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the Correlation Between Erythrocyte Index Levels with The Anemia Morphology in Leprosy Patients Before Therapy: A Secondary Data Research Sadeli, Marrietta Sugiarti; Rusyati, Luh Made Mas; Karna, Ni Luh Putu Ratih Vibriyanti
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.5826

Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae. Chronic infection can cause anemia of chronic disease which is characterized by normochromic normocytic morphology. This study was conducted to assess the relationship between erythrocyte index levels (MCV, MCH, and MCHC) with the morphology of anemia that occurs in leprosy patients before treatment. A cross-sectional study using secondary data from medical records and management information system applications at Sanglah Hospital. The variables of this study were age, sex, hemoglobin levels, and erythrocyte index levels (MCV, MCH, and MCHC). Data were collected after permission was granted and ethical clearance was completed. Of the 156 study samples, 106 patients were diagnosed with leprosy who had not received therapy and 50 patients were not leprosy. The mean age of the patients was 39.15 ± 12.218 years and male patients were more common than female patients. There was a positive correlation between anemia, normal erythrocyte index levels, and the leprosy group. Following are the p-values, prevalence ratios, and confidence intervals; anemia [p= 0.017; PR(95% CI)= 1,458(1.034-2.056)], MCV, MCH, and MCHC [p= 0.020; PR(95% CI)= 1,268(1.010-1.591); p= 0.015; PR(95% CI)= 1,293(1,021-1,639); p= 0.009; PR(95% CI)= 1,297(1,036-1,624)]. The results of the analysis were statistically significant and clinically important. Leprosy patients had anemia before therapy with normochromic normocytic anemia morphology in accordance with anemia of chronic disease.

Beyond the Usual Suspects: Phialophora verrucosa Chromoblastomycosis in a Swimming Pool Attendant and Gardener Andrew Wicaksono; Ni Luh Putu Ratih Vibriyanti Karna; Mario Korwa; Nandya Dwizella; Herman Saputra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1422

Background: Chromoblastomycosis (CBM) is a chronic, debilitating subcutaneous mycosis caused by traumatic inoculation of dematiaceous fungi. As a Neglected Tropical Disease, it poses significant diagnostic and therapeutic challenges, particularly in the endemic tropical and subtropical regions where it is most prevalent. While Fonsecaea pedrosoi is the most common etiologic agent, infections by other species are crucial to document for accurate epidemiological surveillance. Case presentation: A 26-year-old immunocompetent male presented with a four-year history of a slowly progressive, verrucous plaque on his right hand, initiated by minor trauma. His history was notable for regular gardening without protective gear. A comprehensive diagnostic workup was performed. Dermoscopy revealed features characteristic of CBM, including reddish-black dots and yellowish-orange areas. While direct microscopy of skin scrapings was negative, histopathology of a skin biopsy confirmed a suppurative granulomatous reaction with pathognomonic muriform cells. Fungal culture on Sabouraud's dextrose agar definitively identified the causative agent as Phialophora verrucosa. The patient showed marked clinical improvement after three months of treatment with oral itraconazole (200 mg/day). Conclusion: This case highlights the successful diagnosis of a rare CBM pathogen in Indonesia through a systematic, multimodal approach. It reinforces the need for a high index of suspicion for this mycosis in patients from endemic areas with chronic verrucous lesions and a history of cutaneous trauma. The essential role of mycology culture for definitive species identification is underscored, a critical step for guiding therapy and informing public health strategies.

Profile of pyoderma in dermatology outpatient departement at Sanglah General Hospital Denpasar, Bali-Indonesia period January 2016 until December 2017 Ni Luh Putu Ratih Vibriyanti Karna; Dewi Gotama; Sissy
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 1 (June 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/cceews44

