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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Journal of General Procedural Dermatology and Venereology Indonesia JOURNAL LA MEDIHEALTICO eJournal Kedokteran Indonesia Media Dermato-Venereologica Indonesiana Journal of General-Procedural Dermatology & Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal Jurnal MedScientiae
Lili Legiawati
Department Of Dermatology & Venereology, Faculty Of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Atypical mycobacterial infection resembles sporotrichosis in elderly patient Siti Nurani Fauziah; Lili Legiawati; Sri Adi Sularsito; Shannaz Nadia Yusharyahya; Rahadi Rihatmadja; Sondang P Sirait; Fifi Mifta Huda; Indah Widyasari
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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Abstract

Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis. An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no fungal element nor acid-fast bacilli (AFB). Culture and polymerase chain reaction (PCR)of M. tuberculosis were negative. The working diagnosis was atypical mycobacterial infection and treatment with 450 mg rifampicin and 100 mg minocycline daily were administered accordingly. In two months observation following the treatment, the pain was no longer exist, the ulcers were completely healed, and some nodules were in the process of healing Among other Mycobacterium spp, M.marinum is the most common cause of AM infrections. Clinical manifestation of M. marinum infection may present as solitary or multiple nodules on the hands, feet, elbows and knees with sporotrichoid spreading patern. The diagnosis of AM was established based on clinical and laboratory examination. The diagnosis was also confirmed by good clinical response to minocycline and rifampicin. Keywords: atypical, mycobacterium, minocycline, rifampicin
Atopic dermatitis in the elderly Yudo Irawan; Rahadi Rihatmadja; Lili Legiawati; Shannaz Nadia Yusharyahya; Sri Adi Sularsito
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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Abstract

Atopic dermatitis (AD) is a recurrent skin inflammation accompanied by itching. The incidence of AD is increasing worldwide. AD, which persists until elderly or with an onset during elderly, is known as senile AD. It has different prevalence and clinical features from other AD stages. Senile atopic dermatitis affects males more than females, which is different from other stages of AD. Skin manifestation of senile AD is similar with the adult stage of Hanifin-Rajka criteria, but can be atypical. The typical feature of senile AD is eczematous dermatitis around a free-lesion fossa. Other common clinical manifestations are erythroderma and non-specific chronic dermatitis. In the management of senile AD, changes related to aging process should be considered. Management of senile AD is complex, involves combined pharmacological treatment consists of topical and systemic agents, and nonpharmacological aspects. Appropriate treatment considering effectiveness and safety will improve the quality of life of patients with senile AD. Keywords: atopic dermatitis, elderly, clinical feature, senilis, atypical
Poor treatment compliance leads to a higher mutation for rifampicin resistance in multibacillary leprosy patients Siskawati, Yulia; Effendi, Evita H.; Legiawati, Lili; Menaldi, Sri L.
Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (395.047 KB) | DOI: 10.13181/mji.v27i4.1916

Abstract

Background: Multidrug therapy (MDT) is a safe and effective drug combination for leprosy treatment that can prevent drug resistance. Mycobacterium leprae resistance, especially to rifampicin, is a serious problem as it potentially thwarts the worldwide leprosy-elimination program by the World Health Organization (WHO). One of the suspected causes of rifampicin resistance is poor treatment compliance. It was necessary to assess the association between the treatment compliance and the occurrence of mutation rifampicin resistance in multibacillary (MB) leprosy patients.Methods: A comparative, analytical, cross-sectional study was performed in MB leprosy patients who had completed treatment at the Dermatovenereology Outpatient Clinic in Cipto Mangunkusumo Hospital and the Sitanala Center for Leprosy Hospital from Oc­tober 2012 to April 2013. Based on treatment regularity and history of drug discontinuation, the subjects were classified as either having good or poor compliance. Skin smear from a slit skin smear (SSS) examination was further analyzed by using the polymerase chain reaction (PCR) sequencing technique to detect rifampicin resistance.Results: Fifty-seven study subjects were enrolled in this study. In the good treatment compliance group (29 subjects), only 1 case of mutation for rifampicin resistance was found. Meanwhile, in the poor drug compliance group (28 subjects), 8 cases of mutation for resistance (29%) were found. This difference in mutation rate was statistically significant (OR=11.2; 95% CI=1.296–96.787; p=0.012).Conclusion: This study revealed that the risk of occurrence of M. leprae resistance to rifampicin in patients with poor drug compliance was significantly higher than in those with good drug compliance.
Narrowband ultraviolet B phototherapy combined with topical treatment for vitiligo in 2 geriatric patients Rinadewi Astriningrum; Lili Legiawati; Vivianne Chandrakesuma; Shannaz Nadia Yusharyahya
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 4, No 2 (2020): June 2020
Publisher : Universitas Indonesia

