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Buschke-Lowenstein tumour (BLT)/giant condyloma acuminatum (GCA): an immunopathogenesis insight Christopher, Paulus Mario; Kosim, Hartono; Wijaya, Ratna Sari; Suhardi, Silvi; Wijayadi, Linda Julianti
Bali Dermatology and Venereology Journal Vol 3, No 1 (2020)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v%vi%i.27

Buschke Lowenstein tumor (BLT)/giant condyloma acuminatum is a rare variant of a sexually transmitted infection caused by human papillomavirus (HPV) type 6 and 11. HPV has its viral factors that exist to avoid immune surveillance and control through 1) infecting only the basal layer of the epithelium, 2) downregulation of host immunity, 3) suppression of proinflammatory proteins essential for viral clearance. The incidence of BLT/GCA is estimated to be 0.1% in the general population, with males having 2.7 times increased risk than females. A BLT/GCA is characterized by verrucous tumor or palpable cauliflower-likemass, exophytic growth, flesh-colored, and uneven surface. The definitive diagnosis of BLT/GCA is typical morphology along with histopathological examination, and/or viral serotyping. Treatment of BLT/GCA requires a multidisciplinary approach, determined based on age, the extent of the lesion, organ involvement, and organ location.

Update on scrofuloderma Marianto, Marianto; Kosim, Hartono; Agung Mahariski, Pande; Christopher, Paulus Mario
Bali Dermatology and Venereology Journal Vol 2, No 2 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v2i2.20

Tuberculosis is one of the most significant diseases which causes death worldwide. TB infection is assumed to infect the lungs only from a general perspective. In fact, TB infection also causes lesions on the skin. Scrofuloderma, as one of the most common types of cutaneous tuberculosis, often misdiagnosed and managed improperly due to its similarity with abscess. In addition, there were still no national and international guidelines for scrofuloderma. This review to give insights and review about an update in the basic principle of scrofuloderma and management.

Natural History and Risk Factors of Infantile Atopic Dermatitis: A Case Report and Literature Review Christopher, Paulus Mario; Hung, Maggie Stella
Medicinus Vol 9, No 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2762

Atopic dermatitis (AD) or atopic eczema is one of the most common forms of pediatric dermatological skin conditions, primarily beginning in childhood with a variable natural course characterized by intense pruritus and eczematous lesions. This condition requires multifactorial interplay and risk factors to explain the pathogenesis. We hereby report a case of a two-month-old male who presented with widespread erythematous lesions, excoriations, and dry skin since one day before admission. The antenatal history showed use of antibiotics during pregnancy, familial history of atopy, and non-exclusive breastfeeding which are all known risk factors. Dermatological examination revealed skin phototype III with diffuse erythematous patches scattered on the face, trunk, upper and lower limbs, and groin followed with excoriations and palmar hyperlinearity. Further laboratory and histopathological examinations were not conducted. The patient was treated with topical corticosteroid and emollients, resulting in a notable improvement without any further flares. A thorough history taking and physical examination must be conducted to establish the diagnosis based on the Hanifin and Rajka criteria and identify risk factors such as genetic factors, impaired skin barrier, and environmental factors and microbial exposure, which may play a protective or harmful role in AD development. Holistic treatments consist of pharmacological and non-pharmacological treatments, with significant emphasis on education to the patient and caregiver(s) to improve quality of life and prevent exacerbations and infectious complications while minimizing potential medication side effects.

Comparative efficacy of topical 10% versus 5% tranexamic acid in treatment of women with melasma: a double-blind randomized controlled trial Mawu, Ferra Olivia; Kapantow, Marlyn Grace; Pandaleke, Herry E. J.; Cahyadi, Alexandro Ivan; Togelang, Lidya; Tampi, Joan Alexandra; Christopher, Paulus Mario
Universa Medicina Vol. 43 No. 2 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.213-219

BackgroundMelasma is a highly prevalent chronic pigmentary disorder. The pathogenesis is unknown but melasma often occurs in photo-exposed areas, e.g., cheeks, upper lip, chin, and forehead. Tranexamic acid (TA), a plasmin inhibitor, aids in the inhibition of UV-induced plasmin activity and melanogenesis, making it a favorable therapeutic option for melasma. Tranexamic acid may be administered through various routes, e.g., topical. This study aimed to compare the efficacy of topical 10% versus 5% TA in women with melasma. MethodsThis double-blind randomized controlled trial included 16 females with epidermal type melasma who were randomized into two groups to receive either topical 10% TA (n = 8) or 5% TA (n = 8) applied twice daily for eight weeks. Prior to intervention and at 8 weeks after intervention, the intensity and extension of melasma were assessed based on melasma area and severity index (MASI) score and pigmentation score. ResultsMean MASI and pigmentation scores in both treatment groups were similar at base-line (p>0.05). The reduction in MASI and pigmentation scores in the topical 10% TA and 5% TA groups was similar and statistically not significant after 4 and 8 weeks of treatment (p>0.05). There were no drug-related adverse reactions or complications. ConclusionThis study demonstrated that topical 10% TA and 5% TA were effective in treating women with melasma. The utilization of topical 5% TA for melasma is a promising alternative therapeutic option without the need to increase the concentration of the formulation.

