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All Journal Althea Medical Journal Dharmakarya : Jurnal Aplikasi Ipteks Untuk Masyarakat Berkala Ilmu Kesehatan Kulit dan Kelamin Jurnal Farmasi Klinik Indonesia Journal of General Procedural Dermatology and Venereology Indonesia

Hendra Gunawan

Departemen Ilmu Kesehatan Kulit Dan Kelamin Universitas Padjadjaran

Author-ID : 1807898

Agriculture, Biological Sciences & Forestry Arts Humanities Economics, Econometrics & Finance Engineering Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Public Health

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Articles

Reversal reaction with nodules clinical manifestations that initially diagnosed as erythema nodosum leprosum in borderline lepromatous leprosy Laila Tsaqilah; Pati Aji Achdiat; Hendra Gunawan
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 1 (2020): December 2020
Publisher : Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: The reversal leprosy reaction generally manifest as larger, swollen, red and shiny the pre-existing skin lesions which are accompanied with pain. This reaction can be manifest as infiltration and nodules which resembles the features of erythema nodosum leprosum (ENL) leprosy reaction. Case Illustration: We present a case of 26-year-old woman with erythematous nodules on almost all the body since two weeks ago. She had pre-existing erythema plaque on the right elbow became more erythematous and arouse with partially felt pain, fever, and malaise. Nodule lesions in BL leprosy with reaction need to be distinguished between ENL and reversal reaction because they may affect therapy and prognosis. Discussion: The patient was diagnosed as BL leprosy with ENL reaction erythematous nodules on the face, both upper and lower arms, upper and lower limbs, knees, that partially felt pain, but after more careful history and histopathologic examination of the lesions, the nodules didn’t match to the histopathologic features of ENL reaction. Correlation between the clinical and histopathological findings in the form of acid fast bacilli (AFB) and granulomatous inflammation grenz zone with epithelioid cells and lymphocyte cells infiltrations in the dermis established the diagnosis of BL leprosy with reversal reaction. Conclusion: Erythema nodule lesions in leprosy can be an ENL or reversal reaction or a leprosy lesion in type BL leprosy. Reversal reaction should always be considered when diagnosing a skin-colored nodule in leprosy. Appropriate clinical and histopathological findings of the skin-colored nodules are needed to establish the definite diagnosis of reversal reaction. Keywords: leprosy, borderline lepromatous, nodule, reversal reaction, erythema nodosum leprosum

Reversal Reaction in Leprosy Patients: Study on Prevalence, Sociodemographic Characteristics, and Precipitating Factors at a Tertiary Referral Hospital in West Java, Indonesia Hendra Gunawan; Risa Miliawati; Renasha Firda Hanannisa
Althea Medical Journal Vol 9, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v9n1.2329

Background: Heretofore, leprosy remains one of the most stigmatizing diseases with serious social consequences. Patients with leprosy might develop inflammatory reactions that interrupt with stable and chronic disease which are called leprosy reactions. Type 1 leprosy reactions, also known as reversal reactions (RR), are caused by immune responses that initially decreases, then “reverses” to become more intense, leading to considerable disability. The aim of this study was to identify the prevalence, sociodemographic characteristics, and precipitating factors of reversal reaction in leprosy patients.Methods: This was a retrospective study with a cross-sectional design, with an approach to collecting data from the medical records of the Leprosy Clinic, Department of Dermatology and Venereology Dr. Hasan Sadikin General Hospital Bandung West Java, during January 2015–December 2019.Results: The results showed that 53 patients (24.7%) of the total 214 leprosy patients experienced a reversal reaction. The most frequent type of leprosy with reversal reaction was borderline lepromatous (BL) (56.5%). Most of the patients were male (68%), aged between 25–44 years (47.2%), unemployed patients (35.8%), and the last education was senior high school (71.7%). Physical stress was suspected as the most precipitating factor in reversal reaction patients (50.9%).Conclusions: The prevalence of leprosy patients with reversal reaction in a Tertiary Referral Hospital West Java, Indonesia is 24.7%, with various characteristics based on sociodemographic. Physical stress is suspected as the most precipitating factor of RR in leprosy patients. Early diagnosis of reversal reaction is important to prevent nerve damage and disability.

Tingkat pengetahuan penyakit kusta dan komplikasinya pada siswa sekolah menengah atas negeri Jatinangor Hendra Gunawan; Pati Aji Achdiat; Rachel Marsella Rahardjo
Dharmakarya Vol 7, No 2 (2018): Juni
Publisher : Universitas Padjadjaran

