Perusahan garmen yang kecil sebagai industri rumah tangga hampir sebanyak lima rastusan. Dampak dari perkembangan industri garment membutuhkan banyak tenaga kerja dengan merekrut, membuka lapangan pekerjaan baik itu untuk pekerja yang terlatih maupun yang tidak terlatih, kebanyakan merupakan pekerja lepas, tanpa mendapat perhatian dari segi kesehatan. Penelitian ini dilakukan untuk mengumpulkan data tentang pola kelainaan kulit pada(DKAK) pekerja garment  di Kodya Denpasar, karena belum memiliki data yang lengkap dan akurat.Metode: Metode yang digunakan pda penelitian ini adalah survelanse, pada 3 perusahan garment yang besar di Denpasar dengan wawancara dan pemeriksaan terhadap pola penyakit kulitnya.Hasil: Dari 288 pekerja yang di ikut sertakan dalam penelitian ini terdiri dari 105 (36,5%) laki-laki dan 183 (63,5%) perempuan. Dari 288 responden, sebanyak 74 pekerja (25,7%) yang menderita kelainan kulit yang berhubungan dengan pekerjaannya. Katagori pekerjaan yang paling banyak menderita adalah pada pekerja pencelupan (coloring) sebesar 30 orang.Simpulan: Pola penyakit kulit pada pekerja garment sebesar 25,7% menderita DKAK. Katagori penyakit sering adalah pekerja yang berhubungan kontak dengan bahan warna.
Korelasi jumlah sel CD4 dengan skor nugent pada wanita dengan infeksi human immunodeficiency virus Ni Made Dwi Puspawati; Anak Agung Gde Putra Wiraguna; I Gusti Ayu Agung Dwi Karmila; I Ketut Agus Somia
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.999 KB) | DOI: 10.15562/ism.v11i2.677

Abstract

Introduction: CD4 cell counts are still used to assess disease progression due to infection with Human Immunodeficiency Virus (HIV). The lower the number of CD4 cells, the more susceptible patients are to various kinds of opportunistic infections. Nugent Score is a rating system to determine the presence of Lactobacillus which is a normal microbiota in the vaginal ecosystem. The purpose of this study was to determine the relationship of CD4 cell counts with Nugent scores in HIV-infected women.Method: This study is an analytic study with a cross-sectional approach in women with HIV infection in Sanglah Hospital Denpasar. Sampling with consecutive sampling technique. For each sample, venous blood was taken to measure CD4 cell counts and gram stains were examined from a vaginal swab to measure Nugent's score.Results: The study found the average age of the study sample was 36.42 years. Most of the samples had a normal Nugent score (0-3) with a CD4 count> 500 or were not immunodeficient (34%). There was a significant difference in the Nugent score based on the number of partners owned (p<0.05). There was no significant difference in Nugent's score based on condom use, vaginal wash and smoking history (p>0.05). The