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All Journal Medical Journal of Indonesia Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia Jurnal Kedokteran Meditek
Windy Keumala Budianti
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Temuan Klinis dan Terapi Dini pada Anak dengan Sindrom Ramsay-Hunt Noerfani, Rahma Rafina; Budianti, Windy Keumala; Permatasari, Nadya Aninditha; Gifani, Fathya Nabila
Jurnal Kedokteran Meditek Vol 31 No 2 (2025): MARCH
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i2.3497

Abstract

Introduction: Ramsay-Hunt syndrome is a complication of the varicellazoster virus that causes inflammation of the geniculate ganglion cranialnerve VII. This disease is a rare case in children. This case report aims tohighlight the importance of diagnosis, early examination, andappropriate therapy to prevent complications and poor prognosis. CaseIllustration: A 9 year-old girl presented with clear fluid-filled blisters inher left ear for four days before going to the hospital. Two days after thelesions came out, she complained of her face feeling tilted to the right,difficulty close her left eye, and the corner of her mouth being moredrawn towards the normal side. The left auricular helix fossa regionshowed a rash of multiple vesicles in groups containing clear fluid withan erythematous skin base, distributed unilaterally according to thedermatome. The patient was diagnosed with Ramsay-Hunt syndrome.She was treated with a combination of oral acyclovir andmethylprednisolone injections. Discussion: Antiviral therapy within 24–72 hours after the onset of the rash is very effective for healing of the rashand reducing the duration of pain. Corticosteroid as an antiinflammatory can reduce peripheral nerve damage and edema.Combination of corticosteroid with acyclovir for 7 days in herpes zosteraccompanied by facial paralysis is very effective in significantly reducingacute pain and reducing the risk of complications. Conclusion:The exactdiagnosis and combination of antiviral with corticosteroid therapy inchildren can be beneficial in reducing the duration of lesions and pain aswell as the risk of complications.
DERMATOMIOSITIS ANTI-MDA5: LAPORAN DUA KASUS SUATU ENTITAS DENGAN MANIFESTASI DAN PROGNOSIS BERAGAM Halim, P. Anthony; Hamdali, Christie; Pranathania, Andravina; Fitri, Eyleny Meisyah; Budianti, Windy Keumala; Novianto, Endi; Indrawati, Luh Ari
Media Dermato-Venereologica Indonesiana Vol 52 No 1 (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.v52i1.505

Abstract

Pendahuluan: Dermatomiositis anti-melanoma differentiation-associated protein 5 (DM-MDA5) adalah penyakit autoimun sistemik langka yang memiliki temuan klinis bervariasi dan banyak dipelajari dalam satu dekade terakhir. Subtipe tersebut umumnya bermanifestasi sebagai DM amiopatik atau hipomiopatik, sering disertai intersitial lung disease (ILD) berpotensi fatal. Dalam makalah ini, kami melaporkan untuk pertama kalinya di Indonesia, variasi gambaran klinis, radiologis, laboratorium, dan prognosis dua kasus DM-MDA5. Kasus: Pasien pertama, seorang perempuan 25 tahun dengan ruam kemerahan khas DM, kelemahan otot ringan, artralgia, dan alopesia. Pasien kedua, seorang perempuan 43 tahun dengan ruam kemerahan khas DM, ulserasi kulit, rambut rontok, kelemahan otot, nyeri sendi, dan sesak nafas. Diagnosis DM ditegakkan sesuai kriteria Sontheimer dan American College of Rheumatologist/European League Against Rheumatism (ACR/EULAR) 2017. Pada kedua pasien terdeteksi anti-MDA5 dengan titer positif kuat. Rontgen toraks dan CT scan menunjukkan ILD pada pasien kedua. Tata laksana kombinasi menggunakan kortikosteroid dan imunosupresan sistemik, kortikosteroid topikal, penghambat kalsineurin topikal, dan fotoproteksi ketat memperbaiki gejala klinis pada kedua pasien. Diskusi: Pasien DM-MDA5 dapat digolongkan menjadi beberapa fenotipe klinis sesuai temuan klinis dan laboratorium, dengan prognosis beragam terkait insidensi ILD. Kasus pertama memiliki prognosis baik, sedangkan kasus kedua cenderung memiliki prognosis sedang. Hingga kini, belum terdapat tata laksana spesifik DM-MDA5, tetapi terapi antifibrotik dapat bermanfaat pada kasus dengan ILD. Kesimpulan: Klinisi perlu mengenali subtipe DM ini karena memiliki manifestasi yang bervariasi namun cukup khas, dengan prognosis yang beragam. Evaluasi dan tata laksana dini secara multidisiplin pada pasien DM-MDA5 dapat mencegah progresivitas penyakit dan kematian akibat komplikasi.
TANTANGAN TATA LAKSANA PSORIASIS VULGARIS BERAT PADA PASIEN DENGAN SINDROM IMUNODEFISIENSI AKUISITA Ramadhani, Reinanda Marizki; Budianti, Windy Keumala; Fitri, Eyleny Meisyah; Ling, Michael Sie Shun; Hapsari, Windy Atika
Media Dermato-Venereologica Indonesiana Vol 52 No 2 (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.v52i2.519

