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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Indian Journal of Forensic Medicine & Toxicology

Marsudi Hutomo

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Author-ID : 2450724

Immunology & microbiology Public Health

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Drug Patch Test as a Diagnostic Test to Determine the Culprit Drug of Cutaneous Adverse Drug Reaction (CADR) Damayanti; Hari Sukanto; Marsudi Hutomo; Sylvia Anggraeni; Menul Ayu Umborowati; Cita Rosita Sigit Prakoeswa
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): 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.v15i3.15739

Background: Cutaneous Adverse Drug Reaction (CADR) is a frequent problem in clinical practice since there were new drugs or drug misuse, which leads to high morbidity and mortality rate. It is often difficult to determine the offending drug only from the history. Provocation test, intradermal test or skin prick test are of significant value, but having higher risk to re-precipitate life-threatening reaction. Drug patch test (DPT) is a test, which is performed to CADR patient to determine the culprit drug. The main advantages of DPT are, it gives rarely adverse reaction and any commercialized form of drugs can be used.Methods: This is a retrospective study, aimed to analize the clinical relevance between anamnesis and DPT result in patient with history of CADR. All patient, who were performed with DPT in one year period in Dr. Soetomo General Academic Hospital Surabaya Indonesia, were evaluated in this study. Results: There were 14 patients with history of CADR, who performed DPT; consist of 7 maculopapular eruption cases, 4 Stevens-Johnson Syndrome (SJS) cases, 1 Fixed Drug Eruption (FDE) case, 1 Acute Generalized Exanthematous Pustulosis (AGEP) case and 1 Drug Reaction with Eosinophilia and Systemic Reaction (DRESS) case. There were 9 patients (64.3 %), who got positive result of DPT. The relevance between anamnesis and positive result of DPT were shown in 8 patient (88.9%) of 9 patient with positive DPT result. Conclusion: DPT has important role in identifying the culprit drug in CADR, especially when multiple drugs are involved.

Dermoscopy Supports the Diagnose of Papulosquamous Disorders Medhi Denisa Alinda; Marsudi Hutomo; Trisniartami Setyaningrum
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 26 No. 3 (2014): BIKKK DESEMBER 2014
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V26.3.2014.1-7

Background: The diagnose of papulosquamous skin disorder was established by clinical symptoms. However, some of papulosquamous manifestation are alike with each other and lead to misdiagnostic. Histopathology examination usually can help to establish diagnose but this method is invasive and time consuming. Purpose: To evaluate dermoscopic features of papulosquamous disorder. Methods: Descriptive observasional cross sectional study, total sampling in ward and out patient clinic of Dermato-venereology Department Dr. Soetomo General Hospital. Twenty four samples were included in the study, followed by the procedures from anamnesis, physical examination, dermoscopy procedures, and histopathology examination. Results: From 24 samples, 19 samples showed plaque psoriasis describing 12 ring patterns, 1 cluster pattern, 2 patchy patterns, 2 reguler patterns, and 2 unspesiﬁc patterns; 3 samples showed nummular dermatitis describing 2 cluster patterns and 1 unspesiﬁc pattern; and 2 samples showed pityriasis rosea describing 2 pheripery patterns. Conclusion: Dermoscopy can support the diagnosis of papulosquamous skin disorder especially plaque psoriasis.Key words: papulosquamous disorder, dermosocopy, histopathology examination, plaque psoriasis.