majority of patients who experienced immunodeficiency, mild immunodeficiency, and moderate immunodeficiency had normal Nugent scores (47.1%, 80%, 54.5%, respectively). Only the group with the most severe immunodeficiency had bacterial vaginosis (57.1%).Conclusions: No significant differences were found between CD4 cell counts and Nugent scores. This can be caused because there is no relationship between the two or because of confounding factors that have not been controlled. Further research needs to be done by correcting confounding factors so that subsequent research can improve precision. Pendahuluan: Jumlah sel CD4 sampai saat ini masih digunakan untuk menilai perkembangan penyakit akibat infeksi Human Immunodeficiency Virus (HIV). Semakin rendah jumlah sel CD4 semakin rentan penderita terhadap berbagai macam infeksi oportunistik. Skor Nugent adalah sistem penilaian untuk mengetahui keberadaan Lactobacillus yang merupakan mikrobiota normal pada ekosistem vagina. Tujuan penelitian ini untuk mengetahui hubungan jumlah sel CD4 dengan skor Nugent pada wanita terinfeksi HIV.Metode: penelitian ini merupakan penilitian analitik dengan pendekatan cross-sectional pada wanita dengan infeksi HIV di RSUP Sanglah Denpasar. Pengambilan sampel dengan teknik consecutive sampling. Pada setiap sampel dilakukan pengambilan darah vena untuk pengukuran jumlah sel CD4 dan pemeriksaan pengecatan gram dari swab vagina untuk mengukur skor Nugent.Hasil: penelitian didapatkan rerata usia sampel penelitian adalah 36,42 tahun. Sebagian besar sampel memiliki skor Nugent normal (0-3) dengan jumlah CD4 >500 atau tidak imunodefisiensi (34%).Terdapat perbedaan signifikan pada skor Nugent berdasarkan jumlah pasangan yang dimiliki (p<0,05). Tidak ada perbedaan signifikan pada skor Nugent berdasarkan penggunaan kondom, pencuci vagina dan riwayat merokok (p>0,05). Mayoritas pasien yang mengalami imunodefisiensi, imunodefisiensi ringan, dan imunodefisiensi sedang memiliki skor Nugent yang normal (47,1%, 80%, 54,5%, secara berurutan). Hanya kelompok dengan imunodefisiensi berat yang mayoritas memiliki bakterial vaginosis (57,1%).Simpulan: tidak ditemukan perbedaan yang bermakna antara kadar CD4 dengan skor Nugent. Hal ini bisa disebabkan karena memang tidak ada hubungan antara keduanya atau karena faktor perancu yang belum dikontrol. Perlu dilakukan penelitian lanjutan dengan mengkoreksi faktor perancu sehingga penelitian berikutnya dapat meningkatkan presisi.
A case of secondary syphilis with stage four HIV infection accompanied with tuberculous lymphadenitis in bisexual man Ni Made Dwi Puspawati; Ni Nyoman Suryawati; Prima Sanjiwani S. Sudarsa
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (494.602 KB) | DOI: 10.15562/ism.v11i3.687

