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Journal : MEDICINUS

Prosedur Pembedahan pada Hiperhidrosis Aksilaris dengan Teknik Tumesen Liposuction-Curettage Danu Yuliarto; Wibisono Nugraha; Moerbono Mochtar; Ammarilis Murastami
MEDICINUS Vol. 35 No. 1 (2022): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (179.739 KB) | DOI: 10.56951/medicinus.v35i1.86

Abstract

Hyperhidrosis is an excessive sweat production due to autonomic nerve dysfunction that occurs in areas with higher concentration of eccrine gland such as palms, soles of the feet, and axilla. Management of hyperhidrosis includes pharmacological and nonpharmacological approach. Patients with severe focal hyperhidrosis should consider surgical treatment or botulinum toxin injection. Tumescent liposuction with curettage is one of surgical technique option for the treatment of axillary hyperhidrosis. Case: A 32-year-old woman with complaint of excessive sweating, especially in the axillary area. The patient had received oral therapy from a dermatologist prior, but there was no improvement, so the patient was advised to undergo a surgical procedure. In this patient the tumescent liposuction-curettage procedure was performed. Discussion: Treatment of hyperhidrosis with both topical and systemic agents generally provides only temporary suppression of hyperhidrosis. In severe, disturbing cases, the treatment of choice for axillary hyperhidrosis is the surgical procedure. Combination of liposuction-curettage surgical method using tumescent anesthesia is relatively simple and safe. Reduction of apocrine gland secretion after liposuction-curettage takes a relatively long time. This surgical technique has many advantages, such as relatively minimal injury dan short recovery period. Follow-up after this combined liposuction-curettage procedure should be performed subjectively and objectively at 3, 6, and 12 months postoperative.
Kromoblastomikosis Penyakit Jamur yang Terabaikan Danu Yuliarto; Achmad Satya Negara; Harijono Kariosentono; Nugrohoaji Dharmawan; Nurrachmat Mulianto
MEDICINUS Vol. 36 No. 1 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i1.116

Abstract

Chromoblastomycosis is a deep fungal infection of the skin and subcutaneous tissue caused by pigmented or dematiaceous fungi. This disease is endemic in tropical and subtropical regions such as Asia, Africa, and Latin America. Chromoblastomycosis is more common in adult men who work in agricultural areas, work as gardeners, or as carpenters. The diagnosis of chromoblastomycosis is confirmed by the finding of muriform cells or medlar bodies obtained from skin scrapings, microscopic culture, or tissue histopathological examination. The clinical feature varies, the initial lesion is a papule that spreads slowly over several months or years, and then this lesion will form a plaque with atrophic center. Many patients go undiagnosed at the early stage of the disease because this stage is rarely seen. Treatment of chromoblastomycosis includes surgery for the initial lesion and pharmacological therapy using antifungal agent such as itraconazole, the most commonly used drug for the treatment of chromoblastomycosis. The prognosis for chromoblastomycosis is poor, except on new lesions.
Tinjauan Histopatologi pada Pyoderma Gangrenosum dengan Infeksi Sekunder Wibisono Nugraha; Danu Yuliarto; Eka Devinta Novi Diana; Alfina Rahma; Prasetyadi Mawardi; Frieda; Ambar Mudigdo
MEDICINUS Vol. 36 No. 2 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i2.123

Abstract

Background: Pyoderma gangrenosum (PG) is a complex neutrophilic dermatosis, characterized by sterile, painful, necrotic ulcer, and is associated with systemic conditions. PG manifests as papules and vesicles that evolve into painful ulcers. Incidence of PG is relatively rare in Dr. Moewardi Hospital, so it is important to identify and correctly diagnose PG based on its’ histopathological features. Case A 54-year-old man complained of painful scab on several body parts. Hematoxylin and eosin staining in the epidermal layer showed a basket-weave orthokeratosis with necrotic tissue, acanthosis, and basal cell hypermelanosis. In the dermis layer there is a lymphocyte and neutrophil cell infiltrate with slight appearance of leukocytoclastic. Discussion: Pyoderma gangrenosum is a reactive, non-infectious inflammatory dermatosis (neutrophilic dermatoses). In this case, PG occurs in 54-year-old man as painful scab on back and legs. Classical PG characterized by papules, pustules, crusted or necrotic plaque, which typically have undermined, overhanging, dusky purple edges with surrounding induration and erythema. In this patient, the epidermal layer showed ulceration and slight appearance of leukocytoclastic vasculitis in the dermis area and lymphocyte infiltrate with slight neutrophil in the perivascular accompanied by erythrocyte extravasation, which support the diagnosis of PG.