The efficacy of combination of oral antioxidants and topical retinoic acid versus topical retinoic acid monotherapy in mild acne vulgaris patients Mawu, Ferra Olivia; Kapantow, Marlyn Grace; Christopher, Paulus Mario
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 2 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i2.14640

Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous follicle with multifactorial pathogenesis and pleiomorphic clinical manifestations constituting comedones, papules, pustules, nodules, and cysts. Oxidative stress has been reported to contribute in AV pathogenesis. This phenomenon rationalizes antioxidant supplementation as an adjuvant therapy for AV management. Four cases of 22 to 23 yo women with complaints of worsening facial acne for 1 to 6 mo. Initially, acne lesions appeared as skin-colored papules, which increased in number, became reddish papules and pustules, and extended to the jaw and chin. Lesions were accompanied by temporary itching and pain. Dermatological examination revealed multiple circumscribed discrete erythematous papules, miliar to lenticular in size, comedones (+), and pustules (+), with total lesions <30. According to the Lehmann criteria, patients were diagnosed as mild AV. All patients were treated with 0.025% topical retinoic acid cream, while the other two patients received additional oral antioxidant supplementations (zinc and ɑ-lipoic acid) and were followed up every two weeks. Two cases who received additional oral antioxidant supplementations (Group A) exhibited an earlier and higher clinical improvement, characterized by a reduction in the number of lesions on each follow up, till the current report. Oxidative stress in AV pathogenesis causes microenvironment alteration that favours colonization of Cutibacterium acnes. Together with the increase in sebum production, it stimulates the release of pro-inflammatory cytokines, such as interleukin (IL)-1α, IL-8, and tumor necrosis factor-α (TNF α), contributing to the inflammatory response. Antioxidant supplementation plays a role in suppressing the process of lipid peroxidation and inhibiting the expression of pro-inflammatory cytokines. Comprehensive management of AV is based on pathogenesis and the role of oxidative stress. An earlier and higher clinical improvement reduction was noted in Group A, patients who received a combination of 0.025% topical retinoic acid cream and oral antioxidant supplementation.

Successful Management of Post-Excisional Biopsy Dehisced Wound with 1% Framycetin Sulphate and Ozonated Oil Adjuvant: A Case Report Mawu, Ferra Olivia; Sondakh, O. Reymond L.; Tampi, Joan Alexandra; Christopher, Paulus Mario
Journal of Biomedicine and Translational Research Vol 11, No 1 (2025): April 2025
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v11i1.25956

Background: Wound dehiscence is wound edges separation due to disrupted wound healing. Wound dehiscence is a complication in 8% of dermatologic surgeries. In this case, secondary infection of the wound occurred, 1% framycetin sulphate tulle was then chosen to interfere microbial protein synthesis, combined with ozonated oil as adjuvant therapy. Ozone oxidizes bacterial phospholipids and lipoproteins, promotes local tissue metabolism, stimulates fibroblast proliferation, facilitates collagen fiber formation, and supports angiogenesis. This case report described a post-excisional biopsy dehisced wound that was treated with 1% framycetin sulphate tulle and ozonated oil, and this case is the first to report a successful management of post-excisional biopsy dehisced wound with ozonated oil as adjuvant. Case Presentation: An 11-year-old female was brought with a purulent wound on her head post-excisional biopsy. Examination of the parietal region showed a solitary ulcer, 1 cm in diameter, irregular edge, granulated tissue base, serous exudate, crusting, edema, and pus. Treatment was 0.9% NaCl compress, 1% framycetin sulphate tulle, and ozonated oil once weekly. Evaluation on day 21 showed ulcer size reduction and on day 28, ulcer turned into a scar, treatment was continued with mometasone 0.1% cream. Day 86 showed secondary cicatricial alopecia. Complications of a wound in hair-bearing area can occur, in this case, secondary cicatricial alopecia.Conclusion: This paper highlights the utilization of ozonated oil as an adjuvant therapy for a favorable outcome in wound healing.

