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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Bioscientia Medicina : Journal of Biomedicine and Translational Research 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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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Bioscientia Medicina : Journal of Biomedicine and Translational Research

 1 
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

Abstract

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

Abstract

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.
Profile of Urticaria and Angioedema Patients at Dr. Moewardi General Hospital Surakarta, Indonesia Dewi, Ayu Kusuma; Muhammad Eko Irawanto; Stella Gracia Octarica; Shelly Lavenia Sambodo; Rahmat Firdaus Dwi Utama; Sugih Primas Adjie
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 5 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i5.994

Abstract

Background: Urticaria is a heterogeneous inflammatory skin disease that results from the activation and degranulation of cutaneous mast cells, followed by the release of histamine and other mediators that cause sensory nerve activation, vasodilation, plasma extravasation, and recruitment of immune cells. The prevalence and incidence of urticaria and angioedema have been extensively studied worldwide, but there is still limited data in Indonesia, especially regarding the profile of urticaria and angioedema patients. The purpose of this study was to determine the profile of urticaria and angioedema patients at Dr. Moewardi General Hospital for the period January 1st, 2020 - December 31st, 2022. Methods: This study is a cross-sectional retrospective study with secondary data derived from medical records of urticaria and angioedema patients. Results: There were 152 patients with urticaria, most of whom were in the age group >60 years (20.39%), female with a male to female ratio of 1:1.92, and worked as housewives (17.76%) and students (16.45%). Most cases were diagnosed with urticaria (86.84%) with some patients having angioedema (13.16%). The most common comorbidities rhinoconjunctivitis (2.63%), atopic dermatitis (1.97%) and asthma (1.32%). The dominant symptoms were itching and bumps (100%). The main treatment received by patients was single AH1 (71.71%) followed by combination therapy of AH1 and systemic corticosteroids (14.47%), combination therapy of AH1 and topical corticosteroids (10.53%), and the rest received combination therapy of AH1, topical corticosteroids, and systemic corticosteroids (3.29%). The skin prick test was positive in 16 patients (35.56%), with the most common allergens found being peanut (37.5%), egg yolk (37.5%), and tomato (37.5%). Conclusion: The characteristics of urticaria patients were dominated by elderly patients, female gender, and working as housewives or not working. Patients were predominantly diagnosed with urticaria with the most common comorbidities being diabetes mellitus. The main treatment received was AH1 class drugs. The most common types of allergens identified were peanuts, egg yolks, and tomatoes.
Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris Lidjaja, Lifesia Natali; Muhammad Eko Irawanto; Nur Rachmat Mulianto; Arie Kusumawardani; Ivani; Vrenda Alia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 10 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i10.1104

Abstract

Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV. Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity. Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05). Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.
Unveiling the Hidden Patterns: A Dermoscopic Analysis of Vitiligo Lesions at a Tertiary Care Center in Surakarta, Indonesia Sesia Pradestine; Muhammad Eko Irawanto; Osdatilla Esa Putri; Trya Oktaviani; Benedicta Lauda Anandita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (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.v9i4.1258

Abstract

Background: Vitiligo, a common depigmenting disorder, presents with a variety of clinical manifestations. Dermoscopy, a non-invasive skin imaging technique, has emerged as a valuable tool for evaluating pigmentary disorders. This study aimed to analyze the dermoscopic patterns of vitiligo lesions in a cohort of patients at a tertiary care center in Surakarta, Indonesia, and to correlate these patterns with disease stability. Methods: This cross-sectional study included 20 adult patients diagnosed with vitiligo at the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi Regional General Hospital Surakarta in July 2023. A dermoscopic examination was performed on all patients using a polarized light dermoscope. Dermoscopic features were analyzed and categorized based on the BPLeFoSK criteria (Border, Pigment Network, Lesions, Follicular, Koebner). Disease stability was assessed based on clinical and dermoscopic findings. Results: The majority of patients were female (75%) and between 21-40 years old (65%). All patients exhibited the characteristic "white glow" under dermoscopy. Other common findings included reduced or absent pigment network (40% each), perifollicular hyperpigmentation (30%), and perilesional hyperpigment (30%). Satellite lesions and micro-Koebner phenomenon, indicative of disease activity, were observed in 10% of patients each. Based on these findings, 80% of patients were classified as having stable vitiligo, while 20% had unstable vitiligo. Conclusion: Dermoscopy revealed a spectrum of patterns in vitiligo lesions, with the "white glow" being a universal finding. The majority of patients in this cohort had stable vitiligo. Dermoscopy can aid in assessing disease activity and guiding treatment decisions in vitiligo patients.
Dose- and Time-Dependent Efficacy of Topical Hydroquinone in Establishing a C57BL/6 Mouse Model of Vitiligo Benedikta Lauda; Nurrachmat Mulianto; Endra Yustin Ellistasari; Muhammad Eko Irawanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1481

Abstract

Background: Vitiligo is a complex autoimmune depigmenting disorder driven by melanocyte-specific CD8+ T cells, oxidative stress, and genetic susceptibility. The lack of standardized, accessible animal models that recapitulate these pathways hinders therapeutic development. This study aimed to systematically optimize and validate a chemically-induced vitiligo model in C57BL/6 mice. Methods: Eighty (80) male C57BL/6 mice were randomized into ten groups (n=8/group). Experimental groups received once-daily topical applications of hydroquinone (HQ) at 2.5%, 5%, or 10%, or monobenzone (MBZ) at 40% for 8 or 16 days. Vehicle-treated mice served as controls. Efficacy was assessed via quantitative histopathology (Masson-Fontana staining for melanin area), biomolecular assays for oxidative stress (Malondialdehyde [MDA] and Superoxide Dismutase [SOD]), and RT-qPCR for melanogenesis-related (Tyr) and inflammation-related (Tnf) gene expression. Results: A clear dose- and time-dependent depigmentation was observed. The 10% HQ 16-day protocol was maximally effective, inducing a profound reduction in epidermal melanin area (0.06 ± 0.02) compared to 16-day controls (0.40 ± 0.04; p < 0.001). This histopathological finding was significantly correlated with severe cutaneous oxidative stress, evidenced by a 3.75-fold increase in MDA (p < 0.001) and a 50% reduction in SOD activity (p < 0.001) versus controls. Furthermore, this regimen caused a potent suppression of Tyr expression (0.15-fold change; p < 0.001) and a significant upregulation of the pro-inflammatory cytokine Tnf (3.8-fold change; p < 0.001). Conclusion: The 16-day topical application of 10% hydroquinone is a reliable, rapid, and highly reproducible protocol for inducing vitiligo-like depigmentation in C57BL/6 mice. This model successfully recapitulates key pathophysiological pillars of human vitiligo, including melanocytotoxicity, profound oxidative stress, and a pro-inflammatory cutaneous environment, establishing it as a valuable platform for preclinical therapeutic screening.
Co-Authors Adniana Nareswari Ahmad Fiqri Alfina Rahma Ambar Aliwardani Anindya Oktafiani Arie Kusumawardani Ayu Kusuma Dewi 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 Nur Rachmat Mulianto 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