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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Journal of General-Procedural Dermatology & Venereology Indonesia
Surya, Steven Philip
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Health Professions Medicine & Pharmacology

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Case Reports of Left Atrial Myxoma in Elderly and Children Laksono, Sidhi; Surya, Steven Philip; Manuputty, Ferel; Lasanudin, Hengkie Frankie; Prawara, Ananta Siddhi
Sains Medika: Jurnal Kedokteran dan Kesehatan Vol 12, No 1 (2021): June 2021
Publisher : Faculty of Medicine, Universitas Islam Sultan Agung (UNISSULA), Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (880.24 KB) | DOI: 10.30659/sainsmed.v12i1.11632

Abstract

Introduction: Cardiac myxoma is a rare heart disease. Cardiac myxoma can manifest in both intracardiac and extracardiac. This report describes the importance of a careful history taking, physical examination, echocardiography, and complete surgical resection for the management of atrial myxoma in two patients.Case Reports: We reported two cases: a 64 years old female and a 16 years old male with neurological deficit as the chief complaint. The two patients underwent brain imaging and echocardiography evaluation. Both were diagnosed with left atrial myxoma and brain infarction. Surgical resection of the left atrial myxoma was successfully done in both patients and afterward, both were being monitored in the outpatient clinic. During follow up, a gradual clinical improvement can be seen in the right extremities. Echocardiography examination was conducted at 1 month, 3 months, and 6 months follow-ups for both patients and no abnormalities were found. Discussion: Atrial myxomas are the most common primary cardiac tumors. Systemic embolization in atrial myxoma is uncommon manifest as neurological deficit with reported incidence around 20-35%. On the other hand, in stroke or transient ischemic attack patients, atrial myxoma were found in 1 out of 250 young adults and 1 out of 750 older patients. Transthoracic echocardiography (TTE) has up to 95% sensitivity on diagnosing atrial myxoma. The long-term prognosis of the patients when diagnosed and managed correctly is very good and surgery is curative with recurrence rate 1-3%. The patients in our case reports showed gradual clinical improvement with no sign of myxoma recurrence during follow up.Conclusion: Stroke is one of the extracardiac manifestations of atrial myxoma. Thus, it is crucial to evaluate the presence of atrial myxoma in stroke patients. The use of TTE is important in diagnosing atrial myxoma. Resection of atrial myxomas is curative with excellent long-term prognosis and low chance of recurrences.
Cutaneous candidiasis mimicking inverse psoriasis lesion in a type 2 diabetes mellitus patient Surya, Steven Philip; Dewi, Kardiana Purnama; Regina, Regina
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Type 2 diabetes mellitus (T2DM) condition could affect the skin. The disease is among the greatest risk factors of skin infection such as cutaneous candidiasis and is also associated with autoimmune skin diseases such as psoriasis, which lesion morphologies and predilection areas are quite similar. These similarities are a source of confusion to clinicians. Case illustration: We present a 60-year-old female patient with uncontrolled T2DM and multiple erythematous plaques in the form of shiny lesions at the intertriginous area that developed 1 week prior to her hyperglycemic state. The lesions had recurred at the same site for approximately 10 years and were initially diagnosed as intertriginous candidiasis. Bedside testing revealed a positive Auspitz sign, while the patient’s fungal culture was unremarkable. She was diagnosed with inverse psoriasis (IP) and treated with 0.1% mometasone furoate cream twice a day. The lesions improved but were not completely resolved. Discussion: Inverse psoriasis is a subgroup of psoriasis characterized with thin, non-layered scales, and various predilection areas. The features of the primary lesion may be altered by a patient’s activities, such as use of cleansing soap, which may cause lesions to dry out and ooze, similar to cutaneous candidiasis. Additional examination, such as bedside testing and laboratory work, could help obtain a proper diagnosis. Conclusion: The similar morphologies and predilection areas of IP and cutaneous candidiasis lesions may confuse clinicians. In some limited cases, the correct diagnosis may be obtained by complete history taking, physical examination, and other simple tests.
Co-Authors Dewi, Kardiana Purnama Laksono, Sidhi Lasanudin, Hengkie Frankie Manuputty, Ferel Prawara, Ananta Siddhi Regina Regina