Natural History and Risk Factors of Infantile Atopic Dermatitis: A Case Report and Literature Review Christopher, Paulus Mario; Hung, Maggie Stella
Medicinus Vol. 9 No. 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2762

Atopic dermatitis (AD) or atopic eczema is one of the most common forms of pediatric dermatological skin conditions, primarily beginning in childhood with a variable natural course characterized by intense pruritus and eczematous lesions. This condition requires multifactorial interplay and risk factors to explain the pathogenesis. We hereby report a case of a two-month-old male who presented with widespread erythematous lesions, excoriations, and dry skin since one day before admission. The antenatal history showed use of antibiotics during pregnancy, familial history of atopy, and non-exclusive breastfeeding which are all known risk factors. Dermatological examination revealed skin phototype III with diffuse erythematous patches scattered on the face, trunk, upper and lower limbs, and groin followed with excoriations and palmar hyperlinearity. Further laboratory and histopathological examinations were not conducted. The patient was treated with topical corticosteroid and emollients, resulting in a notable improvement without any further flares. A thorough history taking and physical examination must be conducted to establish the diagnosis based on the Hanifin and Rajka criteria and identify risk factors such as genetic factors, impaired skin barrier, and environmental factors and microbial exposure, which may play a protective or harmful role in AD development. Holistic treatments consist of pharmacological and non-pharmacological treatments, with significant emphasis on education to the patient and caregiver(s) to improve quality of life and prevent exacerbations and infectious complications while minimizing potential medication side effects.

Male Androgenetic Alopecia Treated with Single Spin Platelet Rich Plasma: A Case Report Ursula Dien, Anggi Anastasia; Mawu, Ferra Olivia; Adji, Aryani; Anggawirya, William Yudistha; Christopher, Paulus Mario
Eduvest - Journal of Universal Studies Vol. 5 No. 11 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i11.52334

Androgenetic alopecia (AGA) is the most common type of hair loss, causing gradual, progressive miniaturization of hair follicles and shortening of the anagen phase in genetically predisposed men and women, following a distinct pattern. Hair loss usually begins after puberty and is more prevalent in men. This case report details a young male patient with androgenetic alopecia treated with single spin platelet-rich plasma (PRP) therapy combined with topical minoxidil. A 27-year-old Minahasan male experienced hair thinning and loss for 10 years, starting at the middle of his head and spreading outward. Examination showed thinning at the fronto-parietal hairline and vertex, classified as Hamilton-Norwood III vertex. Treatment involved biweekly single spin PRP injections and twice-daily application of 5% topical minoxidil. The PRP was prepared by centrifugation at 3000 rpm for 15 minutes, with up to nine sessions administered. Clinical evaluations through hair pull tests and trichoscopy revealed significant improvement, including increased hair density and changes in follicle diameter in treated areas. By week eighteen, hair density increased markedly, and hair loss diminished without side effects. The patient was highly satisfied with the cosmetic results. This case report indicates that single spin PRP combined with topical minoxidil is an effective, safe, and reliable treatment for male androgenetic alopecia, offering clinical improvement and enhanced hair growth without adverse effects. The simplified PRP protocol provides practical advantages for clinical use, especially in resource-limited settings, and supports growing evidence for PRP as an adjunct therapy for androgenetic alopecia in young Asian patients.

Serum Lipid Profile and Inflammatory Severity in Acne Vulgaris: Implications for Metabolic Health Kapantow, Marlyn Grace; Kapantow, Nova Hellen; Kairupan, Tara Sefanya; Gaghana, Sthefanie Mariska; Christopher, Paulus Mario
Althea Medical Journal Vol 12, No 4 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v12n4.4392

Background: Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous unit with varying degrees of severity. Increasing evidence suggests that metabolic disturbances, including dsylipidemia, may contribute to its inflammatory progression. This study aimed to investigate the association between serum lipid profiles and AV severity. Methods: A cross-sectional study was conducted among 30 patients with AV aged 25–40 years at a tertiary hospital in Manado, Indonesia. Serum triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol levels were measured. Association between lipid parameters and AV severity were assessed using Spearman’s rank correlation. Group differences were analyzed using one-way ANOVA or the Kruskal-Wallis test with post-hoc analysis.Results: Participants were predominantly Minahasa (66.7%) and female (60.0%). Total cholesterol and LDL levels demonstrated strong positive correlations with AV severity (r=0.696 and 0.654, respectively; p<0.001). Patients with severe AV had significantly higher total cholesterol and LDL levels compared to those with mild and moderate AV (F= 13.275; p<0.001 for total cholesterol; H= 12.496; p=0.002 for LDL). Triglycerides levels showed a weak correlation with AV severity (r= 0.375; p=0.041) but no significant intergroup difference (p= 0.112). HDL levels were not significantly associated with AV severity (p= 0.198).Conclusions: Dyslipidemia, specifically elevated total cholesterol and LDL, is strongly associated with severe AV. These findings underscore the importance of metabolic evaluation and lifestyle-based interventions as part of comprehensive management to reduce inflammation and promote long-term metabolic health.

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