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All Journal Medical Journal of Indonesia Berkala Kedokteran eJournal Kedokteran Indonesia Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia Jurnal Kedokteran Meditek Cermin Dunia Kedokteran
Rinadewi Astriningrum
Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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SENSITIVE SKIN: A NEW ENTITY PERSPECTIVE Putu Martha Gerynda Sukma; Windy Keumala Budianti; Sari Chairunnisa; Rinadewi Astriningrum
Berkala Kedokteran Vol 18, No 1 (2022)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (323.176 KB) | DOI: 10.20527/jbk.v18i1.12850

Abstract

Abstract: The phenomenon of “sensitive skin” is a relatively recent terminology in certain populations reporting sensory complaints that are more intense and more frequent than the normal population, especially after using cosmetic products. The incidence of sensitive skin is increasing along with the rapid widespread of skin care products availability. Various studies have been conducted but the pathophysiology of sensitive skin is still unclear. Physiological changes in sensitive skin are influenced by two main factors such as dysfunction in skin barrier and neurosensory. There are various quantitative sensory tests that can be done to determine skin sensitivity. Until now, there is no guideline for treating sensitive skin. Contributing factors, quantitative sensory tests, relation to skin diseases, and managements will be discussed in this literature review.Keywords: Dysfunction; Neurosensory; Sensitive skin; Skin barrier
Development of a Questionnaire Evaluating the Knowledge, Attitude, and Practice on Geriatric Dermatology among Elderly Caregivers Shannaz Nadia Yusharyahya; Valdi Ven Japranata; Christine Lieana; Lili Legiawati; Rinadewi Astriningrum; Wresti Indriatmi
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.228.228-37

Abstract

Information concerning the extent of knowledge, attitude, and practice of elderly caregivers about dermatological care are still limited. This present study aimed to develop a tool with decent validity and reliability to delineate such profiles. A questionnaire was designed by geriatric dermatology experts, followed by content validation and reliability tests using Aiken’s V coefficient, Kuder-Richardson Formula 20 (KR-20) or Cronbach’s α, and Pearson’s correlation. The developed instrument was tested on elderly caregivers, before and after education. Obtained data were analyzed using appropriate inferential statistics. We found that the Aiken’s V coefficient for each item was ≥0.70; KR-20 in knowledge section was 0.81; Cronbach’s α in attitude and practice section were 0.81 and 0.80, respectively; and Pearson’s correlation in all sections was above 0.80. Significant disparities were observed in the initial knowledge (p=0.005) and attitude (p=0.020) based on academic levels. In addition, overall scores generally increased upon education (p<0.001). Therefore, the questionnaire is valid and reliable for assessing elderly caregivers' competencies in geriatric dermatology of which could be improved by education.
Diagnostic procedures in pediatric dermatology Widodo, Arini Astasari; Rahmayunita, Githa; Agustin, Triana; Astriningrum, Rinadewi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Abstract

Diagnostic procedures in pediatric dermatology are different and significantly more challenging than those in adult patients, especially on how to approach the patients. We need to acknowledge that pediatric patients have unique anatomical, physiological, and psychological aspects. Compared to adults, children have smaller procedure area, are less cooperative, and more difficult to understand. For these reasons, we should perform diagnostic procedures on children cautiously. Having extensive knowledge in this field can facilitate us to carry out an ethical, efficient, targeted procedure with less risk. This article reviewed the most appropriate, most comfortable, and least invasive diagnostic procedures for children. Some of the most commonly performed pediatric dermatology procedures highlighted in this article are potassium hydroxide examination, Gram staining examination, acid fast bacilli examination, skin test for allergies, and skin biopsy for children. We also discuss the process of obtaining a written informed consent from the parents who were involved in decision making process and play a crucial role in assisting physicians to calm their children during the diagnostic procedures. 
The use of systemic medications in pediatric dermatoses: A review Narla, Shanthi; Rahmayunita, Githa; Astriningrum, Rinadewi; Shwayder, Tor; Yosi, Ariyati; Lim, Henry W.
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Abstract

