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Steven johnson syndrome induce by carbamazepine in epileptic patient: a case report Pramita, Nyoman Yoga Maya; Sudarsa, Prima Saraswati Sanjiwani; Nukana, Ratih Purnamasari
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Introduction: Steven Johnson Syndrome (SJS) is life-threatening skin reaction, it is a mucocutaneous disorder induced by immune complex-mediated hypersensitivity reaction. Most frequent offending agents are antibiotic, antiretroviral and aromatic anticonvulsants. Problems arise when these drugs are required for long-term use and necessary for several health conditions. These case series aim to describe SJS and provide replacement therapy especially inpatient with epilepsy.Case report: A 37 years old female was consulted from neurology department with chief complaints an erythematous rash on her chest, back upper and lower extremities accompanied with fever, the patient also complaint erosions on her lips. She had history of seizure and was prescribe Carbamazepine. Carbamazepine was replaced and patient treated with dexamethasone intravenously. After 1 week of admitted there is an improvement.Conclusion: Steven Johnson Syndrome (SJS) is a life-threatening disease, the replacement of the suspected drugs and appropriate therapy can improve the prognosis of patient.Ã‚Â

Selection of topical corticosteroids in children atopic dermatitis Stephanie, Aurelia; Sudarsa, Prima Sanjiwani Saraswati; Rusyati, Luh Mas
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.v2i2.30

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically starts in childhood with classic symptoms of dry and itchy skin that occurs continuously and recurrences and even causes sleep disorders and skin that is susceptible to infection. AD sufferers often have atopic comorbidities such as asthma and allergic rhinitis in themselves and their families. The effects of this itching cycle result in growth disturbance and decreased quality of life for AD patients and their parents. Moderate and severe AD have an impact on parents, the stress in medication, and care, which takes up time and money. Atopic dermatitis is due to damage to the skin barrier, so the principle of management is to improve the skin barrier so that the inflammatory process can be avoided. The course of AD is chronic and relapsing; generally, patients come for treatment with an acute phase that sometimes requires topical corticosteroids. However, topical corticosteroids (TC) are used only to treat the acute phase for a short period. After the acute lesions have subsided, corticosteroids can be stopped immediately to prevent side effects and continue with daily skincare.Conclusion: Topical corticosteroids are first-line therapy in the acute phase. The choice of TC is based on age, body location, dosage, and severity of AD. If the acute lesion has subsided, then corticosteroids can be stopped and substituted with other antipruritic therapy and moisturizer.

Focus on the dabrafenib, vemurafenib, and trametinib in clinical outcome of melanoma: a systematic review and meta-analysis Widya Anjani, Ida Ayu; Indrakusuma, Anak Agung Bagus Putra; Arim Sadeva, I Gede Krisna; Wulandari, Putri Ayu; Rusyati, Luh Made Mas; Sudarsa, Prima Sanjiwani Saraswati; Supadmanaba, I Gede Putu; Wihandani, Desak Made
Bali Dermatology and Venereology Journal Vol 3, No 2 (2020)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v3i2.38

Background: Melanoma is the most serious lethal skin cancer, affects the melanin producer cells (melanocytes). Surgery is the most common treatment, whereas for the advance stage the development of a treatment is recommended. BRAF (Dabrafenib and Vemurafenib) inhibitor or MEK inhibitor (Trametinib) is used as the most frequently targeted therapy of melanoma due to more than 80% patient with positive BRAF mutation. In this review, those treatments will be investigated systematically to identify their clinical outcome.Method: This systematic literature review (SLR) was performed from Cochrane, Science Direct, Google Scholar, and Pubmed. Cochrane Risk-of-Bias Tool RoB2 is used to assess RCT studies and New-castle Ottawa Scale Assessment to assess cohort studies by 3 different assessors. Data analysis was carried out by using Review Manager (RevMan 5.4). Heterogenicity test was assessed by I2 Ã‚Â and Chi2 statisticResult: There are 20 studies used in this article (13 RCT and 7 cohorts). The overall survival (OS) and progression-free survival (PFS) of study that using targeted therapy (vemurafenib, trametinib, or dabrafenib) compare other therapies (chemotherapy, immunotherapy,etc) showed risk ratio (RR) was 1.12 (95%CI 1.07,1.17;Ã‚Â I2=100%; p<0,00001). The OS and PFS with monotherapy compare of vemurafenib, trametinib, or dabrafenib with combination therapy showed RR was 1.09 (95%CI.06,1.13;I2=99%; p<0,00001). Conclusion: BRAF and MEK targeted therapy has a good prognosis for a patient with a positive BRAF gene mutation and could be combined with other therapy for a better clinical outcome rather than monotherapy.Keyword: melanoma, dabrafenib, vemurafenib, and trametinib