Abstract

Introduction: Sexually transmitted infections (STIs) is still a major health issue nowadays. Several studies have shown an increased incidence of STIs in the group of man who has sex with man (MSM) and bisexuals when compared to heterosexual men or women. This is inseparable from risky sexual behaviour practiced by this population, so it is not impossible for individual in this population to be suffering from more than one STI.Case description: We report one case of secondary syphilis with fourth stage HIV infection accompanied with tuberculous lymphadenitis in a bisexual man.Conclusion: Management of each specific condition have to in accordance with treatment standards guideline. Long term evaluation regarding patient compliance, laboratory serology test, and further education regarding the disease and transmission are mandatory.
Peranan sirkumsisi dalam pencegahan infeksi menular seksual Putu Ayu Dewita Ganeswari; Luh Made Shanti Maheswari; Ni Made Dwi Puspawati
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (370.457 KB) | DOI: 10.15562/ism.v11i3.835

Abstract

Sexually transmitted infections (STIs) are a threat to society in the era of global health. Data from the World Health Organization (WHO) states, more than 1 million cases of STIs are found every day worldwide. The increase number of STI cases requires health workers to think about various preventive measures so that the cases do not increase. Prevention of STIs can be done with several conventional steps including being faithful to one partner and using a condom during sexual intercourse. There was a consideration in the quantity and quality of scientific evidence documenting the safety and health benefits of circumcised men as a method of preventing STIs. Male circumcision has emerged as a means of reducing the transmission of sexually transmitted infections. In recent decades, several studies have produced evidence on the effects of male circumcision on HIV transmission. Circumcision in men is recommended as an effective preventive strategy against sexually transmitted infections, in addition to several methods such as increasing screening and counseling, delivering education related to abstinence, using condoms, reducing the habit of changing sexual partners, and testing for HIV early so that it can start immediately antiretroviral therapy. There were a lot of controversy surrounding male circumcision. The correct procedure for circumcision can be beneficial, although short-term surgical complications and suspected long-term harm are also possible. Infeksi menular seksual (IMS) merupakan ancaman bagi masyarakat pada era kesehatan global. Data World Health Organization (WHO) menyatakan bahwa lebih dari 1 juta kasus IMS ditemukan setiap hari di seluruh dunia. Peningkatan jumlah kasus IMS mengharuskan tenaga medis untuk memikirkan berbagai tindakan preventif agar semakin hari kasus tidak semakin bertambah. Pencegahan terhadap adanya IMS dapat dilakukan dengan beberapa langkah konvensional diantaranya setia pada satu pasangan dan menggunakan kondom saat berhubungan seksual. Terdapat pertimbangan dalam kuantitas dan kualitas bukti ilmiah yang mendokumentasikan keamanan dan manfaat kesehatan pada pria yang telah disirkumsisi sebagai salah satu metode pencegahan IMS. Sirkumsisi pada pria telah muncul sebagai sarana dalam mengurangi transmisi infeksi menular seksual. Dalam beberapa dekade terakhir, beberapa penelitian telah menghasilkan bukti mengenai efek sirkumsisi pada pria dalam transmisi human immunodeficiency virus (HIV). Sirkumsisi pada pria dianjurkan sebagai strategi pencegahan yang efektif terhadap infeksi menular seksual, selain dengan beberapa metode seperti meningkatkan skrining dan konseling, penyampaian edukasi terkait dengan abstinensia, penggunaan kondom, mengurangi kebiasaan berganti-ganti pasangan seksual, dan tes HIV lebih dini sehingga dapat segera memulai terapi antiretroviral. Banyak kontroversi seputar sirkumsisi pada pria. Prosedur tindakan sirkumsisi yang benar bisa membawa manfaat, meskipun komplikasi bedah jangka pendek dan dugaan kerugian jangka panjang juga masih mungkin terjadi.
Adverse skin reactions of healthcare workers using N95 mask and latex gloves at Kasih Ibu Denpasar General Hospital Bali Indonesia during coronavirus disease 2019 (COVID-19) pandemic – a descriptive study Firly Clarissa Suyanto; Ariana Ariana; Ni Made Dwi Puspawati
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.978 KB) | DOI: 10.15562/ism.v12i2.1052

Abstract

Introduction: Corona virus disease 2019 (COVID-19), caused by SARS-CoV-2, was first identified in Wuhan, Hubei Province, China in December 2019. World Health Organization (WHO) then officially declared the disease as a global pandemic in March 2020. It has rapidly spread throughout the world, causing a huge burden to the health sector. With the increasing number of cases, healthcare workers (HCWs) were exposed to the regular use of personal protective equipment (PPE) such as N95 masks, latex gloves, and gowns. As a result of long term use of PPE, many adverse skin reactions may occur. Hence, this study aims to determine the adverse skin reactions among healthcare workers using PPE.Method: This study is a cross-sectional descriptive study conducted at Kasih Ibu Denpasar General Hospital Bali Indonesia. Questionnaires were used for the research. A total of 45 valid questionnaires were collected, with the majority being women (88.9%) and with an age range of 20 – 30 years old (55.6%).Result: The result showed that the most common adverse skin reactions among HCWs wearing N95 masks were indentation and ear pain (73.3%) and nasal bridge scarring (48.9%). The most common adverse skin reactions among HCWs wearing latex gloves were dry skin (46.7%) and skin soaked with sweat (17.8%).Conclusion: Our study explored the adverse skin reactions due to long term use of PPE, N95 mask and latex gloves in particular. These adverse skin reactions are mostly mild because they continue using PPE.
Peran sirkumsisi sebagai pencegahan infeksi herpes genetalis: suatu studi kohort retrospektif Made Wardhana; Martina Windari; Marrietta Sugiarti Sadeli; Anak Agung Gde Putra Wiraguna; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Pande Agung Mahariski
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.07 KB) | DOI: 10.15562/ism.v12i2.1069