Research has begun to illustrate a favorable efficacy and side-effect profile for many systemic agents used in pediatric dermatological conditions (i.e. atopic dermatitis, psoriasis, scleroderma, alopecia areata, chronic spontaneous urticaria, autoimmune blistering disorders, and hidradenitis suppurativa) despite not having extensive randomized clinical trials. The purpose of this article is to summarize the available data on the treatment regiments, safety, and efficacy of systemic immunosuppressants, including the newer biologics, focusing on the most up-to-date systematic reviews or randomized clinical trials. The review demonstrates that many of the present studies lack data on long-term efficacy and consist of small patient populations. Further research into the long-term safety of these systemic medications is of vital importance especially due to the chronic nature of most pediatric dermatological conditions that require the use of systemic agents.
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 and Venereology Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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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.
Generalized pustular psoriasis and Cushing’s syndrome in childhood due to corticosteroids misuse Azizah, Fitri; Rahman, Yusnita; Rihatmadja, Rahadi; Agustin, Triana; Astriningrum, Rinadewi; Rahmayunita, Githa
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 5, No. 3
Publisher : UI Scholars Hub

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Abstract

Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake of pus along with red-purple striae all over the body.Discussion: Adverse effects of steroid-induced adrenal insufficiency are time-dependent and generally reversible. Gradual discontinuation of steroids must adhere to physiological dose of steroids, mostly in 3.49 ± 2.92 months. Other treatments available are emollients, salicylic acid, calcipotriol, coal tar, topical steroids, phototherapy, retinoids, and cyclosporine. Topical steroids cannot be the main therapy in severe psoriasis due to the possible side effects of excessive usage. Conclusion: Misuse of topical and systemic steroid in children could lead to Cushing’s syndrome, a multisystem disorder resulting from prolonged exposure to excess glucocorticoids, either both systemic or topical. Children could easily develop systemic reactions to topical steroids due to their higher total body surface area to body weight ratio.
Recent progress in immunotherapy for skin cancer Mughni, Fadhli Aulia; Astriningrum, Rinadewi; Hoemardani, Aida SD; Bramono, Kusmarinah; Sampurna, Adhimukti T.; Sutarjo, Agassi Suseno
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Skin cancer is a global health concern due to its growing incidence and high mortality rate. The most common therapeutic modalities in skin cancer include surgery, radiotherapy, and chemotherapy. However, those therapies do not specifically target cancer cells and may damage healthy tissues. Cancer induces immune response by releasing soluble antigens and danger signals caused by tumor cellular stress or death, while the immune system continuously monitor and control malignant proliferation through cancer immunoediting. Therefore, targeting this mechanism is a promising approach to manage cancer, especially those unresponsive to conventional therapies. Immunotherapy is a specific therapy that manipulates the immune system to fight the disease. Previous studies have shown promising results in its clinical use in melanoma and non-melanoma skin cancer (NMSC). However, its potential toxicity and tolerability may pose significant obstacles in developing effective cancer immunotherapy. Biomedical, immunological, and clinical research in skin cancer is still needed to elaborate further on its pathogenesis and design safe and effective therapy for each skin cancer.
Berbagai Instrumen Penilaian Photoaging dan Karakteristiknya Putu Martha Gerynda Sukma; Shannaz Nadia Yusharyahya; Sri Linuwih SW Menaldi; Lili Legiawati; Rinadewi Astriningrum
Jurnal Kedokteran Meditek Vol 29 No 1 (2023): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i1.2454

Abstract

Seiring dengan bertambahnya usia seseorang, kulit sebagai jaringan terluar dari tubuh manusia akan memberikan gambaran paling terlihat dari proses penuaan. Penuaan kulit dipengaruhi oleh dua faktor yaitu faktor intrinsik dan faktor ekstrinsik. Faktor intrinsik terjadi secara alamiah dan berkaitan dengan proses degenerasi seluler. Faktor ekstrinsik berkaitan dengan pajanan sinar matahari, rokok, dan polusi udara. Penyebab utama penuaan kulit akibat faktor ekstrinsik berupa pajanan kronik sinar ultraviolet dikenal sebagai photoaging. Tanda klinis photoaging dapat bervariasi, namun yang sering ditemukan berupa perubahan pigmentasi dan keriput. Saat ini telah tersedia lebih dari 100 instrumen penilaian penuaan kulit menggunakan fotografi, dermoskopi, dan alat diagnostik multifungsi namun masih belum ada yang dianggap sebagai baku emas. Tinjauan pustaka ini bertujuan untuk membahas berbagai instrumen penilaian photoaging yang sering digunakan dalam praktik klinis sehari-hari dan karakteristik dari masing-masing instrumen tersebut.
Perkembangan Terkini Proses Penuaan Kulit Natalia Rania Sutanto; Shannaz Nadia Yusharyahya; Hanny Nilasari; Lili Legiawati; Rinadewi Astriningrum; Eyleny Meisyah Fitri
Jurnal Kedokteran Meditek Vol 29 No 1 (2023): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i1.2455

