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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Indian Journal of Forensic Medicine & Toxicology Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research MEDICINUS

Muhammad Eko Irawanto

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Author-ID : 2277877

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Hemorrhagic Varicella in a 41-Year-Old Woman with Evans Syndrome : Case Report Alfina Rahma; Eka Devinta Novi Diana; Frieda; Wibisono Nugraha; Muhammad Eko Irawanto; Moerbono Mochtar
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17445

Background: Varicella is an infection caused by the varicella-zoster virus (VZV) with symptomsof an exanthematous vesicular rash and systemic symptoms. Hemorrhagic varicella commonlyseen in immunocompromised patients. Evans syndrome (ES) is an autoimmune with two or morecytopenias,including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP).Case: 41-year-old woman complains of swelling filled with reddish fluid almost all over herbody,sometimes painful and accompanied by fever. Patient also experienced vaginal bleeding resultingin anemia (Hb 8.8 g/DL) and thrombocytopenia (platelets 34,000/uL). Dermatological status of thegeneralized,multiple hemorrhagic vesicles with an erythematous base,partially ruptured. Tzank testrevealed multinucleated giant cells. Patient suffered AIHA and received therapy with methylprednisolone4 mg/day and mycophenolic acid 2x500 mg/day.Conclusion: We report a case of hemorrhagic varicella in a 41-year-old woman with Evan’s syndromewith concurrent features of AIHA and ITP. Dermatological status of the generalized, multiplehemorrhagic vesicles with an erythematous base,some of ruptured with erosions. Tzank test revealedmultinucleated giant cells. Patient was treated with acyclovir 5x800 mg for 7 days,2% salicylic acid and0.5% menthol applied every 12 hours and mupirocin 2% ointment applied twice a day on the erosionarea and clinical improvement was found after 17 days of therapy.

The Association of Keloid Site with its Histopathological Features: an Analytical Observational Study Wibisono Nugraha; Muhammad Eko Irawanto; Moerbono Mochtar; Nur Rachmat Mulianto; Novan Adi Setyawan; Nugrohoaji Dharmawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.47-52

Background: Keloid is a growth of fibrous tissue in the wound tissue of susceptible individuals. This tissue extends beyond the boundaries of the previous wound. The site of keloids commonly appears on a high-tension area, such as the chest, shoulders, and neck. Histopathologically keloids show thickened the epidermis and the vascularization and infiltration of inflammatory cells in the dermis. Purpose: This study aims to determine the relationship between the site of keloids and the histopathological appearance of keloids. Methods: An analytical observational study was conducted on keloid patients visiting the Dermatovenereology outpatient clinic of Dr.Moewardi Hospital. The sample collection used consecutive sampling techniques Result: The majority of keloid patients are >30 years old (46.4%). Most patients with keloids were female (53.6%). Keloids were mostly found on the chest (25.0%). Tounge-like appearance of the epidermis at the edges of the lesions was mostly on the shoulders and chest (33.3% each, p=0.048); flattened appearance was found on the middle epidermis of the lesions, which were mostly on the ears, shoulders, and upper extremities (22.7% each, p=0.011). Increased vascularity was found in the dermis at the edges of the lesions, especially in the ear and chest areas (31.3% each, p=0.046). Moderate-severe inflammatory infiltrates in the dermis at the edges of the lesions were commonly found on the chest (p=0.04). Conclusion: There is a significant relationship between the site of the lesion and the histopathological appearance of the keloid in epidermal as well as dermal layers.

Korelasi Kadar Serum Nitric Oxide (NO) dengan Tipe dan Derajat Keparahan Psoriasis Fiska Rosita; Bobby Febrianto; Ambar Aliwardani; Putti Fatiharani; Wibisono Nugraha; Muhammad Eko Irawanto; Nurrachmat Mulianto
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Psoriasis is a chronic, immune-mediated disorder that results from a polygenic predisposition. Nitric oxide (NO) has been considered as important factors in the pathogenesis of psoriasis. This study aims to determine the correlation of serum NO levels with the type and severity of psoriasis. This cross-sectional study was conducted from May to September 2018. Difference in the average of serum NO levels in psoriasis patients with control groups is analyzed using t-test. The Spearman correlation test was used to see the correlation of serum NO levels with type and severity of psoriasis measured by Psoriasis Area and Severity Index (PASI) score. There was significant difference between serum NO level in the control group compared to the group of psoriasis patients (p=0.037). Patient with generalized pustular psoriasis has the highest mean of NO level (59.07 µmol/L). There was no significant correlation between serum NO level with type (r=0.008, p=0.9710 and severity (r=0.157, p=0.486) of psoriasis. Nitric oxide levels are elevated in psoriasis patients, which indicate that oxidative stress plays an important role in the etiopathogenesis of psoriasis.