Abstract

Background: Recurrent genital herpes (RGH) is a sexually transmitted infection that is a serious public health problem and is quite prominent in most countries worldwide. Management for this infection is antiviral and circumcision. Male circumcision significantly reduces human immunodeficiency virus (HIV) infection and other sexually transmitted infections. This research aims to evaluate circumcision efficacy as the prevention for herpes simplex virus type 2 (HSV-2) infection compared with oral acyclovir.Methods: This research is an experimental study with a retrospective cohort approach. We included 45 males, 24 subjects circumcised and 21 subjects without circumcision and took oral acyclovir as standard treatment. RGH was diagnosed based on typical clinical manifestation. Follow up treatment every two weeks and continued to 2 months after circumcised and given with oral acyclovir. Successful treatment was stated without recurrent genital herpes.Results: Of 24 circumcised subjects, 19 were cured, and five non-circumcised subjects suffered recurrent genital herpes (not cured). Among 21 subjects without circumcision was cured, and 12 subjects were not cured. Based on these results, the value of NNT= 2.7.Conclusion: Circumcision can be considered effective in reducing the incidence of HGR and prevent recurrence of HGR with the NNT value of 2.7.  Latar Belakang: Herpes genetalis rekuren (HGR) merupakan infeksi menular seksual menjadi masalah kesehatan masyarakat yang serius dan cukup menonjol pada sebagian besar negara di dunia. Penanganannya adalah oral dengan antivirus dan tindakan sirkumsisi. Sirkumsisi pada pria secara signifikan mengurangi insiden infeksi human immunodeficiency virus (HIV) dan penyakit infeksi menular lainnya. Penelitian ini mengevaluasi efikasi sirkumsisi sebagai pencegahan infeksi virus herpes simpleks tipe 2 (HSV-2) dibandingkan dengan pemberian obat asiklovir.Metode: Studi ekperimental dengan pendekatan retrospektif kohort dengan mengikutsertakan 45 subjek pria dewasa, 24 subjek disirkumsisi dan 21 tanpa sirkumsisi dan hanya diberikan asiklovir sebagai obat standar. Diagnosis HGR dilakukan secara klinis dengan yang manifestasi klinis yang khas da pemeriksaan Tzanck. Setelah pemberian terapi dilakukan kontrol setiap 2 minggu sampai 2 bulan. Terapi dinyatakan berhasil bila tidak ada kekambuhan.Hasil: Dari 24 subjek disirkumsisi, 19 subjek dinyatakan sembuh dan 5 subjek mengalami kekambuhan (tidak sembuh). Dari 21 subjek tanpa sirkumsisi, 9 subjek dinyatakan sembuh dan 12 subjek dinyatakan tidak sembuh. Berdasarkan hasil ini didapatkan nilai NNT=2,7.Simpulan: Sirkumsisi dapat dinilai cukup efektif mengurangi angka kejadian HGR dan dapat mencegah kekambuhan HGR dengan nilai NNT 2.7.
Sifilis sekunder pada seorang remaja perempuan: laporan kasus Ida Ayu Uttari Priyadarshini; Elice Wijaya; Ni Made Dwi Puspawati
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (676.688 KB) | DOI: 10.15562/ism.v12i2.1078