Introduction: Pyodermas are infections in the epidermis, just below the stratum corneum or in hair follicles. It is most common in children, although it can also affect adults. Pyoderma often found in tropic areas. Pyoderma is caused by Staphylococcus, Streptococcus, or both. This study aimed to identify the profile of pyoderma in Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods January 2016 – December 2017. Method: Study design using descriptive retrospective model, done by taking data from daily visit record in Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods January 2016 – December 2017. Result: Pyodermas is one of the common skin problems observed in patients attending dermatology OPD. The number of new cases in pyoderma is 202 cases (7,32%), often found in males and 0-5 years age group (35,64%). The diagnosis of furuncle is the most finding type of pyoderma and the most commonly given therapy is a combination therapy of systemic antibiotics with topical. Co-amoxiclav is the most common drug that uses orally and fusidic acid as topical ointment. Conclusion: pyoderma remains as the most common skin infection in dermatology outpatient department at Sanglah General Hospital, Bali-Indonesia. Introduction: Pyodermas are infections in the epidermis, just below the stratum corneum or in hair follicles. It is most common in children, although it can also affect adults. Pyoderma often found in tropic areas. Pyoderma is caused by Staphylococcus, Streptococcus, or both. This study aimed to identify the profile of pyoderma in Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods January 2016 – December 2017. Method: Study design using descriptive retrospective model, done by taking data from daily visit record in Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods January 2016 – December 2017. Result: Pyodermas is one of the common skin problems observed in patients attending dermatology OPD. The number of new cases in pyoderma is 202 cases (7,32%), often found in males and 0-5 years age group (35,64%). The diagnosis of furuncle is the most finding type of pyoderma and the most commonly given therapy is a combination therapy of systemic antibiotics with topical. Co-amoxiclav is the most common drug that uses orally and fusidic acid as topical ointment. Conclusion: pyoderma remains as the most common skin infection in dermatology outpatient department at Sanglah General Hospital, Bali-Indonesia.

Systematic review of melasma treatments: advantages and disadvantages Sang Ayu Arta Suryantari; Ni Putu Tamara Bidari Sweta; Elvina Veronica; I Gusti Ngurah Bagus Rai Mulya Hartawan; Ni Luh Putu Ratih Vibriyanti Karna
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 3 No. 2 (December 2020)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/dy28rh70

Background: Melasma is acquired chronic hyperpigmentation mainly affecting women. The pathogenesis of melasma is uncertain, but it is predominantly related to ultraviolet (UV) exposure. Due to its chronic and relapsing nature, melasma is challenging to treat. The currently available treatment often has undesirable side effects and suboptimal results. The treatment principle includes protecting from UV radiation, inhibiting melanin synthesis, and increasing the pathway to remove melanin. Objectives: To define available treatments for melasma and determine advantages and disadvantages, including topical, oral and procedural. Method: Medline, Cochrane library and PubMed databases were searched for articles from January 2011 to June 2020. Only RCTs, comparative, prospective, retrospective and systematic reviews focusing on melasma treatments were extracted, analyzed and discussed. Results: We found 197 studies that met the inclusion and exclusion criteria, with 2314 participants included in this review. The treatments included topical, oral and procedural. In several studies, hydroquinone alone or combination remains the most effective treatment for melasma. Oral and topical tranexamic acid is a beneficial adjuvant treatment in refractory melasma with minimal adverse effects. Procedural treatments such as chemical peels, laser and light-based therapies, and microneedling have mixed and unpredictable results. Overall, the side effects tend to be mild and affect a few of the subjects. Conclusions: The current state of the evidence suggests that some treatments with multiple modalities have their respective advantages and disadvantages. The choice of treatment modality must be adjusted according to the type of melasma, such as its severity, extent and location. A better understanding of melasma through further research may improve the therapy options with the least adverse effects.

Case report: a child with type 1 neurofibromatosis and intellectual disability Elice Wijaya; Ni Luh Putu Ratih Vibriyanti Karna; Ida Ayu Uttari Priyadarshini
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 4 No. 2 (December 2021)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/fz3cvm46

Background: Neurofibromatosis is a genetic disorder that manifests as a tumor surrounding the nerves and several other pathologic presentations. Case: Female, 11 years old, according to history, physical examination and supporting the investigation, was consistent with the diagnostic criteria of type 1 neurofibromatosis (NF-1). The patient also has an intellectual disability. A tumor on the foot region that was functionally disabling was found on the patient, and surgical treatment was performed. Cognitive disorder is the most common neurological complication in individuals with NF-1 and usually presents with a low intelligence quotient (IQ). There is no specific treatment to prevent the development of NF-1. However, early treatment can minimize and prevent further complications. Treatment for the patient involves multiple clinical disciplines. Conclusion: A neurofibromatosis case can be diagnosed clinically alone, since many other systemic involvements require a multi-disciplinary approach.

