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All Journal Journal of General Procedural Dermatology and Venereology Indonesia
Sri Adi Sularsito
Department of Dermatology & Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
Medicine & Pharmacology

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A rare case of late onset reticulate acropigmentation of Kitamura without involvement of the palms and soles Conny Melly; Sri Adi Sularsito; Sondang Panjaitan Sirait; Rahadi Rihatmadja; Indah Widyasari; Vini Onmaya
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 1 (2015): August
Publisher : Universitas Indonesia

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Background: Reticulate acropigmentations of Kitamura (RAPK) is an autosomal dominant inherited disorder characterized by pigmented, angulated, irregular freckle-like lesion with atrophy on the surface, arranged in a reticulate pattern on the dorsa of the hands and feet. It was first described by Kitamura and Akamatsu in Japan in 1943. The usual age of onset is the first and second decades of life. Palms and soles reveal pits and breaks in the epidermal ridge pattern. The histopathological examination show epidermal atrophy, digitate and filiform elongated rete ridges with clumps of heavy melanin pigmentation at their tips.Case: A 59-year-old male presented with asymptomatic and progressive brownish-black discoloration in a reticulate pattern on the dorsal aspect of his hands and feet. The lesions initially appeared when the patient was 45 years old. It was not preceded by any erythema or inflammation. There was no similar case in the family. Laboratory findings were within normal limits.Discussion: Skin biopsy taken from the dorsal of the hand and foot revealed hyperkeratosis, thinning of epithelium, filiform elongation of the rete ridges, increased melanocyte numbers in the basal layer, and lymphocyte infiltration in the dermis. Based on the clinical and histological findings he was diagnosed as RAPK. From some reports, sporadic cases without the involvement of other family members may occur, like our patient. Palms and soles involvement in RAPK is still debated, some considered it as a characteristic sign of this disorder while others refuted it. Keywords: reticulate acropigmentation of Kitamura, histopathology, late onset, sporadic
Atypical mycobacterial infection mimicking carbuncle in an elderly patient: A case report Terlinda Barros; Lili Legiawati; Shannaz Nadia Yusharyahya; Sri Adi Sularsito; Imelda Wihadi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 1 (2015): August
Publisher : Universitas Indonesia

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Background: Atypical mycobacterium infection occurs under certain skin conditions, namely the disruption of skin integrity and mucous membranes accompanied by the reduction of cellular immunity. However, atypical mycobacterial infection in elderly patients is rarely reported. Case: A 64 years old male patient, complained of red lumps on the upper-backfor a month, accompanied by mild fever and minimal pain. Three months before, the patient had accupuncture on the neck and upper back. Physical examination showed multiple miliar to lenticular sized papules and pustules on an erythematous-violaceus base with hard and immobile palpable nodes and infiltrate. After clinical and laboratory workup, the patient was diagnosed withcarbuncle with Candida spp colonization. The treatment consisted of systemicantibiotics and topical antifungals. There was no clinical improvement after 3 weeks. Histopathology and laboratory results suggested atypical mycobacterium infection. Discussion: Atypical mycobacterium infection should be considered in elderly patients with skin and soft tissue infections that show no clinical improvement tostandard therapy. Keywords: skin and soft tissue infection, atypical mycobacterium, geriatric patients
Co-Authors Conny Melly Imelda Wihadi Indah Widyasari Lili Legiawati Rahadi Rihatmadja Shannaz Nadia Yusharyahya Sondang Panjaitan Sirait Terlinda Barros Vini Onmaya