Salivary Cortisol Levels Representing Serum Cortisol Levels in Atopic Dermatitis Patients Novia Indriyani Adisty; Marsudi Hutomo; Diah Mira Indramaya
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 3 (2015): BIKKK DESEMBER 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder, recurrent lesion with a distinctive and specific distribution of lesions according phases. Patients with allergic diseases have been known to have a variety of patterns of cortisol. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and the role of cortisol has been studied in patients with DA. Free cortisol adrenal cortex is considered biologically active, which passively diffuses into all body fluids including saliva. Another advantage is the saliva examination is non-invasive, stress free and easy to do anywhere. Purpose: To analyze the correlation between levels of serum cortisol and salivary cortisol in patients with AD. Methods: Analytical, observational, cross-sectional study of the 29 AD patients who underwent blood and saliva samples by the method of "passive drooling" conducted on the hour 8:00 to 9:00 to see the levels of serum cortisol and salivary cortisol. Results: Twenty-nine subjects revealed mean serum cortisol levels 6,703,82g/dL, mean salivary cortisol levels was 1,430,96g/dL. Equation of salivary cortisol = 0,471+0,142*serum cortisol 2 (R=28,5%). Conclusions: The increasing of serum cortisol level of AD patients will result in increased levels of cortisol in saliva. Saliva collection methods by “passive drooling” were able to describe the serum cortisol levels at 28,5%.Key words: atopic dermatitis, serum cortisol, salivary cortisol.

Retrospective Study: Management of Atopic Dermatitis Nanny Herwanto; Marsudi Hutomo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Atopic dermatitis (AD) is a chronic skin inflammatory disease, characterized with mild to severe itching, relapses, and mostly appears in infants and children. Although there has been current advances in the management of AD but satisfactory treatment has not been obtained. Purpose: To evaluate the treatment of patients with AD, hence better management can be provided. Methods: Retrospective study of newly diagnosed AD patients in Allergy Immunology Division of Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya during 2012-2014. Result: Antihistamine is the most widely prescribed medication, as many as 234 (36.3%) of all patients visits and cetirizine was the most given antihistamine in 142 (58%) of the patients. Emollients still used minimally, such as urea 10% cream in 71 (11%) patients, ambiphilic cream (biocream®) in 52 (8.1%) patients, and vaseline album in 11 (1.7%) patients. Conclusion: Emollients therapy is important in the management of AD and hence its usage should be adequate.Key words: atopic dermatitis, management, retrospective.

Allergic Contact Dermatitis due to Henna Tattoo with Secondary Infection Fransiska Rismauli Natallya; Marsudi Hutomo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Recently henna tattoo become popular. Incidence of allergic contact dermatitis due to henna tattoo is increasing. Para-phenylenediamine (PPD) is suspected as a contact sensitizer because it is often added to henna tattoo to make a darker color. Patch test is needed to determine the allergen. Case: A 18 year-old woman with chief complaint itchy redness patches, burning sensation, and blisters containing pus on her lower left arm after she applied henna tattoo on those site 3 days before. It was the second time applying henna and the reaction was appeared. The patient was treated with oral antibiotic for 5 days, oral antihistamine, and wet dressing with NaCL 0.9% for 3 days. Three days after wet dressing, topical corticosteroid was applied, and the lesion resolved. Patch test was performed 10 months later and showed positive reaction to PPD and toluenesulfonamide formaldehyde resin (TSFR). The previous history, patient had allergy to nail polish which TSFR was suspected as a contact sensitizer. Discussion: Allergic contact dermatitis is a hypersensitivity reaction caused by skin contact with an environmental allergen. Prior sensitization is required for allergy to develop. Patch test is the gold standard to determine the allergen. Based on history and physical examination, clinical relevance of patch test showed positive current relevance (possible) for PPD, and past relevance for TSFR. Conclusion: Avoiding the allergens are important in the management of contact dermatitis.Key words: Allergic contact dermatitis, henna tattoo, para-phenylenediamine (PPD), patch test.

Co-Authors Anggraeni, Sylvia Cita Rosita Sigit Prakoeswa Damayanti Diah Mira Indramaya Fransiska Rismauli Natallya Hari Sukanto, Hari Medhi Denisa Alinda, Medhi Denisa Menul Ayu Umborowati Nanny Herwanto Novia Indriyani Adisty Trisniartami Setyaningrum

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