Abstract

Penuaan kulit merupakan fenomena biologis yang tidak dapat dihindari oleh manusia. Mekanisme yang mendasari penuaan kulit selalu berkembang sehingga penting untuk mengetahui mekanisme molekular terbaru, serta perubahan yang terjadi akibat penuaan agar klinisi dapat menentukan tata laksana yang tepat untuk mencegah dan mengobati penuaan kulit. Terdapat dua faktor yang berperan dalam terjadinya penuaan kulit, yaitu faktor intrinsik dan ekstrinsik. Faktor intrinsik adalah genetik, metabolisme sel, dan perubahan hormonal. Selain itu, terdapat faktor ekstrinsik seperti radiasi ultraviolet, inframerah, dan karsinogen lingkungan yang turut berperan pada penuaan kulit. Pemendekan telomer, stres oksidatif, disfungsi mitokondria, radiasi ultraviolet dan inframerah, peranan polusi udara dan rokok, peranan aryl hydrocarbon receptor (AhR), kerusakan deoxyribo nucleic acid (DNA), cellular senescence, perubahan hormon, pengaruh mikrobiota, vitamin D, akumulasi advanced glycation end products (AGEs), serta inflammaging memegang peranan penting dalam proses penuaan. Proses penuaan tersebut menyebabkan penurunan fungsi dan kapasitas kulit secara progresif yang berpuncak pada gangguan fungsi kulit dan kerentanan terhadap penyakit. 
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 and Venereology Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Abstract

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.
Co-Authors Adistri, Kara Aldri Frinaldi Andhira, Vega Andira Hardjodipuro Hardjodipuro Arini Astasari Widodo Arini Astasari Widodo Ariyati Yosi Azizah, Fitri Chandrakesuma, Vivianne Christine Lieana Eyleny Meisyah Fitri Githa Rahmayunita Githa Rahmayunitha Gunardi, Keiko Yolanda Halim, Dionisius Ivan Yonathan Hanny Nilasari Hartanto, David Dwiadiputra Henry W. Lim Henry W. Lim Hoemardani, Aida SD Ilyas, Nabila Chalisya Inadia Putri Chairista Irma Bernadette Isni Maulina Sukmara, Isni Maulina Jonlean, Reganedgary Kenny Andrianus Kusmarinah Bramono Kusumawardhani, Dina Larisa Paramitha Lili Legiawati Lili Legiawati Lim, Henry W. Mahda Rizki Liana Marizki Ramadhani, Reinanda Menaldi, Sri Linuwih Susetyo Wardhani Mughni, Fadhli Aulia Nadia Yusharyahya, Shannaz Narla, Shanthi Natalia Rania Sutanto Puteri, Fathirah Rahmatiah Putu Martha Gerynda Sukma Putu Martha Gerynda Sukma Rahadi Rihatmadja Rahadi Rihatmadja Rahadi Rihatmadja Rahman, Yusnita Reisa Reshinta Reshinta, Reisa Rheza, Agung Mohamad Riani Laurensia Sampurna, Adhimukti T. Sandra Widaty Sari Chairunnisa Shannaz Nadia Yusharyahya Shannaz Nadia Yusharyahya Shannaz Nadia Yusharyahya Shanthi Narla Shanthi Narla Shwayder, Tor Sirait, Sondang Panjaitan Sutarjo, Agassi Suseno Tor Shwayder Tor Shwayder Triana Agustin Triana Agustin Valdi Ven Japranata Vivianne Chandrakesuma Windy Keumala Budianti Wresti Indriatmi B. Makes Yosi, Ariyati