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Abstract

Background: Narrowband ultraviolet B (NB-UVB) become the mainstay of widespread vitiligo therapy due to its great efficacy and safety compared with other modalities. The use of NB-UVB for vitiligo has been widely studied in adult patients, while studies on geriatric patients specifically are still very limited. This report aims to show the immediate response after the initial treatment, side effects of therapy, and other problems that were encountered during therapy in two geriatric patients with vitiligo who have been followed up for more than 12 months.Case Illustration: We reported two geriatric patients with vitiligo treated with NB-UVB phototherapy combined with topical treatment for more than 12 months. The first patient was 68-year-old woman, with Fitzpatrick skin type IV, who had vitiligo on her face, both lower arms and hands, and both legs and feet. The second patient was a 61-year-old man with Fitzpatrick skin type IV who had generalized vitiligo. The first repigmentation occurred on the 5th session in the first patient and on the 6th session in the second patient, using a cumulative dose of 1223 mJ/cm2 and 1541 mJ/cm2, respectively.Discussion: After NB-UVB phototherapy, there was a great improvement on the face in both patients, followed by the trunk and legs. However, the duration of treatment needed to achieve homogeneous repigmentation is longer in geriatric patients than in the general population.Conclusion: NB-UVB was well tolerated and showed good clinical response to treat vitiligo in the elderly. However, little is known about the safety and efficacy of phototherapy in elderly patients with vitiligo. Keywords: Geriatric, narrowband, phototherapy, therapy, vitiligo
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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Abstract

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
Efficacy of low level laser therapy in the treatment of postherpetic neuralgia Lili Legiawati; Marsha Bianti
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 3, No 1 (2018): December 2018
Publisher : Universitas Indonesia

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Abstract

Background: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and defined as pain that persists for more than 90 days after the onset of HZ rash. The chronic pain of PHN is debilitating and often associated with significant morbidity. It is a neuropathic pain and manifests as allodynia, hyperalgesia, or spontaneous pain. Although it is not considered to be life-threatening, sometime HZ is inadequately treated and may result in more severe PHN. Various treatment protocols for PHN are available; however, the result remains unsatisfactorily. The use of low level laser therapy (LLLT) in pain management is relatively new and is used with increasing frequency in the management of chronic pain.Aim: To assess the efficacy of low level laser therapy in the treatment of postherpetic neuralgia.Methods: Articles were searched through Pubmed/ MEDLINE, Cochrane, and Google scholar. Two randomized-controlled trials by Kemmotsu et al. and Moore et al. were obtained and critically appraised.Results: Based on the appraisal, studies by Kemmotsu et al. and Moore et al. are considered valid, important, and applicable. The results demonstrated a significant reduction in PHN intensity following a course of LLLT (p< 0.05).Conclusion: There is a statistically significant difference between the involvement of LLLT in PHN patients and without involvement of LLLT. LLLT is a noninvasive, painless, and safe method of treatment and may be recommended as an early intervention for pain therapy of PHN. Keywords: low level laser therapy, herpes zoster, pain, postherpetic neuralgia, treatment
Photodermatoses in Children Siti Nurani Fauziah; Wresti Indriatmi; Lili Legiawati
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 2, No 2 (2017): December 2017
Publisher : Universitas Indonesia

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Abstract

Photodermatoses cover the skin&rsquo;s abnormal reactions to sunlight, usually to its ultraviolet (UV) component or visible light. Etiologically, photodermatoses can be classified into 4 categories: (1) immunologically mediated photodermatoses (idiopathic photodermatoses); (2) drug- or chemical-induced photosensitivity; (3) hereditary photodermatoses; and (4) photoaggravated dermatoses. The incidence of photodermatoses in the pediatric population is much lower than in adults, Polymorphous light eruption (PMLE) is the most common form of photodermatoses in children, followed by erythropoietic protoporphyria. Early diagnosis and investigations should be performed to avoid long-term complications. Photoprotection is the mainstay of photodermatoses management, including use of physical protection and sunscreen. Keywords: children, photodermatoses, photoprotection, polymorphous light eruption.
Centella asiatica : alternative dry skin therapy in type 2 diabetes mellitus Lili Legiawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (19.061 KB) | DOI: 10.19106/JMedSci005303202108

