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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 Fauziah, Siti Nurani; Legiawati, Lili; Sularsito, Sri Adi; Yusharyahya, Shannaz Nadia; Rihatmadja, Rahadi; Sirait, Sondang P.; Huda, Fifi Mifta; Widyasari, Indah
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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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.
Photodermatoses in Children Fauziah, Siti Nurani; Indriatmi, Wresti; Legiawati, Lili
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 2, No. 2
Publisher : UI Scholars Hub

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Photodermatoses cover the skin’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.
Efficacy of low level laser therapy in the treatment of postherpetic neuralgia Legiawati, Lili; Bianti, Marsha
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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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.
Narrowband ultraviolet B phototherapy combined with topical treatment for vitiligo in 2 geriatric patients Astriningrum, Rinadewi; Legiawati, Lili; Chandrakesuma, Vivianne; Nadia, Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia – Dr. Ci
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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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.
The importance of multidisciplinary approach in management of pressure injury in elderly with multiple comorbidities Kusumawardhani, Dina; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Astriningrum, Rinadewi; Adistri, Kara
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Background: Pressure injury (PI) can occur as a result of prolonged bed rest in immobilized patients. The healing process is often slow if the wounds are not managed comprehensively, particularly in elderly patients or patients with neurological disorder, diabetes mellitus, and malnutrition. Proper treatment can improve the healing process. Case illustration: A 66-year-old female with multiple comorbidities presented with PI on the left lower back, as well as the sacral and right gluteal regions. She was diagnosed with grade 3 and unstageable PI, and was treated using a multidisciplinary approach. Her wounds were treated with a combination of hydrogels and polyurethane foam dressings. Discussion: Managing comorbidities, optimizing local wound care, regular repositioning in special mattress, and improving nutritional status are necessary to accelerate healing in cases of PI. There was an increase in the wound granulation and epithelialization, as well as a decrease in the ulcer size and exudates after 16 weeks of treatment. A considerable amount of time is needed to treat grade 3 and unstageable PI in an immobile elderly patient with multiple comorbidities. Conclusion: Multidisciplinary collaboration among healthcare workers is essential for the treatment of PI in elderly populations.
The effects of vitamin D on chronic wounds Priyanto, Mufqi Handaru; Miranda, Eliza; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Novianto, Endi; Bramono, Kusmarinah; Krisanti, Roro Inge Ade
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Background: Wounds that fail to proceed through the normal healing process are referred to as chronic wounds, also known as ulcers. Chronic wounds have immeasurable biological, psychological, social, and economic effects, bringing tremendous challenges for patients, doctors, healthcare providers, and healthcare systems. Discussion: This condition is associated with a variety of comorbidities and complex etiologies. The global incidence of chronic wounds is expected to increase with longer life expectancy. Thus, a holistic approach is necessary, such as proper wound management, proper control of comorbidities, and provision of adequate nutrition, including vitamin D supplementation. Vitamin D is an essential pro-hormone for cell differentiation, proliferation, and growth. It affects the skin’s immune response, and is therefore thought to promote wound healing and tissue repair. Many studies have been published on the association between low vitamin D levels and chronic wounds. However, whether or not vitamin D supplementation directly contributes to wound healing still needs to be elucidated. Conclusion: Despite the many reports on vitamin D as an adjuvant treatment for chronic wounds, further large-scale clinical studies are needed to cement the role of vitamin D as an effective standard therapy for chronic wound healing.
Microbioma in Aging Skin Nugraheni Pasaribu, Uly Aanda Maria; Rihatmadja, Rahadi; Yusharyahya, Shannaz Nadia; Widaty, Sandra; Legiawati, Lili; Pandjaitan-Sirait, Sondang MHA
Journal La Medihealtico Vol. 5 No. 3 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i3.1315