Kusta merupakan penyakit menular yang masih ditakuti oleh masyarakat. Kusta dipercaya sebagai penyakit kutukan dari Tuhan, penyakit keturunan atau karena ilmu gaib yang sulit disembuhkan, dianggap memalukan dan menimbulkan aib bagi keluarga. Perlakuan diskriminasi terhadap pasien kusta tidak terlepas dari masih rendahnya pengetahuan masyarakat tentang kusta. Tingkat pengetahuan dan sikap masyarakat diketahui berkorelasi dengan dukungan terhadap pasien kusta. Peningkatan pengetahuan dengan penyebaran informasi seperti kegiatan penyuluhan tentang kusta dan komplikasinya merupakan salah satu upaya penting yang harus dilakukan untuk mengurangi stigma dan diskriminasi masyarakat terhadap pasien kusta. Kegiatan pengabdian kepada masyarakat (PPM) berupa penyuluhan ini dilakukan di SMA Negeri Jatinangor, Kecamatan Jatinangor, Kabupaten Sumedang. Peserta penyuluhan yaitu siswa dengan total peserta 50 orang. Pengumpulan data dilakukan dengan menggunakan kuesioner. Setiap lembar kuesioner terdiri dari 10 pertanyaan, yang meliputi etiologi, epidemiologi, penularan, tanda dan gejala, pengobatan, komplikasi, dan pencegahan kusta. Tingkat pengetahuan seluruh siswa SMA tentang kusta dan komplikasinya sebelum dilakukan penyuluhan masih rendah. Pemberian materi penyuluhan diketahui meningkatkan pengetahuan siswa. Dari hasil kuesioner setelah penyuluhan diketahui bahwa 92% peserta penyuluhan memiliki pengetahuan tentang penyakit kusta yang tinggi dan hanya 8% peserta dengan tingkat pengetahuan yang rendah. Tingkat pengetahuan masyarakat yang rendah dipengaruhi oleh tiga faktor utama yaitu tingkat pendidikan yang rendah, kurangnya upaya penyebaran informasi tentang kusta, dan kepercayaan pada masyarakat yang bersifat turun temurun. Penyuluhan dapat meningkatkan pengetahuan siswa tentang penyakit kusta dan komplikasinya. Siswa SMA diharapkan dapat menjadi ujung tombak dalam penyebaran informasi penyuluhan pada keluarga dan masyarakat, sehingga dapat mengurangi stigma dan diskriminasi masyarakat terhadap pasien kusta.

Pengaruh Krim Asam Traneksamat terhadap Pembentukan Keriput dan Kadar Matriks Metaloproteinase-1 pada Mencit (Mus Musculus) Jantan Galur Balb/c yang Dipajan Sinar Ultraviolet B Andrew Citrawan; Oki Suwarsa; Hendra Gunawan; Sudigdo Adi; Ronny Lesmana; Achadiyani Achadiyani; Sunaryati S. Adi
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Pemberian asam traneksamat (AT) per oral telah terbukti dapat mengurangi keriput yang diinduksi oleh kulit kering pada mencit. Namun, dosis oral yang setara terlalu besar untuk digunakan pada manusia dalam jangka panjang karena dapat menimbulkan toksisitas, sehingga perlu dicari sediaan alternatif lain secara topikal seperti sediaan krim. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian krim AT terhadap pembentukan keriput pada kulit mencit jantan galur Balb/c yang dipajan sinar ultraviolet B (UVB). Penelitian dilakukan terhadap 24 ekor mencit di Laboratorium Farmakologi dan Terapi serta Laboratorium Sentral Universitas Padjadjaran pada bulan Februari hingga Mei 2018. Mencit dibagi secara acak ke dalam empat kelompok, yaitu satu kelompok kontrol (P0) hanya mendapatkan pajanan sinar UVB tanpa krim AT dan tiga kelompok perlakuan (P1, P2, dan P3) mendapat pajanan sinar UVB dan diberikan krim AT dengan konsentrasi masing-masing 3%, 4%, dan 5%. Setelah 10 minggu, dilakukan penilaian kondisi keriput pada kulit punggung mencit berdasarkan metode Bisett, dilanjutkan dengan biopsi kulit punggung mencit untuk pemeriksaan kadar matriks metaloproteinase-1 (MMP-1) dengan teknik western blot (WB). Diperoleh perbedaan nilai rata-rata skor keriput yang bermakna sebesar 2,1±0,105 pada kelompok P0, 1,1±0,167 pada P1 dan P2, serta 1,3±0,211 pada P3 (p=0,005). Diperoleh pula nilai rata-rata kadar MMP-1 yang bermakna, yakni sebesar 0,75±0,08 pada kelompok P0, serta 0,54±0,033, 0,40±0,052, dan 0,54±0,072 pada P1, P2, dan P3 secara berturut-turut (p=0,008). Berdasarkan hasil tersebut, dapat disimpulkan bahwa pemberian krim AT mampu memperlambat pembentukan keriput dan menurunkan kadar MMP-1 pada kulit punggung mencit jantan galur Balb/c yang dipajan sinar UVB.Kata kunci: Keriput, krim asam traneksamat, matriks metaloproteinase-1, sinar ultraviolet B The Effect of Tranexamic Acid Cream on Wrinkle Formation and Matrix Metalloproteinase-1 Levels on Male Balb/c Mice Skin Exposed to Ultraviolet B RadiationsAbstractOral tranexamic acid (TXA) has been proven to ameliorate wrinkle induced by skin dryness in hairless mouse. However, the equal human oral dose is too high and can induce toxicity if used in long term, and study of topical preparations for wrinkle treatment is limited. Therefore, this study was conducted using topical preparations as an alternative for oral treatment to examine the effects of TXA cream in wrinkle formation. Four weeks old of twenty-four male Balb/c mice, divided into four groups, then 3%, 4% and 5% TXA cream were administered on the back skin of mice in each group shortly after ultraviolet B (UVB) exposure, except for control group that only exposed to UVB lights without given any TXA creams. Wrinkle formation and matrix metalloproteinase (MMP-1) level were observed after 10 weeks of treatments. There were significant differences of wrinkle score, with mean value were 2.1±0.105 for control group, 1.1±0.167 for 3% and 4% groups, and 1.3±0.211 for 5% group (p=0.005). There were also significant differences of MMP-1, with mean value were 0.75±0.08 for control group, 0.54±0.033, 0.40±0.052, and 0.54±0.072 for 3%, 4% and 5% group, respectively (p=0.008). Based on significant differences of wrinkle score and MMP-1 level, it can be concluded that administration of TXA cream may able to delay wrinkle formation and reduce the MMP-1 level on the mice skin exposed to ultraviolet B.Keywords: Matrix metalloproteinase-1, tranexamic acid, ultraviolet B, wrinkle