Analisis In Silico Potensi Minyak Kedelai (Glycine max) dalam Terapi Dermatitis Atopik Primadhanty. R. S. Bhadra; Mardiana; Ahmad Fiqri; Ummi Rinandari; Didik H. Utomo; Muhammad Eko Irawanto
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Soybean oil contains various bioactive phytochemicals such as phenolic acids, flavonoids, isoflavones, saponins, phytosterols and sphingolipids which might give benefit in the treatment of atopic dermatitis (AD). This study aimed to evaluate the soybean oil compounds using computational in silico analysis for the treatment of atopic dermatitis. The active compounds of soybean oil were extracted from the KNApSAcK database. Results showed that soybean oil might possess some potential bioactivity such as immunosuppressant, antiinflammatory, improves skin barrier function, antieczema and histamine inhibitor. The highest potential bioactivity of soybean oil was as antiinflammatory, with an average value of probable to be active (Pa) 0.684; while the high potency active compound is alpha-tocopherol (Pa: 0.956).

Ulkus Marjolin yang Berkembang dari Ulkus Trofik Kronis pada Pasien Kusta Adniana Nareswari; Harijono Kariosentono; Nugrohoaji Dharmawan; Muhammad Eko Irawanto; Nurrachmat Mulianto
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Marjolin’s ulcer is a malignant complication of chronic ulcer. Changes in ulcer lesions to malignancy can be caused by chronic irritation, infection, decreased vascular variation, and increased expression of proto-oncogene. The most common histopathological form of Marjolin's ulcer is squamous cell carcinoma. A 55-year-old man, complaining of a protruding wound on his left hand that has not healed since three years ago. The patient was diagnosed with leprosy 30 years ago with a history of incomplete treatment. On physical examination, the left palmar region showed solitary ulcer, ±10x8x1.5 cm in size, nodular surface, reddish, hard consistency, with bulging and irregular edge. Slit-skin smear (SSS) examination with Ziehl-Neelsen staining found abundant acid-fast bacilli. Histopathological examination of the ulcer edge shows appearance of epithelial tumor, with differentiated epidermal cells invading the dermis, tumor cells arranged focally and concentrically with a mass of keratin appeared as horn pearl cells. Fite-Faraco staining found abundant M. leprae acid-fast bacilli. Based on the patient’s medical history and clinical examination, patient was diagnosed with Marjolin's ulcer in multibacillary (MB) leprosy. Patient was treated with MB multidrug therapy for 12 months and below-wrist amputation.

Pengaruh Astaxantine Oral terhadap Kadar Serum Tumor Necrosis Factor Alpha pada Pasien Akne Vulgaris-lores Reti Anggraeni; Niluh Widjayanti; Harijono Kariosentono; Indah Julianto; Endra Yustin; Muhammad Eko Irawanto; Prasetyadi Mawardi
MEDICINUS Vol. 33 No. 3 (2020): MEDICINUS
Publisher : PT Dexa Medica

Background: Acne vulgaris (AV) is chronic inflammatory disease affecting the pilosebaceous unit manifested as closed and open comedones, papules, pustules, and nodules. Treatment of AV generally involves more than one drug due to multifactorial pathogenesis. Objective: This study aims to determine the efficacy of 4 mg oral astaxanthin as an adjuvant AV therapy in decreasing serum level of inflammatory marker tumor necrosis factor alpha (TNF-α). Method: This is a double-blind randomized controlled trial. Subjects were 34 patients with mild and moderate AV (Global Acne Grading System/GAGS 1-30) that were treated with combination of tretinoin 0.025% and clindamycin phosphate 1.2%. Astaxanthin was added to the treatment group and lactulose as placebo was added to the control groups, given for 4 weeks. The pretest and posttest results in both groups were analyzed statistically using nonparametric test. Results: Decrease in TNF-α serum levels occurred in both groups but significant difference compared to baseline were only found in treatment group (p=0.015). There was no significant difference in the reduction of TNF-α levels between both groups (p=0.459). Conclusion: Although the results did not show a significant difference overall, but in the treatment group, astaxanthin can significantly lower TNF-α serum levels compared to baseline.