Generalized pustular psoriasis with nail psoriasis in children: a case report Gotama, Dewi; Sudarsa, Prima Sanjiwani Saraswati; Saputra, Herman
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.v2i2.28

Background: Pustular psoriasis in children is one of the clinical variants of psoriasis. It is classified into generalized pustular psoriasis (GPP) and localized pustular psoriasis. The aetiology of psoriasis in children has not been known but is believed to be multifactorial. Nail psoriasis rarely occurs in children who suffer from skin psoriasis, with an incidence lower than that reported in adults. The diagnosis is generally made from the clinical and histological examination. The choice of therapy depends on the severity of the disease. Until now, there have been no specific guidelines for the management of psoriasis in children.Case report: A-15-years-old Balinese girl presenting with erythema, confluent scaly plaques over the trunk and extremities with pustules localized on the lower extremity. She had a history of fever before the lesions appear. Right third digital nails examination showed subungual hyperkeratosis and onycholysis. Positive auspitz sign and karsvlek phenomena were found. Biopsy result suitable for psoriasis. The patient got improvement after treated with methotrexate tablet orally and desoximetasone cream topically within four weeks without any side effect.Conclusion: Combination therapy with methotrexate tablet and desoximetasone cream give an effective result. However, the safety and side effects of methotrexate in children still need further monitoring.Ã‚Â

HUBUNGAN STRES TERHADAP TIMBULNYA AKNE VULGARIS PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA PROGRAM STUDI PENDIDIKAN DOKTER ANGKATAN 2017 Komang Saputra Yadnya; Anak Agung Gde Putra Wiraguna; Ni Putu Ratih Vibriyanti Karna; Prima Sanjiwani Sudarsa
E-Jurnal Medika Udayana Vol 9 No 12 (2020): Vol 9 No 12(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i12.P12

ABSTRAK Akne vulgaris dapat timbul karena beberapa faktor risiko, salah satunya adalah stres. Stres memicu peningkatan hormon androgen, dimana hormon androgen membuat kelenjar minyak membesar dan terjadilah peningkatan jumlah sebum. Penelitian ini dilaksanakan untuk mengetahui hubungan antara stres terhadap timbulnya akne vulgaris pada mahasiswa Program Studi Pendidikan Dokter angkatan 2017 FK UNUD. Desain penelitian yang digunakan metode cross-sectional dengan menggunakan data primer melalui kuisioner PSS-10 untuk mengetahui tingkat stres pada mahasiswa dan observasi untuk membuktikanada tidaknya akne vulgaris pada saat itu. Sampel penelitian ini terdiri dari 79 mahasiswa Program Studi Pendidikan Dokter angkatan 2017 FK UNUD yang diambil secara cluster sampling. Hasil penelitian didapatkan sampel yang menderita akne vulgaris sebanyak 28 orang (35,4%) sedangkan yang tidak mengalami adalah 51 orang (64,6%). Sampel yang mengalami stres adalah 60 orang (75,9%) sedangkan yang tidak 19 orang (24,1%). Setelah melakukan uji statistik terhadap akne vulgaris dan stres dengan uji chi-square diperoleh nilai p=0,02 (<0,05) yang membuktikan adanya hubungan antara stres dengan akne vulgaris pada Mahasiswa Fakultas Kedokteran Universitas Udayana Program Studi Pendidikan Dokter angkatan 2017. Kata Kunci: Akne Vulgaris, Sebum, Stres

