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All Journal Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia
Irawan, Yudo
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Health Professions Medicine & Pharmacology

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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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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.
Failure to use routine prevention of disability (POD) assessment resulting In permanent disability Zoulba, Erika; Sjamsoe, Emmy Soedarmi; Menaldi, Sri Linuwih; Marissa, Melani; Irawan, Yudo
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Disability is one of problems in leprosy or Morbus Hansen (MH), which can cause the patient loose his autonomy and may affect his social relationship with family and community. Disability occurs due to neurological inflammation that can manifest as silent neuritis (which develops without any pain). Silent neuritis can be recognized early with a routine prevention of disability (POD) assessment. A 19-year-old male patient was referred from a District General Hospital with a history of numbness and stiffness of his 4th and 5th fingers of his left hand since 1 month before admittance. The patient was refered by Community Health Center (CHC or PUSKESMAS) after a one year treatment and RFT. During his treatment at the CHC, no assessment of peripheral nerve or POD had ever been performed. The POD assessment at our hospital demonstrated sensory deficit at some points of assessment on both palms and reduced muscle strength of the first and 5th fingers in both hands. Nerve conduction velocity (NCV) performed at the outpatient of Neurology Department, showed multiple mononeuropathy MH with irreversible damage. Nerve damage is still considered reversible when it occurs less than 6 months. In this case, the silent neuritis was not detected early and there was delayed treatment; as showed by NCV which revealed a manifestation of irreversible nerve damage. Routine POD assessment may detect the condition and appropriate treatment may overcome the nerve damage.
Suspected resistance of MDT-MB in Multibacillary Leprosy of Hansen's disease: Two case reports Irawan, Yudo; Menaldi, Sri Linuwih; SD, Emmy Soedarmi; Marissa, Melani; Zoulba, Erika
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 3
Publisher : UI Scholars Hub

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Resistance to multidrug therapy (MDT) is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH). There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB) resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB) index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI) of 15/6 and morphological index (MI) of 0.50%. The second case, a 42-year-old man came with paresthetic lesions on his face, chest, back, both arms and legs since 2 years ago, accompanied by thickening of ulnar and lateral peroneal nerve. The BI was 12/5 and the MI was 0.40%. Both patients were diagnosed with borderline lepromatous type of MH and received MDT-MB for 12 months. Diagnosis of suspected resistance was established because no clinical improvement or any significant decrease of AFB index after completing the MDT treatment. The patients had secondary resistance after polymerase chain reaction evaluation showed that they were still rifampicin-sensitive. There was clinical improvement and significant decrease in FAB index after the patients continued the MDT-MB treatment with 600 mg additional rifampicin. The diagnosis of bacterial resistance should be made based on clinical evaluation before completion of treatment. Based on the two case reports, the resistance suspected may be secondary. Treatment using additional regimen can be initiated once the resistance has been proven.
Ulcus vulvae acutum - A rare case Santoso, Irene Dorthy; Anggraini, Ika; Indriatmi, Wresti; Irawan, Yudo; Nilasari, Hanny; Marissa, Melani; Sirait, Sondang P.; Rihatmadja, Rahadi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 3, No. 2
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Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy. Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of Behçet’s. The patient was treated with a combination of 2.5% lidocaine and 2.5% prilocaine creams for 1 week, 2% fusidic acid ointment for 1 week, with no significant progression. Later, the therapy was changed to 0.05% clobetasol propionate ointment for 10 days. Complete healing occurred in about 10 weeks with no scarring. Discussion: Diagnosis of ulcus vulvae acutum in this patient was made by excluding other differential diagnoses. Conclusion: Ulcus vulvae acutum is a difficult diagnosis, and clinician should be aware of this entity especially when encountering young woman without previous sexual experience problem with ulcer.
INOSINE PRANOBEX SEBAGAI TERAPI TAMBAHAN PADA KUTIL GENITAL: SEBUAH LAPORAN KASUS Adisasmito, Ayutika Saraswati; Nur Azizah, Anggita; Halim, Melissa; Irawan, Yudo; Marissa, Melani; Nilasari, Hanny; Indriatmi, Wresti
Media Dermato-Venereologica Indonesiana Vol 52 No 3 (2025): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v52i3.446

