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Generalized Pustular Psoriasis in Childhood: A Rare Case Asnawi, Vella; Maulida, Mimi; Earlia, Nanda; Hidayati, Arie; Ismida, Fitri Dewi; Liana, Mahda Rizki; Maghfirah, Karamina; Bulqiah, Mikyal
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 35 No. 3 (2023): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V35.3.2023.231-236

Abstract

Background: Generalized pustular psoriasis (GPP) rarely occurs under 10 years of age. GPP is typically characterized by an eruption of generalized pustules accompanied by systemic symptoms such as fever for several days, malaise, and anorexia. Pustules are sterile, with a size of 2-3 mm, and spread over the trunk and extremities. This disease can be life-threatening; therefore, optimal therapy is required. Purpose: to report a rare case of GPP in childhood. Case: A 4-year-old girl with complaints of widespread red patches that spread to her neck, back, and hands, with red patches turning into streaks that are partially pus-filled and itchy. In almost all parts of the body, skin abnormalities were seen in the form of generalized erythematous plaques, well-defined borders, multiple pustules on the edges, and some plaques covered by thick scales and crusts. In the calculation of body surface area (BSA), the result is 44%, and in the calculation of generalized pustular psoriasis area and severity index (GPPASI), the result is 21.30. The patient was treated with combination topical therapy of 3% salicylic acid, desoximethasone cream 0.25%, momethasone cream 0.1% vaseline albume as emollients, and coal tar. Significant improvement was seen after 1 month of therapy. Discussion: GPP in children is a rare case. GPP is idiopathic and can be life-threatening. Until now, there has been no standard therapy that is considered the most effective and safe for children. Topical therapy may be an option.
Clinical Insights and Diagnostic Dilemmas: Two Cases of Livedoid Vasculitis Earlia, Nanda; Budini, Sulamsih Sri; Lestari, Wahyu; Handriani, Risna; Ismida, Fitri Dewi; Pradistha, Aldilla; Dinillah, Teuku Muhammad Muizzy; Vemulen, Dara Avinda; Athira, Athira
Indonesian Journal of Case Reports Vol. 2 No. 1 (2024): June 2024
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v2i1.183

Abstract

Livedoid Vasculitis (LV) is a thrombo-occlusive vasculopathy involving dermal vessels, especially in the lower extremities. Clinical symptoms of LV are chronic, recurrent, scarring, and painful purpuric ulcers. Diagnosing and providing therapy for LV is a challenge because there are no standard guidelines. We present clinical insights and diagnostic approaches on two cases of LV to improve early diagnosis and prevent misdiagnosis, which were confirmed based on history, dermatological examination, and skin biopsy. In the first case, it was a woman, 23 years old, who came with complaints of a blackish-red rash appearing on both legs. There were scars on several parts of the patient's legs, which felt painful, and the legs looked swollen. On histopathological examination, fibrin deposition in the vessel walls, endothelial proliferation, and intraluminal hyaline thrombin were found. In the second case, it was a man, 19 years old, who came with complaints of pain when walking accompanied by wounds on both lower legs. On histopathological examination, fibrin deposition in the vessel walls, endothelial proliferation, and intraluminal hyaline thrombin were found. The conclusion from the histopathology results was LV. After receiving therapy, both cases showed improvement: swelling in the legs was reduced, red and black rashes began to disappear, ulcers improved, pain decreased, and scars became blurred. These two cases provide examples of success in diagnosing LV. Being able to diagnose LV early and correctly is very important so that adequate therapy can be given and good outcomes can be achieved.
Relationship between presenting symptoms and tumor location in colorectal cancer patients Ismida, Fitri Dewi; Maghfirah, Desi; Salam, Nurbahri L; Yusuf, Fauzi; Mulia, Vera Dewi; Purnomo, Avisena Gatot
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.321-328

Abstract

BackgroundColorectal cancer (CRC) often shows symptoms at an advanced stage, causing delayed diagnosis and poorer prognosis. Initial symptoms, or chief complaints, are usually identified through patient history and can vary based on tumor location. This can help in establishing a diagnosis. This study aimed to determine the relationship between presenting symptoms and tumor location in CRC patients at Zainoel Abidin Regional General Hospital, Banda Aceh. Methods This cross-sectional study was conducted using secondary data from medical records (2019–2022) for 163 CRC patients. Information on symptoms of patients were collected from patient files: anemia, anorexia, diarrhea, constipation, abdominal pain, rectal bleeding, and palpable abdominal mass. Tumor locations were classified as right colon, left colon, rectum, and left colon plus rectum. Bivariate analysis was used to analyze the data. Results Of the 163 patients, 98 (58%) were aged eā€50 years, 82 (50.3%) were male, and 99 (60.7%) had rectal tumors. The percentage of patients presenting with rectal bleeding was significantly higher in rectal cancers (47.47%) as compared with cancers in the left colon (28.57%) and left colon and rectal (33.33%) cancers (p=0.000). The percentage of patients presenting a palpable abdominal mass was significantly higher in right colon (31.58%) compared with left colon (4.76%) and rectal cancer (1.01%) (p=0.000). ConclusionsTumor location in the right colon is associated with palpable abdominal mass, while rectal location is associated with rectal bleeding in CRC patients. Familiarity with clinical symptoms of CRC could make patients more sensitive to undergo more frequent screening for cancer.
Coexistence of Psoriasis Vulgaris and Systemic Lupus Erythematosus: A Rare Clinical Case Earlia, Nanda; Zulfan, Zulfan; Pradistha, Aldilla; Asrizal, Cynthia Wahyu; Yoo, Soo-Ji; Wisesa, Wizurai; Abdurrazaq, Abdurrazaq; Ikram, Tubagus Pasca Faiz; Ismida, Fitri Dewi; Murtadha, Raihan; Zuhra, Sofi Alfia; Ramadhani, Cut Sukma
Indonesian Journal of Case Reports Vol. 3 No. 1 (2025): June 2025
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v3i1.278

Abstract

Psoriasis vulgaris is a chronic skin inflammation characterized by the appearance of clearly limited erythematous plaques, along with rough, thick, and silvery-white scales. Systemic Lupus Erythematosus (SLE) is a multifactorial autoimmune disease with diverse clinical manifestations and can involve one or more organs. This case report presents a patient with Psoriasis Vulgaris with SLE. A 47-year-old woman presented with erythematous plaque lesions with thick scales and some hyperpigmentation, numerous, plaque-sized lesions with regional distribution on the scalp, right and left cubital areas, gluteal, left tibia, and yellow unguium dyschromia was seen on the distal lateral aspect, solitary on the right 3rd digit. Histopathological examination found typical Psoriasis Vulgaris. The patient was diagnosed with Psoriasis Vulgaris. In 2022, the patient was diagnosed with SLE and received Hydroxychloroquine sulfate therapy. The patient was treated with a combination therapy including methotrexate (MTX) and topical medications. This case highlights the importance of comprehensive evaluation for Psoriasis Vulgaris therapy with a previous history of SLE and the choice of treatment in patients with the coexistence of PV and SLE.