Abstract

Pendahuluan: Prevalensi psoriasis dilaporkan meningkat pada pasien sindrom imunodefisiensi akuisita (SIDA). Tata laksana psoriasis vulgaris berat pada pasien SIDA merupakan tantangan tersendiri karena dibutuhkan pertimbangan terapi yang selektif untuk meminimalkan efek samping terutama pada kondisi imunokompromais. Pada kasus, dilaporkan resolusi komplit psoriasis vulgaris berat pada pasien SIDA. Laporan kasus: Seorang laki-laki 37 tahun mengeluh bercak merah bersisik tebal pada skalp, wajah, badan, dan kedua ekstremitas yang dirasakan memberat sejak 3 bulan lalu. Pasien memiliki riwayat SIDA namun putus obat. Pada regio skalp, wajah, badan, dan ekstremitas ditemukan plak eritematosa, multipel, skuama putih kering kasar berlapis, body surface area 46,5%, skor psoriasis area severity index 39,6. Pasien diberikan fototerapi narrowband UV-B (NB-UVB), obat anti retroviral (ARV), terapi topikal, serta tata laksana multidisiplin. Diskusi: Terdapat perbedaan alur tata laksana psoriasis vulgaris berat pada pasien SIDA. Lini pertama, penggunaan ARV, fototerapi, terapi topikal dengan keterlibatan multidisiplin. Lini kedua retinoid oral dan bila recalcitrant baru dipertimbangkan pemberian obat non biologik atau obat biologik secara hati-hati. Kesimpulan: Pemilihan tata laksana psoriasis vulgaris berat pada pasien SIDA memiliki alur berbeda karena harus sangat selektif dengan pertimbangan risiko dan manfaat yang sesuai. Terapi kombinasi fototerapi NB-UVB, terapi topikal, obat ARV, dan kerja sama multidisiplin memberikan resolusi komplit.
Sifilis Menyerupai Lupus Eritematosus: The Great Imitator Budianti, Windy Keumala; Sarah, Ratu Siti Khadijah
Jurnal Kedokteran Meditek Vol 30 No 1 (2024): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v30i1.2883