The role of anti-phenolic glycolipid-1 serological test in leprosy Ni Luh Putu Ratih Vibriyanti Karna; Anak Agung Indah Jayanthi; Desak Nyoman Trisepti Utami
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 5 No. 1 (June 2022)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/3zcf9307

The number of new leprosy cases in the world is surprisingly high, Indonesia is still at the third rank in the term of new leprosy cases over the world. Leprosy control strategies can be successful if early diagnosis and appropriate therapy are carried out. Currently, several serological tests have been developed which can help detecting subclinical leprosy, making the diagnosis,and monitoring therapy. One such serological tests is the anti-Phenolic Glycolipid-1 (PGL-1) serological test. The antibody response to PGl-1 is mainly IgM, the amount of this antibody is correlated to the number of bacteria; so, the titer is higher in lepromatous type compared with tuberculoid type, this causes serological tests still have limitation in diagnosing leprosy, especially in paucibacillary type leprosy.

Mycobacterium marinum Co-infection Masquerading as Treatment-Resistant Chromoblastomycosis: A Diagnostic and Therapeutic Challenge in Cutaneous Co-infection Stefanus Soewito Sutanto; Ni Luh Putu Ratih Vibriyanti Karna; Herman Saputra; Robert Thiodorus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1624

Background: Co-infection of chromoblastomycosis and Mycobacterium marinum (fish tank granuloma) within a single cutaneous lesion is exceptionally rare and presents a formidable diagnostic challenge owing to overlapping clinical and histopathologic features. The chronic verrucous or nodular morphology, predilection for distal extremities, and aquatic exposure history common to both conditions can lead to misdiagnosis, prolonged ineffective therapy, and patient morbidity. Case presentation: A 31-year-old Indonesian male with a fishkeeping hobby presented with a persistent erythematous plaque on the right middle finger, present since 2022, following a puncture injury sustained while collecting mosquito larvae and water fleas as fish food. He was initially diagnosed with chromoblastomycosis (Phialophora spp. on culture) in September 2023 and treated with itraconazole 200 mg daily and topical miconazole 2% for 48 weeks without resolution. Repeat biopsy in 2024 demonstrated negative periodic acid-Schiff and Ziehl-Neelsen stains but revealed non-caseating tuberculoid granulomas. Considering the patient's aquatic exposure, antifungal failure, and granulomatous histopathology, a diagnosis of fish tank granuloma due to M. marinum co-infection was established. Combination antimycobacterial therapy with rifampicin 600 mg and ethambutol 1500 mg daily produced clinical resolution at six-month follow-up. Conclusion: This case underscores the necessity of considering M. marinum in patients with antifungal-refractory chronic skin lesions and aquatic exposure, and highlights the diagnostic value of repeat histopathology with directed staining when initial therapy fails.

Mycobacterium marinum Co-infection Masquerading as Treatment-Resistant Chromoblastomycosis: A Diagnostic and Therapeutic Challenge in Cutaneous Co-infection Stefanus Soewito Sutanto; Ni Luh Putu Ratih Vibriyanti Karna; Herman Saputra; Robert Thiodorus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1624

Background: Co-infection of chromoblastomycosis and Mycobacterium marinum (fish tank granuloma) within a single cutaneous lesion is exceptionally rare and presents a formidable diagnostic challenge owing to overlapping clinical and histopathologic features. The chronic verrucous or nodular morphology, predilection for distal extremities, and aquatic exposure history common to both conditions can lead to misdiagnosis, prolonged ineffective therapy, and patient morbidity. Case presentation: A 31-year-old Indonesian male with a fishkeeping hobby presented with a persistent erythematous plaque on the right middle finger, present since 2022, following a puncture injury sustained while collecting mosquito larvae and water fleas as fish food. He was initially diagnosed with chromoblastomycosis (Phialophora spp. on culture) in September 2023 and treated with itraconazole 200 mg daily and topical miconazole 2% for 48 weeks without resolution. Repeat biopsy in 2024 demonstrated negative periodic acid-Schiff and Ziehl-Neelsen stains but revealed non-caseating tuberculoid granulomas. Considering the patient's aquatic exposure, antifungal failure, and granulomatous histopathology, a diagnosis of fish tank granuloma due to M. marinum co-infection was established. Combination antimycobacterial therapy with rifampicin 600 mg and ethambutol 1500 mg daily produced clinical resolution at six-month follow-up. Conclusion: This case underscores the necessity of considering M. marinum in patients with antifungal-refractory chronic skin lesions and aquatic exposure, and highlights the diagnostic value of repeat histopathology with directed staining when initial therapy fails.

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