Abstract

Diabetes mellitus (DM) in Indonesia has rapidly increased during recent years. World Health Organization (WHO) predicted that in 2030, Indonesia would be ranked fourth for the largest DM patients in the world. As the disease progresses, uncontrolled type 2 DM (T2DM) results in dry skin as the most prevalent skin disorder. Despite the prevalence and morbidities that lead to infection, ulcer, gangrene that can lead to amputation when insufficiently treated, dry skin in T2DM has limited therapeutic options. Currently, available therapies for dry skin in T2DM have not considered factors of hyperglycemia and hyperinsulinemia, which disturb skin homeostasis. Nonetheless, in T2DM, there are neuropathy and biostructural changes of the skin which induce dry skin. Alternative herbal medicine, Centella asiatica is getting well-known nowadays because of its vast amount of benefits. Centella asiatica has been studied for its antioxidant, antidiabetic, anti-inflammation, antiglycation, and neuroprotective activities. Furtherly, these properties may display benefits when introduced to T2DM dry skin therapy. The previous clinical study had shown that topical C. asiatica improved dry skin. This clinical study was also supported by in vitro studies. Currently, pharmacological profile studies of C. asiatica including dosage, toxicity, and safety have been available. This article aimed to review the current literature on the potential of C. asiatica as an alternative to treat dry skin in T2DM.
Atypical mycobacterial infection mimicking carbuncle in an elderly patient: A case report Barros, Terlinda; Legiawati, Lili; Yusharyahya, Shannaz Nadia; Sularsito, Sri Adi; Wihadi, Imelda
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

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.
Atopic dermatitis in the elderly Irawan, Yudo; Rihatmadja, Rahadi; Legiawati, Lili; Yusharyahya, Shannaz Nadia; Sularsito, Sri Adi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Abstract

Atopic dermatitis (AD) is a recurrent skin inflammation accompanied by itching. The incidence of AD is increasing worldwide. AD, which persists until elderly or with an onset during elderly, is known as senile AD. It has different prevalence and clinical features from other AD stages. Senile atopic dermatitis affects males more than females, which is different from other stages of AD. Skin manifestation of senile AD is similar with the adult stage of Hanifin-Rajka criteria, but can be atypical. The typical feature of senile AD is eczematous dermatitis around a free-lesion fossa. Other common clinical manifestations are erythroderma and non- specific chronic dermatitis. In the management of senile AD, changes related to aging process should be considered. Management of senile AD is complex, involves combined pharmacological treatment consists of topical and systemic agents, and non pharmacological aspects. Appropriate treatment considering effectiveness and safety will improve the quality of life of patients with senile AD.
Co-Authors Adistri, Kara Astriningrum, Rinadewi Barros, Terlinda Bianti, Marsha Chairista, Inadia Putri Chandrakesuma, Vivianne Endi Novianto Evita H. Effendi Fauziah, Siti Nurani Fifi Mifta Huda Halim, Dionisius Ivan Yonathan Hartanto, David Dwiadiputra Hoemardani, Aida SD Huda, Fifi Mifta Imelda Wihadi Indah Widyasari Irawan, Yudo Keumala Budianti, Windy Krisanti, Roro Inge Ade Krisanti, RR Inge Ade Kusmarinah Bramono Kusumawardhani, Dina Larisa Paramitha Marsha Bianti Melody Febriana Andardewi Miranda, Eliza Muhammad, Parikesit Nadia, Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo National Central General Hospital Jakarta, Indonesia Shannaz, Yusharyahya Nugraheni Pasaribu, Uly Aanda Maria Pandjaitan-Sirait, Sondang MHA Priyanto, Mufqi Handaru Rahadi Rihatmadja Rahadi Rihatmadja Rheza, Agung Mohamad Rinadewi Astriningrum Rosdiana, Dewi Selvina Sampurna, Adhimukti T Sandra Widaty Shannaz Nadia Yusharyahya Sirait, Sondang P. Siskawati, Yulia Siti Nurani Fauziah Sitohang, Irma Bernadette Simbolon Sondang P Sirait Sri Adi Sularsito Sri Adi Sularsito Sri Adi Sularsito Sri L. Menaldi Sujudi, Yufanti Suseno, Lis Surachmiati Terlinda Barros Vivianne Chandrakesuma Wahyudi, Danang T Wardani, Amanda Nandi Widyasari, Indah Wihadi, Imelda Windy Keumala Budianti Wresti Indriatmi B. Makes Yudo Irawan Yudo Irawan