Tingkat Perbedaan Serum Nitric Oxide terhadap Derajat Keparahan dan Durasi Psoriasis Ambar Aliwardani; Bobby Febrianto; Fiska Rosita; Putti Fatiharani Dewi; Muhammad Eko Irawanto
MEDICINUS Vol. 35 No. 1 (2022): MEDICINUS
Publisher : PT Dexa Medica

Psoriasis belongs to erythrosquamous dermatosis with uncertain etiology. Nitric oxide (NO) that acts as growth and differentiation regulator of keratinocytes is thought to play an important role in the pathogenesis of this disease. This study was aimed to determine the difference of nitric oxide serum level with the severity and duration of psoriasis patients. A cross-sectional study was conducted in 22 subjects with psoriasis vulgaris in the outpatient clinic of Dr. Moewardi Hospital Surakarta from May-September 2018 with 22 healthy individuals as control group. The severity of psoriasis was assessed using psoriasis area severity index (PASI), and serum NO is measured using Greiss method. Data then analysed using T-test and Kruskal Wallis tests (p<0.05). There was a significant difference in serum NO between the psoriasis patients and control group (p=0.020); there was no significant difference between serum NO patients and PASI score and duration of disease. It can be concluded that NO is an important factor in the inflammatory process in psoriasis, especially in active lesion.

Terapi Zink Oral pada Vitiligo Eka Devinta Novi Diana; Muhammad Eko Irawanto
MEDICINUS Vol. 36 No. 3 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/g52hfk35

Background: World Health Organization (WHO) estimates that 2 billion people in the world have zinc deficiency. Clinical manifestation of zinc deficiency includes immune system dysfunction, increase of oxidative stress, and release of proinflammatory cytokines. Oxidative stress is one of main factors that plays important role in various autoimmune diseases such as vitiligo. Discussion: Vitiligo is the most common depigmentation disease caused by melanocyte damages which characterized by depigmentation macule or patch on the skin or mucous membranes. Treatment of vitiligo is still considered a challenge, and various treatment modalities show varying results. Zinc is a micronutrient and antioxidant that posseses antiapoptotic activity by influencing melanogenesis and eliminating free radicals. Conclusion: Zinc inhibits oxidative stress and prevent melanocyte damage so it can bd considered as an adjuvant treatment for vitiligo.

From Patches to Plaques: A Diagnostic Challenge in a Case of Erythroderma Secondary to Pityriasis Rubra Pilaris Kamilah, Lian; Rahmat Firdaus Dwi Utama; Shelly Lavenia Sambodo; Muhammad Eko Irawanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1297

Background: Erythroderma, a dramatic and potentially life-threatening condition characterized by fiery redness engulfing over 90% of the skin's surface, presents a formidable diagnostic challenge due to its myriad underlying causes. Among these, pityriasis rubra pilaris (PRP), a rare inflammatory skin disorder, stands out with its distinctive features and often perplexing presentation. This case unveils the intricate diagnostic journey of a young man whose erythroderma masked an underlying PRP, further complicated by the subtle interplay of stress. Case presentation: An 18-year-old male presented with a one-month history of alarming erythroderma accompanied by distressing itching, fever, and sleep disturbances. Adding to the complexity, he exhibited characteristic 'nappes claires' – islands of normal skin amidst the erythrodermic sea – a hallmark of PRP. Palmoplantar keratoderma, alopecia areata, and ectropion further painted an intriguing clinical picture. Histopathological examination revealed the telltale 'checkboard' pattern, confirming PRP as the culprit. Notably, the patient's history revealed a compelling link between stress and disease exacerbation, adding a psychosomatic dimension to the case. Systemic corticosteroids and methotrexate, alongside topical emollients, brought about significant clinical improvement, underscoring the importance of early diagnosis and targeted treatment. Conclusion: This case underscores the critical need to consider PRP in the labyrinth of erythroderma diagnoses, particularly when 'nappes claires' and a history of stress are intertwined. By shining a light on the diagnostic subtleties and therapeutic nuances of PRP-associated erythroderma, this report empowers clinicians to navigate the complexities of this rare and challenging condition, ultimately improving patient outcomes and quality of life.