Abstract

Manifestasi klinis yang terlihat pada sifilis sering menyerupai penyakit inflamasi kronis seperti lupus eritematosus. Sebuah studi menyatakan angka kejadian misdiagnosis sifilis dengan lupus eritematosus sebanyak 166 kasus sepanjang tahun 2006-2011. Seorang laki-laki 24 tahun datang dengan lesi oral, bercak merah pada kedua telapak tangan dan kaki disertai telogen efluvium, madarosis, artralgia, dan nyeri otot. Pasien telah didiagnosis Lupus Eritematosus Sistemik (LES) dengan keterlibatan mukokutan dan muskuloskeletal berdasarkan klinis dan serologis kemudian dirawat oleh sejawat Internis dengan obat imunosupresan selama 3 minggu tetapi keluhan bertambah parah. Pasien kemudian dirujuk ke dokter dermatologi dan venereologi untuk pengobatan bercak pada telapak tangan dan kaki. Hasil pemeriksaan mengarah pada sifilis sekunder dan didukung hasil serologi. Pasien mendapatkan injeksi benzathine penicillin 2,4 juta IU intramuskular dan klinis membaik dalam satu minggu. Tujuan laporan kasus ini untuk meningkatkan kewaspadaan terhadap diagnosis sifilis yang merupakan the great imitator yang memiliki tampilan klinis dan serologis menyerupai penyakit autoimun.
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.
Telogen effluvium incidence in women wearing hijab compared to non-hijab: A cross-sectional study Sirait, Sondang Pandjaitan; Widaty, Sandra; Legiawati, Lili; Surachmiati Suseno, Lis; Krisanti, Roro Inge Ade; Budianti, Windy Keumala; Miranda, Eliza; Rihatmadja, Rahadi; Oktarina, Caroline; Pandelaki, Paulus Anung Anindita; Situmeang, Irhen
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Hair loss is a normal experience, but if the amount of hair loss exceeds what is considered normal, it will usually cause anxiety for the patient. In Indonesia, almost every Muslim woman wears a hijab. The hijab is one of many factors believed to cause hair loss. Telogen effluvium (TE) itself is a hair cycle disorder in which the anagen phase terminates prematurely, resulting in diffuse club hair loss without scarring, and TE itself has many risk factors. The purpose of this study was to determine the relationship between the incidence of TE in women who wear hijabs and those who do not. Methods: This cross-sectional study was conducted from August 2019 to April 2021 involving 188 healthy women aged 18 years and over who had not yet reached menopause. In the hijab group, it was determined that they should wear a minimum of 8 hours a day for at least 5 years. The test was carried out on hair that had not been washed using a trichogram, to look for hair characteristics in each group (hijab-wearing and non-hijab-wearing). Analysis of the data obtained was carried out using the Chi-square test and odds ratio. Results: Telogen effluvium was higher in subjects wearing hijab (26.8%) than in subjects who did not wear hijab (18.1%), (p-value 0.040, OR 2.036). Conclusion: There was a significant relationship between TE in women who wear hijab compared to those who do not. Further studies should be conducted in other populations with a larger sample size to confirm these results.
Systemic antibiotic selection in skin and soft tissue infections Purnawan, Shafira Anindya; Budianti, Windy Keumala; Widaty, Sandra
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Antibiotics are used in daily practice. To properly select antibiotics, it is important to pay attention to the definitive diagnosis, class of antibiotic, dose, interval, route of administration, and exact duration of use. Discussion: The World Health Organization (WHO) categorizes antibiotics into three groups: Access, Watch, and Reserve—known as the AWaRe classification—to help guide appropriate usage and combat antibiotic resistance. The Gyssens flowchart serves as a valuable tool for clinicians to qualitatively evaluate antibiotic utilization. In skin and soft tissue infections (SSTIs), treatment strategies are tailored according to the characteristics of the infection, including purulence, necrosis, and overall severity. For mild-to-moderate non-purulent SSTIs, beta-lactam antibiotics, such as penicillin and cephalosporin, alongside lincosamides like clindamycin, are recommended as first-line therapies. In cases of moderate-to-severe non-purulent SSTIs, empirical therapy must account for methicillin-resistant Staphylococcus aureus (MRSA). Meanwhile, purulent SSTIs require an initial incision and drainage, with subsequent treatment options including topical antibiotics for mild cases and systemic antibiotics for more complicated or severe infections. Extensive purulent SSTI in adults is empirically considered MRSA. Conclusion: Control of antimicrobial resistance can be achieved by using antibiotics according to the AWaRe classification and evaluating the use of antibiotics qualitatively using the Gyssens flowchart.
Psoriasis Genomics: A Review Hutasuhut, Magna; Budianti, Windy Keumala; Indriatmi, Wresti; Setyorini, Mirawati
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Psoriasis is a dermatological condition influenced by genetic and epigenetic factors, environmental triggers, as well as immune responses. Genomics refers to the study of individual genes (genomes) and their interactions with environmental influences. In the context of psoriasis genomics, the interplay between genetic predisposition and environmental factors contributes to the manifestation and variations of the disease. With advancements in molecular genotyping technology and genome-wide association studies (GWASs), researchers have identified 50 genetic markers linked to psoriasis. Discussion: Several genetic loci associated with psoriasis have been identified, including PSORS 1-15. The genetics of psoriasis is also linked to its onset, precipitating factors, associated comorbidities, and clinical variations. Advances in psoriasis genomics are leading to more targeted and innovative treatment approaches. The latest therapeutic developments for psoriasis mainly focus on the interleukin-23 (IL-23)/T-helper 17 (Th17) pathways. Conclusion: The development of GWASs provides new knowledge about psoriasis, including its pathogenesis and specific treatments.
DERMATITIS ATOPIK TIPE LIKENOID GENERALISATA AWITAN DEWASA Aziza, Anggita Nur; Sukmara, Isni Maulina; Halim, Dionisius Ivan Yonathan; Budianti, Windy Keumala
Media Dermato-Venereologica Indonesiana Vol 52 No 4 (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.v52i4.542