Metabolic Syndrome In Psoriasis Vulgaris Patient Wulan Yuwita; Hendra Gunawan; Unwati Sugiri; Dendi Sandiono
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 3 (2016): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Background: The management of metabolic syndrome in psoriasis vulgaris is rather complicated, including lifestyle modification, diet intake intervention, increasing daily activities, and managing the comorbidity factors. Purpose: Management of metabolic syndrome in psoriasis vulgaris requires holistic approach. Case: A case of metabolic syndrome with psoriasis vulgaris in a-56-year-old woman was reported with chief complaint generalized erythematous plaques, papules, scales, and hyperpigmented macules. Blood pressure was 160/90 mmHg with central obesity and waist circumference was 98 centimeters. The patient manifested with onychodystrophy and subungual hyperkeratosis digiti I pedis bilateral. Fasting blood glucose was 119 mg/dL, and triglyceride was 185 mg/dL. Management: Patient management included methotrexate, bisoprolol, captopril, simvastatin, lifestyle modification, and diabetic diet (1300 kkal and protein 0.8 mg/kg/body weight/day). Conclusion: Holistic management revealed a good response in this case. The initial psoriasis area and severity index (PASI) score before therapy was 24.8, became 9.0 after therapy on day 155th of observation.

The Effect of Systemic Methotrexate and Cyclosporine Combination Therapy inPsoriasis Vulgaris Patients in Bandung, Indonesia Oki Suwarsa; Fatima Aulia Khairani; Syawalika Ulya Isneny; Erda Avriyanti; Hartati Purbo Dharmadji; Miranti Pangastuti; Endang Sutedja; Hendra Gunawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 3 (2021): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.3.2021.200-204

Background: Methotrexate (MTX) and cyclosporine have been used as effective systemic mono-therapy for psoriasis. Several factors are considered to switch monotherapy to combination therapy because monotherapy is no longer effective and has higher side effects. Hence,clinicians have avoided systemic therapy combinations due to its toxicity. However, some studies showed that this combination therapy could be usedeffectively for psoriasis patients. Purpose: This study aimed to analyze the efficacy and adverse effects of systemic MTX and cyclosporine combination therapy in Indonesian psoriasis vulgaris patients. Methods: The retrospective study assessed the effectiveness of 3 monthsmono-therapyand combination therapy of systemic MTX and cyclosporine in psoriasisvulgaris patients from 2016–2017 in Dermatology Clinic, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia. Result: Psoriasis area and severity index (PASI) score 90 were achieved in the group MTX (50%) and cyclosporine group (50%), while none in the combination group.However, eight patients (50%) in group MTX and cyclosporine reached the primary endpoint of PASI 50. One patient in cyclosporine group had adverse effects on kidney profiles. Nonetheless, other patients had no biochemical changes. But, there was no significant difference in the change of PASI between each group (p=0.102). Conclusion: We propose that combination therapy of MTX and cyclosporine is relatively safe and efficacious in treating Indonesian psoriasis vulgaris patients. This combination treatment isas effective as MTX or cyclosporinemono-therapy.

Co-Authors Achadiyani Andrew Citrawan Dendi Sandiono Endang Sutedja Erda Avriyanti Fatima Aulia Khairani Hartati Purbo Dharmadji Laila Tsaqilah Miranti Pangastuti Oki Suwarsa Pati Aji Achdiat Rachel Marsella Rahardjo Renasha Firda Hanannisa Risa Miliawati Ronny Lesmana Sudigdo Adi Sunaryati S. Adi Syawalika Ulya Isneny Unwati Sugiri Wulan Yuwita

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