HUBUNGAN TINGKAT PENGETAHUAN DAN SIKAP MENGENAI PAPARAN SINAR MATAHARI DAN KANKER KULIT PADA MAHASISWA KELAUTAN DAN PERIKANAN UNIVERSITAS UDAYANA, BALI Sang Ayu Arta Suryantari; agung bagus sista Satyarsa; I Gusti Ayu Tika Indriani; Prima Saraswati Sudarsa; Luh Mas Rusyati; Made Swastika Adiguna
Essence of Scientific Medical Journal Vol 17 No 1 (2019): Volume 17 No. 1 (Januari-Juni 2019) ESSENTIAL: Essence Of Scientific Medical Jou
Publisher : Kelompok Ilmiah Hippocrates Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/ESTL.2019.v17.i01.p07

Pendahuluan: Mahasiswa yang sering melakukan aktivitas belajar di luar ruangan termasuk kelompok yang berisiko mengalami kanker kulit. Hal tersebut disebabkan karena mereka sering terpapar sinar matahari langsung dengan intensitas yang tinggi. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat pengetahuan dan sikap mahasiswa Fakultas Kelautan dan Perikanan Universitas Udayana terhadap paparan sinar matahari dan kanker kulit. Metode: Penelitian yang digunakan yaitu analitik cross-sectional yang dilaksanakan pada tanggal 18 Juni – 20 Juni 2018 di Fakultas Kelautan dan Perikanan Universitas Udayana, Bali. Data karakteristik sosiodemografi, tingkat pengetahuan dan sikap diperoleh menggunakan kuesioner yang tervalidasi sebelumnya. Data kemudian dianalisis menggunakan SPSS. Hasil: Terdapat 119 orang responden yang terlibat dalam penelitian ini dengan median usia 20 (16-24) tahun. Sebagian besar responden adalah perempuan (64,7%). Sebanyak 108 orang (90,8%) memiliki pengetahuan yang baik dan sebanyak 60 orang (50,4) memiliki sikap positif. Pembahasan: Terdapat hubungan yang bermakna antara jenis kelamin dan sikap (p=0,047) serta antara tingkat pengetahuan dan sikap (p=0,000). Simpulan: Dapat disimpulkan bahwa responden yang memiliki pengetahuan yang baik dan sikap positif cukup tinggi. Terdapat hubungan yang bermakna antara tingkat pengetahuan dan sikap mengenai paparan sinar matahari dan kanker kulit.

Steven johnson syndrome induce by carbamazepine in epileptic patient: a case report Nyoman Yoga Maya Pramita; Prima Saraswati Sanjiwani Sudarsa; Ratih Purnamasari Nukana
Bali Dermatology and Venereology Journal Vol. 2 No. 1 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v2i1.14

Introduction: Steven Johnson Syndrome (SJS) is life-threatening skin reaction, it is a mucocutaneous disorder induced by immune complex-mediated hypersensitivity reaction. Most frequent offending agents are antibiotic, antiretroviral and aromatic anticonvulsants. Problems arise when these drugs are required for long-term use and necessary for several health conditions. These case series aim to describe SJS and provide replacement therapy especially inpatient with epilepsy.Case report: A 37 years old female was consulted from neurology department with chief complaints an erythematous rash on her chest, back upper and lower extremities accompanied with fever, the patient also complaint erosions on her lips. She had history of seizure and was prescribe Carbamazepine. Carbamazepine was replaced and patient treated with dexamethasone intravenously. After 1 week of admitted there is an improvement.Conclusion: Steven Johnson Syndrome (SJS) is a life-threatening disease, the replacement of the suspected drugs and appropriate therapy can improve the prognosis of patient.Â

Generalized pustular psoriasis with nail psoriasis in children: a case report Dewi Gotama; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra
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.v2i2.28