Abstract

Pendahuluan: Beberapa modalitas terapi telah tersedia untuk mengobati kondiloma akuminata. Pendekatan tata laksana multimodalitas diperlukan pada kasus yang sulit sembuh. Inosine pranobex (IP) telah dilaporkan sebagai terapi tambahan untuk kutil anogenital. Kemampuan IP memanipulasi imunitas seluler dan humoral dapat bersifat antivirus. Pada laporan kasus ini, kami melaporkan keberhasilan terapi IP pada pasien imunokompeten yang sebelumnya mengeluhkan progresivitas kutil walaupun dalam terapi konvensional. Kasus: Seorang laki-laki berusia 26 tahun datang dengan keluhan kutil pada sisi kanan orifisium uretra eksternal (OUE) sejak 2 bulan yang lalu. Setelah empat sesi terapi asam trikloroasetat (TCA) 90%, pasien mengeluhkan kutil bertambah pada sisi kiri OUE. Terapi IP 3 gram per hari ditambahkan ke dalam regimen terapi pasien. Setelah pasien mengonsumsi IP secara rutin selama 2 minggu dan menyelesaikan 6 sesi tambahan tutul TCA 90%, kutil menghilang secara klinis. Pasien menyangkal timbulnya efek samping setelah konsumsi rutin IP. Diskusi: Respons terapi yang terbatas terhadap TCA 90% pada pasien ini menunjukkan kemungkinan manfaat terapi lainnya. Penambahan IP, sebagai imunomodulator yang meningkatkan imunitas seluler dan humoral, memberikan perbaikan klinis dengan efek samping minimal hingga tidak ada. Hasil ini mendukung penerapan kombinasi TCA 90% dan IP sebagai alternatif terapi pada kutil anogenital yang memberi respons minimal terhadap monoterapi. Kesimpulan: Penambahan IP pada terapi konvensional memberikan perbaikan klinis pada pasien kutil anogenital yang tidak membaik dengan terapi TCA 90% saja.
PERKEMBANGAN TERKINI MANIFESTASI KLINIS FRAMBUSIA Natasha, Joanne; Menaldi, Sri Linuwih SW; Irawan, Yudo; Novianto, Endi
Media Dermato-Venereologica Indonesiana Vol 51 No 2 (2024): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v51i2.338

Abstract

Yaws, a neglected tropical disease, is still become the health problem in several countries. World Health Organization has proposed 2030 goals for yaws eradication after the previous target has not been achieved. Indonesia is still one of the largest contributors to yaws cases in Southeast Asia. The variety of lesions and the development of atypical clinical features make the yaws diagnose as a challenge. WHO guideline is used as a reference to determine the clinical manifestations, divided into early stage (infectious) lesions to advanced (non-infectious) yaws lesions. Yaws clinical features should be mastered by health workers in Indonesia, considering that the establishment of suspected cases begin with a clinical examination then confirmed by serological test. Several recent clinical surveillance had not reported early-stage lesions as the most common clinical finding, but rather had scars which was previously removed from the modified WHO guidelines. Missed diagnosis causes continually transmission.
BERBAGAI PENANDA BIOLOGIS PADA URTIKARIA KRONIK SPONTAN Bianti, Marsha; Budianti, Windy Keumala; Irawan, Yudo
Media Dermato-Venereologica Indonesiana Vol 47 No 4 (2020)
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v47i4.377