Abstract

Microbiota is inseparable to the skin. Just as in the gastrointestinal tract, the skin microbiome reflects the health of the organ where it resides. It contributes to skin barrier function and ensures its homeostasis. However relatively stable over time, microbiome composition and number may be influenced by various aging -related changes − dryness, blemish, wrinkles and alteration of sebaceous gland activity impacting the skin ecological conditions − and vice versa. Several generations have been reported to promote the process while others may play a more protective role in this regard.
Markedly clinical improvement of papulopustular rosacea with multimodality therapeutic approach: a case report Priyanto, Mufqi Handaru; Wardani, Amanda Nandi; Legiawati, Lili; Sitohang, Irma Bernadette Simbolon; Suseno, Lis Surachmiati
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 6, Issue 1 (June 2023)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/85p5m842

Abstract

Introduction: Rosacea is a chronic inflammatory skin disease that mainly affects the central area of the face. There are four subtypes, and they may progress between subtypes or span multiple subtypes. Due to its long course of the disease, optimum treatments are needed to control the disease progression. Case: We reported rapid improvement of combining topical metronidazole, doxycycline, and light emitting diode for treating a patient with papulopustular rosacea in a 44-years-old woman, a week from the initial therapy. Discussion: Therapeutic approaches to rosacea mainly focus on controlling the symptoms with anti-inflammatory agents. More recently, photodynamic therapy, especially light-emitting diodes, has been introduced as a valid alternative or an adjuvant therapy to conventional treatment through their synergic mechanism between therapeutic modalities. Conclusions: This combination treatment may be effective for treating papulopustular rosacea without any side effects.
Inhibitor Transient Receptor Potential Vanilloid Type 1: Penggunaan Topikal pada Berbagai Dermatosis Muhammad, Parikesit; Paramitha Wibawa, Larisa; Keumala Budianti, Windy; Legiawati, Lili; Menaldi, Sri Linuwih; Rosdiana, Dewi Selvina
Jurnal MedScientiae Vol. 3 No. 2 (2024): Agustus
Publisher : Fakultas Kedokteran dan Ilmu Kesehatan Ukrida

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/JMedScientiae.v3i2.3179

Abstract

Transient receptor potential vanilloid type 1 (TRPV1) plays an important role in the pathophysiology of pruritus and pain. TRPV1 inhibitors can reduce the sensation of itching and pain by blocking nociceptive signals from peripheral nerve fibers to the central nervous system. Topical TRPV1 inhibitors is also thought to improve skin barrier function. Therefore, TRPV1 inhibitors are considered as potential therapy in various dermatoses. Topical TRPV1 inhibitors that are currently being studied are asivatrep for atopic dermatitis and trans-4-tert-butylcyclohexanol for various dermatoses associated with sensitive skin. Further studies with better quality and longer duration are needed to assess the efficacy and safety profile of TRPV1 inhibitors.
Cellulitis and Bullous Erysipelas in a Geriatric Patient Hartanto, David Dwiadiputra; Rheza, Agung Mohamad; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Astriningrum, Rinadewi; Sirait, Sondang P.
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

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Erysipelas and cellulitis are common infections of the skin. Erysipelas is a superficial infection affecting the upper layers of the skin, while cellulitis affects the deeper tissues. Bullous formation represents a severe clinical condition of erysipelas. We report a case of cellulitis concurrent with bullous erysipelas focusing on diagnostic and treatment challenges in a geriatric patient with comorbid. A 70-year-old male with a history of diabetes mellitus was admitted to the emergency department with a chief complaint of painful erythematous, warm on palpation, swelling and blistering on his right lower leg for one week. The wound culture was sterile. Cellulitis and bullous erysipelas were determined as the diagnosis. The patient was treated concurrently with intravenous ampicillin-sulbactam, as well as incision and debridement. Clinical symptoms were improved after several days of hospitalization.  Bullous erysipelas is an aggressive form of erysipelas that responds less well to therapy. Microbiological culture in erysipelas and cellulitis are negative in up to 70% of cases, including in our patient. Thus, the diagnosis was made based on clinical examination. The administration of intravenous broad-spectrum antibiotic ampicillin-sulbactam and additional incision and debridement significantly improved the patient. In conclusion this case of cellulitis and bullous erysipelas in a geriatric patient with diabetes mellitus was successfully treated with intravenous broad-spectrum antibiotic ampicillin-sulbactam and additional incision and debridement.
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