Background: Pustular psoriasis in children is one of the clinical variants of psoriasis. It is classified into generalized pustular psoriasis (GPP) and localized pustular psoriasis. The aetiology of psoriasis in children has not been known but is believed to be multifactorial. Nail psoriasis rarely occurs in children who suffer from skin psoriasis, with an incidence lower than that reported in adults. The diagnosis is generally made from the clinical and histological examination. The choice of therapy depends on the severity of the disease. Until now, there have been no specific guidelines for the management of psoriasis in children.Case report: A-15-years-old Balinese girl presenting with erythema, confluent scaly plaques over the trunk and extremities with pustules localized on the lower extremity. She had a history of fever before the lesions appear. Right third digital nails examination showed subungual hyperkeratosis and onycholysis. Positive auspitz sign and karsvlek phenomena were found. Biopsy result suitable for psoriasis. The patient got improvement after treated with methotrexate tablet orally and desoximetasone cream topically within four weeks without any side effect.Conclusion: Combination therapy with methotrexate tablet and desoximetasone cream give an effective result. However, the safety and side effects of methotrexate in children still need further monitoring.Â

Selection of topical corticosteroids in children atopic dermatitis Aurelia Stephanie; Prima Sanjiwani Saraswati Sudarsa; Luh Mas Rusyati
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.v2i2.30

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically starts in childhood with classic symptoms of dry and itchy skin that occurs continuously and recurrences and even causes sleep disorders and skin that is susceptible to infection. AD sufferers often have atopic comorbidities such as asthma and allergic rhinitis in themselves and their families. The effects of this itching cycle result in growth disturbance and decreased quality of life for AD patients and their parents. Moderate and severe AD have an impact on parents, the stress in medication, and care, which takes up time and money. Atopic dermatitis is due to damage to the skin barrier, so the principle of management is to improve the skin barrier so that the inflammatory process can be avoided. The course of AD is chronic and relapsing; generally, patients come for treatment with an acute phase that sometimes requires topical corticosteroids. However, topical corticosteroids (TC) are used only to treat the acute phase for a short period. After the acute lesions have subsided, corticosteroids can be stopped immediately to prevent side effects and continue with daily skincare.Conclusion: Topical corticosteroids are first-line therapy in the acute phase. The choice of TC is based on age, body location, dosage, and severity of AD. If the acute lesion has subsided, then corticosteroids can be stopped and substituted with other antipruritic therapy and moisturizer.

Focus on the dabrafenib, vemurafenib, and trametinib in clinical outcome of melanoma: a systematic review and meta-analysis Ida Ayu Widya Anjani; Anak Agung Bagus Putra Indrakusuma; I Gede Krisna Arim Sadeva; Putri Ayu Wulandari; Luh Made Mas Rusyati; Prima Sanjiwani Saraswati Sudarsa; I Gede Putu Supadmanaba; Desak Made Wihandani
Bali Dermatology and Venereology Journal Vol. 3 No. 2 (2020)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v3i2.38

Background: Melanoma is the most serious lethal skin cancer, affects the melanin producer cells (melanocytes). Surgery is the most common treatment, whereas for the advance stage the development of a treatment is recommended. BRAF (Dabrafenib and Vemurafenib) inhibitor or MEK inhibitor (Trametinib) is used as the most frequently targeted therapy of melanoma due to more than 80% patient with positive BRAF mutation. In this review, those treatments will be investigated systematically to identify their clinical outcome.Method: This systematic literature review (SLR) was performed from Cochrane, Science Direct, Google Scholar, and Pubmed. Cochrane Risk-of-Bias Tool RoB2 is used to assess RCT studies and New-castle Ottawa Scale Assessment to assess cohort studies by 3 different assessors. Data analysis was carried out by using Review Manager (RevMan 5.4). Heterogenicity test was assessed by I2 Â and Chi2 statisticResult: There are 20 studies used in this article (13 RCT and 7 cohorts). The overall survival (OS) and progression-free survival (PFS) of study that using targeted therapy (vemurafenib, trametinib, or dabrafenib) compare other therapies (chemotherapy, immunotherapy,etc) showed risk ratio (RR) was 1.12 (95%CI 1.07,1.17;Â I2=100%; p<0,00001). The OS and PFS with monotherapy compare of vemurafenib, trametinib, or dabrafenib with combination therapy showed RR was 1.09 (95%CI.06,1.13;I2=99%; p<0,00001). Conclusion: BRAF and MEK targeted therapy has a good prognosis for a patient with a positive BRAF gene mutation and could be combined with other therapy for a better clinical outcome rather than monotherapy.Keyword: melanoma, dabrafenib, vemurafenib, and trametinib

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