Abstract

Chronic spontaneous urticaria (CSU) is a mast cell driven skin disorder that is characterized by the development of recurrent itchy wheals for 6 weeks or more due to unknown causes. Diagnosis is purely clinical while assessment of disease activity, its impact on quality of life, as well as treatment efficacy are based on history, physical examination, and the use of questionnaires. However, questionnaires have the disadvantage of being subjective. In the last decade, studies have been focusing on understanding of chronic spontaneous urticarial pathomechanism and identification of potential biomarkers to determine disease activity, clinical course, and treatment efficacy. Some of the biomarkers that have been studied are D-dimer, C reactive protein, interleukin-6, FcεRI, and vitamin D. Biomarkers will then be classified into clinical and molecular biomarkers. With identification of biomarkers that considered to be more objective and reliable, personal approach in evaluating the course of the disease and the most suitable treatment for patients can be achieved.
INFEKSI MENULAR SEKSUAL PADA PEREMPUAN YANG BERHUBUNGAN SEKS DENGAN PEREMPUAN Halim, Melissa; Krisanti, Roro Inge Ade; Indriatmi, Wresti; Nilasari, Hanny; Irawan, Yudo
Media Dermato-Venereologica Indonesiana Vol 51 No 1 (2024): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v51i1.426

Abstract

ABSTRAK Sebagian perempuan menunjukkan orientasi atau ketertarikan seksual, identitas gender, dan perilaku seksual yang berbeda. Infeksi menular seksual (IMS) pada perempuan yang berhubungan seks dengan perempuan (PSP), perempuan yang berhubungan seks dengan perempuan dan laki-laki (PSPL) baik riwayat lampau atau saat ini, maupun transgender laki-laki, jarang mendapat perhatian. Terdapat beragam faktor risiko penularan IMS pada kelompok PSP, PSPL, dan transgender laki-laki. IMS yang dialami dapat disebabkan oleh virus, bakteri, atau pun protozoa. Strategi pencegahan IMS termasuk pemeriksaan penapisan perlu disesuaikan dengan anatomi dan aktivitas seks setiap orang. Prinsip tata laksana IMS pada kelompok minoritas seksual tersebut sama dengan tata laksana IMS secara umum. Keterbatasan studi mengenai IMS pada kelompok ini menyebabkan belum tersedia data epidemiologi yang representatif. Pemahaman mengenai IMS pada PSP, PSPL, dan transgender laki-laki dapat meningkatkan kualitas pelayanan kesehatan pada kelompok minoritas ini.
VARIASI HASIL ANOSKOPI DAN PERANNYA UNTUK DETEKSI KUTIL INTRA-ANUS: SERIAL KASUS Halim, Melissa; Adisasmito, Ayutika Saraswati; Azizah, Anggita Nur; Irawan, Yudo; Nilasari, Hanny; Marissa, Melani
Media Dermato-Venereologica Indonesiana Vol 51 No 2 (2024): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v51i2.478

Abstract

Pendahuluan: Kutil intra-anus, yang disebabkan oleh infeksi human papilloma virus (HPV), meningkat insidennya terutama pada kelompok risiko tertentu seperti laki-laki yang berhubungan seks dengan laki-laki (LSL) dan individu dengan infeksi HIV. Laporan kasus: Dilaporkan empat kasus kutil intra-anus yang mendasari pemeriksaan anoskopi sebagai alat diagnostik utama, diikuti dengan pemeriksaan tes asam asetat dan aplikasi asam trikloroasetat (TCA) 90%. Hasil pemeriksaan menunjukkan variasi dalam presentasi klinis kutil intra-anus, dengan satu kasus mengarah pada diagnosis lesi subklinis. Kesimpulan: Variasi dalam presentasi klinis kutil intra-anus menekankan pentingnya pemantauan berkala dengan anoskopi disertai evaluasi dari terapi yang telah diberikan.
Co-Authors Adisasmito, Ayutika Saraswati Anggraini, Ika Azizah, Anggita Nur Bianti, Marsha Chelsea, Edelyne Endi Novianto Halim, Melissa Hanny Nilasari Krisanti, Roro Inge Ade Lili Legiawati Marissa, Melani Menaldi, Sri Linuwih SW Natasha, Joanne Nur Azizah, Anggita Rahadi Rihatmadja Santoso, Irene Dorthy SD, Emmy Soedarmi Shannaz Nadia Yusharyahya Sirait, Sondang P. Sjamsoe, Emmy Soedarmi Sri Adi Sularsito Sri L. Menaldi Windy Keumala Budianti Wresti Indriatmi B. Makes Yolanda, Lisda Zoulba, Erika