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Oral Vitamin D Supplementation as Add-On Therapy in Adult Patients with Atopic Dermatitis Febrianto, Bobby; Prasetyadi Mawardi; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 12 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i12.895

Background: Recent studies have highlighted the possible role of vitamin D in atopic dermatitis (AD) so that it can be used as therapeutical of AD. The aim of study to evaluate the effect of vitamin D supplementation as add-on therapy in adult patients with AD. Methods: Twenty-four adult patients with AD were included in a randomized, double-blind, placebo-controlled trial study. This study was conducted in Dr. Moewardi General Hospital Surakarta, Indonesia, from February to March 2023. Subjects were randomly assigned to oral cholecalciferol 5,000 IU/day versus placebo for 4 weeks and all subjects were given emollient. The severity of AD was evaluated by using scoring of atopic dermatitis (SCORAD) before and after the trial. Results: Compared to placebo, vitamin D supplementation for 1 month obtained clinically and statistically improvement in SCORAD score compare to control (-4.508 : 4.500, p= 0.000). Moreover, vitamin D supplementation had strong negative correlation to SCORAD score after the trial (r= -0.780, p= 0,000). There were no adverse effects in either group. and Conclusion: Clinical improvement was achieved after vitamin D supplementation as add-on therapy in adult patients with AD.

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.

Granulomatosis Wegener dengan Antineutrophil Cytoplasmic Antibodies (ANCA) Negatif pada Laki-laki Usia 38 Tahun Achmad Satya Negara; Harijono Kariosentono; Endra Yustin Elistasari
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Background : Wegener’s granulomatosis or granulomatosis with polyangiitis is a systemic necrotizing vasculitis, which affects small- and medium-sized blood vessels. This disease is often associated with antineutrophil cytoplasmic antibodies (ANCA). Etiology of Wegener’s granulomatosis may originate from infectious, environmental, chemical, toxic or pharmacological triggers in people who are genetically predisposed to this autoimmune disease. The disease can present with nonspecific symptoms such as malaise, myalgia, arthralgia, anorexia, and weight loss. Skin manifestations of Wegener’s granulomatosis includes leukocytoclastic vasculitis, purpura, ulcer and subcutaneus nodul. It also known could affect different organs. Case: A 38-year-old man came with a chief complaint of erythematous patches and stiffness on his face, body, arms and legs. The dermatological status showed a saddle nose and discrete multiple purpura on the superior and inferior extremities. ANCA examination result was negative. Histopathological examination of the epidermal layer showed dense proliferation of lymphocyte cells, perivascular infiltrates and a few neutrophil cells. In the dermis layer, there were granulomas consisting of many epitheloid histiocytes and foamy macrophages also damaged blood vessels with neutrophil infiltration on the walls and erythrocyte extravasation. Discussion: Wegener’s granulomatosis is a rare autoimmune disease of localized granulomatous inflammation of the upper and lower respiratory tract and systemic vasculitis associated with ANCA. Symptoms that arise in Wegener’s granulomatosis are often mild at first, but may progress to a more severe clinical features. A negative ANCA examination cannot immediately rule out the diagnosis. Initial therapy for Wegener’s granulomatosis are cyclophosphamide and glucocorticoids for 3-6 months. Patient showed clinical improvement with the reduction of purpura throughout the body after five weeks treatment.

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.

Kromoblastomikosis Penyakit Jamur yang Terabaikan Danu Yuliarto; Achmad Satya Negara; Harijono Kariosentono; Nugrohoaji Dharmawan; Nurrachmat Mulianto
MEDICINUS Vol. 36 No. 1 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i1.116

Chromoblastomycosis is a deep fungal infection of the skin and subcutaneous tissue caused by pigmented or dematiaceous fungi. This disease is endemic in tropical and subtropical regions such as Asia, Africa, and Latin America. Chromoblastomycosis is more common in adult men who work in agricultural areas, work as gardeners, or as carpenters. The diagnosis of chromoblastomycosis is confirmed by the finding of muriform cells or medlar bodies obtained from skin scrapings, microscopic culture, or tissue histopathological examination. The clinical feature varies, the initial lesion is a papule that spreads slowly over several months or years, and then this lesion will form a plaque with atrophic center. Many patients go undiagnosed at the early stage of the disease because this stage is rarely seen. Treatment of chromoblastomycosis includes surgery for the initial lesion and pharmacological therapy using antifungal agent such as itraconazole, the most commonly used drug for the treatment of chromoblastomycosis. The prognosis for chromoblastomycosis is poor, except on new lesions.

The Crescendo Reaction in Patch Testing: A Key Diagnostic Sign in Allergic Contact Cheilitis from Modern Matte Lipsticks Rahmat Firdaus Dwi Utama; Harijono Kariosentono; Ayu Kusuma Dewi; Shelly Lavenia Sambodo; Stella Gracia Octarica; Sugih Primas Adjie
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.798

Allergic contact cheilitis (ACC) from lipsticks is a frequent diagnostic challenge, often mimicking irritant contact cheilitis (ICC). The patch test is the diagnostic standard, but its accuracy relies heavily on the interpretation of reaction dynamics over time. This report illustrates the pivotal role of the crescendo reaction pattern in confirming an allergic etiology. A 21-year-old female presented with a six-month history of debilitating pruritus, papules, and subsequent xerosis with severe post-inflammatory hyperpigmentation on her lips. The symptoms were directly correlated with the daily use of several popular commercial matte and long-lasting lipsticks. Patch testing was performed with the European Standard Series and the patient’s own cosmetic products. While standard allergens were negative, three specific lipsticks elicited a classic crescendo reaction: a weak positive (+) erythema at 48 hours that intensified to a strong positive (++) reaction with papules and palpable infiltration at the 72- and 96-hour readings. This dynamic confirmed a Type IV hypersensitivity reaction and a diagnosis of ACC. Management focused on strict allergen avoidance and barrier repair, resulting in complete resolution of symptoms and significant improvement in her quality of life. In conclusion, the crescendo pattern observed in patch testing is a compelling in vivo marker of an allergic, memory T-cell-driven immune response. Its presence provides conclusive evidence for ACC, reliably distinguishing it from the decrescendo pattern characteristic of irritation. Meticulous observation of the temporal evolution of patch test reactions is paramount for accurate diagnosis and effective patient management in cheilitis.

Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (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.v8i8.1046

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.

Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (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.v8i8.1046

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.

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