Abstract

Pendahuluan: Dermatitis atopik (DA) memiliki karakteristik pruritus, eritema, indurasi, skuama. Manifestasi klinis ini dapat pula ditemukan pada berbagai penyakit kulit yang menyerupai, terjadi bersamaan, atau merupakan komplikasi DA. DA awitan dewasa dapat menunjukkan variasi klinis yang tidak biasa. Kasus: Laki-laki berusia 36 tahun, mengeluhkan bercak kemerahan yang terasa gatal di badan dan ekstremitas sejak 6 bulan lalu. Keluhan disertai bercak tebal di kedua tungkai. Pasien memiliki riwayat asma serta riwayat akalasia dengan malnutrisi berat. Pasien awalnya didiagnosis dermatitis yang disebabkan defisiensi asam lemak esensial dengan infeksi sekunder, dermatitis numularis, liken simpleks kronikus, dan dermatitis seboroik. Setelah evaluasi lebih lanjut, pasien memenuhi kriteria Hanifin-Rajka disertai kadar IgE yang tinggi, sehingga ditegakkan diagnosis DA awitan dewasa. Diskusi: Laporan kasus ini menunjukkan penegakkan diagnosis DA awitan dewasa tipe generalisata berdasarkan klinis. Pemeriksaan penunjang untuk menyingkirkan diagnosis banding dermatitis kontak tidak dapat dilakukan karena pasien dalam terapi imunosupresan. Penatalaksanaan DA dilakukan secara sistematik disertai pemberian terapi sistemik. Kesimpulan: Penegakan diagnosis DA awitan dewasa berdasarkan klinis merupakan sebuah tantangan. Manifestasi klinis seringkali tidak sesuai dengan kriteria diagnosis yang umum digunakan terutama pada kasus de novo. Pemeriksaan penunjang seperti kadar IgE, eosinofil, uji kulit, dan biopsi kulit terkadang diperlukan untuk penegakan klinis secara tepat sehingga pasien dapat diberikan tata laksana yang sesuai. 
Co-Authors Aldri Frinaldi Andardewi, Melody Febriana Astri Adelia, Astri Aulia, Izzah Aziza, Anggita Nur Bianti, Marsha Debinta, Arlha Aporia Dina Kusumawardhani Effendy, Isaak Eliza Miranda Endi Novianto Evita Halim Effendi Evita Halim Effendi Eyleny Meisyah Fitri Fahira, Alessa Fitri, Eyleny Meisyah Fitria Agustina Gifani, Fathya Nabila Halim, Dionisius Ivan Yonathan Halim, P. Anthony Hamdali, Christie Heri Wibowo Hutabarat, Hernayati Hutasuhut, Magna Indrawati, Luh Ari Irawan, Yudo Isni Maulina Sukmara, Isni Maulina Joedo Prihartono Krisanti, Roro Inge Ade Kuniawan, Kristian Kusmarinah Bramono Lili Legiawati Lili Legiawati Ling, Michael Sie Shun Marissa, Melani Mawardi, Prasetya Meilinda, Puti Rineska Melody Febriana Andardewi Noerfani, Rahma Rafina Oktarina, Caroline Olivia, Taruli Pandelaki, Paulus Anung Anindita Parikesit Muhammad Permatasari, Nadya Aninditha Pranathania, Andravina Purnawan, Shafira Anindya Rahadi Rihatmadja Ramadan, Edwin Ti Ramadhani, Reinanda Marizki Ratu Siti Khadijah Sarah Sandra Widaty Setyorini, Mirawati Shafira Anindya Shafira Anindya, Shafira Sirait, Sondang Pandjaitan Situmeang, Irhen Surachmiati Suseno, Lis Suyatna, Fransiscus Dhyanagiri Windy Atika Hapsari, Windy Atika Wresti Indriatmi B. Makes Yasnova, Nevi Yudo Irawan