UVB-Induced Oxidative Collapse and Melanogenic Activation in a Rat Model of Cutaneous Hyperpigmentation: A Multi-Parametric Analysis Sesia Pradestine; Endra Yustin Ellistasari; Nurrachmat Mulianto; Indah Julianto; Muhammad Eko Irawanto; Nugrohoaji Dharmawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1442

Background: Ultraviolet B (UVB) radiation is a primary driver of cutaneous hyperpigmentation disorders, with oxidative stress recognized as a key pathogenic mechanism. However, a comprehensive, multi-level characterization of the causal link between chronic UVB exposure and the resulting oxidative, histological, and melanogenic responses is needed. This study aimed to quantitatively validate a preclinical model of UVB-induced hyperpigmentation by characterizing the reciprocal regulation of key oxidative stress biomarkers and correlating these changes with objective histological evidence of hyperpigmentation. Methods: This controlled in vivo experimental study used 14 male Sprague Dawley rats, divided into a control group (KN; n=7) and a UVB-exposed group (KP; n=7). The KP group received chronic UVB radiation (300 mJ/cm² daily, 5 days/week for 4 weeks). Dorsal skin tissue was harvested for analysis. Oxidative stress was assessed by quantifying malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) levels via ELISA. Hyperpigmentation was objectively validated and quantified using Fontana-Masson staining for melanin deposition and immunohistochemistry for microphthalmia-associated transcription factor (MITF). Results: Chronic UVB exposure induced significant hyperpigmentation, confirmed by a 5.8-fold increase in epidermal melanin content (p < 0.001) and a 4.1-fold increase in the number of MITF-positive melanocytes (p < 0.001) in the KP group. This was accompanied by a profound oxidative imbalance: MDA levels increased by 7.5-fold (p < 0.001), while the activities of SOD, CAT, and GPx decreased by 80.5%, 65.2%, and 71.4%, respectively (all p < 0.001). A strong negative correlation was observed between MDA and all antioxidant enzymes, particularly SOD (r = -0.985, p < 0.001). Conclusion: Chronic UVB exposure directly triggers a collapse of the cutaneous antioxidant network, leading to severe lipid peroxidation. This state of profound oxidative stress is causally linked to melanocyte activation and excessive melanin synthesis, driving the hyperpigmentation phenotype. This robustly validated preclinical model provides a powerful platform for investigating the molecular pathophysiology of UVB-induced pigmentary disorders and for evaluating novel therapeutic interventions.

Co-Authors Adniana Nareswari Ahmad Fiqri Alfina Rahma Ambar Aliwardani Anindya Oktafiani Arie Kusumawardani Ayu Kusuma Dewi Benedicta Lauda Anandita Benedikta Lauda Bobby Febrianto Dharmawan, Nugrohoaji Didik H. Utomo Eka Devinta Novi Diana Endra Yustin Endra Yustin Ellistasari Fiska Rosita Frieda Harijono Kariosentono Indah Julianto Ivani Kamilah, Lian Lidjaja, Lifesia Natali MARDIANA Moerbono Mochtar Niluh Widjayanti Novan Adi Setyawan Nurrachmat Mulianto Osdatilla Esa Putri Prasetyadi Mawardi Primadhanty. R. S. Bhadra Putti Fatiharani Putti Fatiharani Dewi Rahmat Firdaus Dwi Utama Reti Anggraeni Sesia Pradestine Shelly Lavenia Sambodo Stella Gracia Octarica Sugih Primas Adjie Trya Oktaviani Ummi Rinandari Vrenda Alia Wibisono Nugraha

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