Abstract

Introduction: Syphilis is one of the most common sexually transmitted infections worldwide. Syphilis can be acute to chronic. Syphilis is caused by the parasite Treponema pallidum (T. pallidum). Transmitted through sexual contact and blood. In this case, we report a case of secondary syphilis in an adolescent girl.Case report: an 18-year-old girl came with complaints of red spots on the palms of the hands and soles of the feet, with a history of sores in the pubic area that were painless and odorless and then healed on their own so no treatment was given. A history of positive sexual contact approximately one week before the patient came for examination. On dermatological status, right and left palmar and plantar locations found erythematous macules, round to geographical in shape with diameters of 0.5 cm - 1.5 cm and 0.5 cm x 0.7 cm - 0.7 cm x 1 cm, scattered discrete and localized distributions. The patient was differentially diagnosed with secondary syphilis with syphilitic roseola, pityriasis rosea and palmoplantar psoriasis. To confirm the diagnosis, a serological examination was carried out on June 10th 2020, Venereal disease research laboratory test (VDRL) examination with reactive results with a titer of 1:32 and reactive treponema pallidum hemagglutination assay (TPHA) with a TPHA titer of 1:2560. He was given a single dose of intramuscular (IM) injection of benzathine penicillin G 2.4 million international units (IU) and education on further follow up for VDRL laboratory test.Conclusion: A case of secondary syphilis with manifestations of syphilitic roseola has been reported in an 18-year-old teenager. The patient's has a generally good prognosis because in general the patient's condition is good, but considering the patient is still a teenager, it is possible to have irresponsible sexual relations later in life.  Pendahuluan: Sifilis merupakan salah satu penyakit infeksi menular seksual yang sering ditemukan. Sifilis dapat berbentuk akut hingga kronis. Sifilis disebabkan oleh parasit Treponema pallidum (T. pallidum). Menular melalui kontak seksual dan darah. Pada kasus ini dilaporkan sebuah kasus sifilis sekunder pada remaja perempuan.Laporan kasus: remaja perempuan 18 tahun datang dengan keluhan bercak-bercak kemerahan pada telapak tangan dan telapak kaki, dengan riwayat luka pada daerah kemaluan tidak nyeri dan tidak berbau kemudian sembuh sendiri sehingga tidak dilakukan pengobatan. Riwayat kontak seksual positif kurang lebih satu minggu sebelum pasien datang melakukan pemeriksaan. Pada status dermatologi, lokasi palmar dan plantar dekstra et sinistra ditemukan makula eritema, berbentuk bulat hingga geografika dengan ukuran diameter 0,5 cm - 1,5 cm dan 0,5 cm x 0,7 cm – 0,7 cm x 1 cm, tersebar diskret dan distribusi lokalisata. Pasien didiagnosis banding dengan sifilis sekunder dengan roseola sifilitika,  pitiriasis rosea dan palmoplantar psoriasis. Untuk menegakkan diagnosis dilakukan pemeriksaan serologis pada tanggal 10 Juni 2020 yakni pemeriksaan VDRL dengan hasil reaktif dengan titer 1:32 dan TPHA reaktif dengan titer TPHA 1:2560. Diberikan terapi injeksi benzatin penisilin G 2,4 juta international unit (IU) intramuskular (IM) dosis tunggal dan edukasi pemantauan pengobatan yang akan dilakukan yakni pemeriksaan VDRL ulang pada bulan ke-1 setelah terapi.Simpulan: Telah dilaporkan satu kasus sifilis sekunder dengan manifestasi roseola sifilitika pada remaja berusia 18 tahun. Prognosis pasien adalah dubia ad bonam karena pada umumnya kondisi pasien baik, namun mengingat pasien masih remaja, ada kemungkinan untuk melakukan hubungan seksual yang tidak bertanggung jawab di kemudian hari.
Moluskum kontagiosum dengan human immunodeficiency virus stadium IV yang diterapi dengan KOH 20% Michael Hostiadi; I Gusti Ayu Agung Elis Indira; Ni Made Dwi Puspawati; Ketut Wida Komalasari
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (401.463 KB) | DOI: 10.15562/ism.v13i2.1211

Abstract

Background: The prevalence of molluscum contagiosum (MC) was found to increase in the HIV population with a prevalence of 5-18%. Persistent molluscum lesions gradually increase in size. Some develop into giant, tumor-like, nodular lesions that can exceed 1 cm in diameter and cause esthetic defects in HIV-positive patients. Conventional treatment is usually not effective enough and requires additional therapy in immunocompromised cases. Case: A 31-year-old woman with stage IV HIV had the main complaint of a skin-colored rash near the genital area. Venereological examination found multiple papules with smooth, shiny surfaces with central umbilication discrete configuration and localized distribution. The molluscum body comes out after being squeezed. The treatment given is 20% potassium hydroxide spots on MC lesions every 24 hours topically. Two weeks after therapy was given, no new lesions were found without any side effects. Conclusion: Administration of 20% potassium hydroxide can be considered an MC treatment option in HIV patient with minimal side effects and is easy to use.   Latar Belakang: Prevalensi moluskum kontagiosum (MK) didapatkan meningkat pada populasi human immunodeficiency virus (HIV) dengan prevalensi 5-18%. Lesi moluskum persisten yang secara bertahap bertambah besar, beberapa berkembang menjadi raksasa, seperti tumor, lesi nodular yang dapat melebihi diameter 1cm, dan dapat menyebabkan kecacatan secara estetik sering ditemui pada pasien dengan HIV positif. Pengobatan konvensional biasanya tidak cukup ampuh dan membutuhkan tambahan terapi lainnya pada kasus imunokompromais. Kasus: Seorang perempuan usia 31 tahun, HIV positif stadium IV dengan keluhan utama berupa bintil-bintil bewarna serupa kulit di dekat area genital, bila ditekan keluar bintik putih seperti nasi. Pemeriksaan venereologis ditemukan papul multipel permukaan licin berkilat dengan umbilikasi sentral konfigurasi diskret dengan distribusi lokalisata. Penatalaksanaan yang diberikan adalah tutul kalium hidroksida (KOH) 20% pada lesi MK setiap 24 jam topikal. Dua minggu setelah terapi diberikan tidak ditemukan adanya lesi baru dan tanpa adanya efek samping. Simpulan: Pemberian KOH 20% dapat dipertimbangkan sebagai pilihan terapi MK pada HIV dengan efek sampung minimal dan mudah digunakan.
Co-Authors Aditya Permana Aditya Permana Aditya Permana Anak Agung Gde Putra Wiraguna Andrew Wicaksono Andrew Yoshihiro Wirya Andrew Yoshihiro Wirya Ariana Ariana Aurelia Stephanie Darmaputra, I Gusti Nyoman Devi, Putu Akopita Dewi Gotama Dewi Gotama Elice Wijaya Elis Indira, I Gusti Ayu Agung Firly Clarissa Suyanto Gotama, Dewi Herman Saputra Herman Saputra Herman Saputra I Dewa Made Rendy Sanjaya I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman Sunyamurti Wirawan I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Ayu Agung Sattwika I Gusti Ayu Sattwika I Gusti Nyoman Darmaputra I Ketut Agus Somia I Komang Arimbawa Ida Ayu Trisna Dewi Ida Ayu Uttari Priyadarshini Indah, Made Sanitca Indira, I Gusti Ayu Agung Elis Intaran, Kadek Devi Aninditha Jordaniel Setiabudi Ketut Kwartantaya Winaya Ketut Wida Komalasari Krisnaputri, Nandya Putu Luh Made Mas Rusyati Luh Made Shanti Maheswari Made Hermina Laksmi Made Martina Windari Made Sanitca Indah Made Sanitca Indah Made Swastika Adiguna Made Wardhana Mahariski, Pande Agung Marrietta Sugiarti Sadeli Martalova AJ, Adelia Martina Windari Michael Hostiadi Michael Hostiadi, Michael Mudita, Tritya Murti, Nyoman Indra Karunia Natih, Sintha Aprillia Gita Ni Kadek Setyawati, Ni Kadek Ni Luh Putu Ratih Vibriyanti Karna Ni Putu Candra Nirmalasari P Ni Putu Wina Widyastuti Nyoman Suryawati Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Pande Agung Mahariski Pemana, Aditya Prima Saraswati Sanjiwani Sudarsa Putu Ayu Dewita Ganeswari Putu Gde Hariwangsa Ricky Fernando Maharis Rikcy Fernando Maharis Sattwika, I Gusti Ayu Setyono, Alfred Sissy Sissy Sissy Sissy, Sissy Sutiawan, Indry Salonika Tiara Evangelista Triatmakusuma, Yogi Tritya Mudita Tritya Mudita Vanessa Vijayamurthy Winaya, Ketut Kwartantaya Wirya, Andrew Yoshihiro