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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Berkala Ilmu Kesehatan Kulit dan Kelamin Mutiara Medika: Jurnal Kedokteran dan Kesehatan Journal of General Procedural Dermatology and Venereology Indonesia
Niken Indrastuti
Department Of Dermatology And Venereology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Systemic provocation in doxycycline induced fixed drug eruption: a case report Niken Indrastuti, Anik Murwaningsih Rosmarini Estri Sih Hananti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2872.668 KB) | DOI: 10.19106/JMedScie004502201306

Abstract

Fixed drug eruption (FDE) is recurrent lesions that upon repeated uptake of causative drug, always appears at the same skin and mucosal site. Determination of causal relationship in drug allergy is very important. In this case report, cases of doxycycline-induced FDE was reported. The subject of the research was a 29-year-old male, referred by dermatologist, with history of reccurent FDE. Physical examination revealed an oval well demarcated patch hyperpigmentation. Patch test was perfomed on previous involved and uninvolved site. The result of the patch test was irrelevant. Retesting patch test gave similar result. Systemic provocation test or drug provocation test (DPT)  with doxcycline were done with suspected drug under ambulatory survelance and gave positive result. In this case, the DPT succeeded to identify doxycycline as the causal agent of FDE. The work-up of a suspected drug hypersensitivity includes a detailed clinical history, physical examination, skin tests, and provocation tests. The DPT is recommended to confirm drug’s hypersensitivity reactions. Systemic provocation test is considered as the gold standard for diagnosing FDE.Keywords:   fixed drug eruption - doxycycline - causal relationship - patch test - systemic provocation test
Systemic provocation in doxycycline induced fixed drug eruption: a case report Anik Murwaningsih; Rosmarini Estri Sih Hananti; Niken Indrastuti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2872.668 KB) | DOI: 10.19106/JMedScie004502201306

Abstract

Fixed drug eruption (FDE) is recurrent lesions that upon repeated uptake of causative drug, always appears at the same skin and mucosal site. Determination of causal relationship in drug allergy is very important. In this case report, cases of doxycycline-induced FDE was reported. The subject of the research was a 29-year-old male, referred by dermatologist, with history of reccurent FDE. Physical examination revealed an oval well demarcated patch hyperpigmentation. Patch test was perfomed on previous involved and uninvolved site. The result of the patch test was irrelevant. Retesting patch test gave similar result. Systemic provocation test or drug provocation test (DPT)  with doxcycline were done with suspected drug under ambulatory survelance and gave positive result. In this case, the DPT succeeded to identify doxycycline as the causal agent of FDE. The work-up of a suspected drug hypersensitivity includes a detailed clinical history, physical examination, skin tests, and provocation tests. The DPT is recommended to confirm drug’s hypersensitivity reactions. Systemic provocation test is considered as the gold standard for diagnosing FDE.
The role of nickel contact allergy in nummular dermatitis in Indonesia Niken Indrastuti; Moh Hakimi; Marsetyawan HNE Soesatyo; Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 1 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (277.457 KB) | DOI: 10.19106/JMedSci005101201907

Abstract

In the recurrence of nummular dermatitis (ND) as a problem for patients, it is necessary to identify interferon-γ (IFN- γ), interleukin-4 (IL-4), interleukin-17 (IL-17), and stimulation of lymphocytes against nickel. This study aimed to investigate the role of nickel contact allergy in ND. Forty-two patients with ND were studied and 42 healthy subjects who were equal in age, sex and atopy history as control. All subjects underwent nickel skin patch test, detection of IFN-γ, IL-4, IL-17 in blood, and lymphocyte stimulation assays. To determine cut off point of the variables, receiver operator characteristic (ROC) curves were calculated. Bivariate and multivariate analyses were performed to measure the strength of association using odds ratio (ORs) and 95% confidence intervals (95% CI). Statistical analysis was performed using McNemar X2-square test and multiple conditional logistic regression. Nickel contact allergy was shown by nickel patch test (OR= 3.5; 95% CI = 1.09–14.60), stimulation index/SI (OR= 29; 95% CI = 4.81-1184.43), IFN-γ (OR= 4.25; 95% CI = 1.39–17.36). These results were supported after multivariate analysis with conditional logistic regression which showed nickel patch test (OR= 9.63; 95% CI= 1.02–109.38; p= 0.04), SI (OR= 42.19; 95% CI = 2.32–766.03; p= 0.01), IFN-γ (OR= 11.51; 95% CI = 1.08–122.63; p= 0.04). Nickel contact allergy is an important risk factor for ND. Patients with ND are recommended to be tested for nickel contact allergy.
Cutaneous Manifestations of Breast Cancer Patients in Combination with Capecitabine and Lapatinib Chemotherapy Nita Damayanti Sulistianingrum; Niken Indrastuti; Yohanes Widodo Wirohadidjojo
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 23, No 1 (2023): January
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v23i1.12276

Abstract

The combination of chemotherapy with lapatinib and capecitabine in human epidermal growth factor receptor 2 (HER2) positive breast cancer is quite effective. The combination of these two agents increases the risk of dermatological toxicities. A woman, 38 years old, HER2 positive breast cancer with a combination of chemotherapy agents between lapatinib and capecitabine gives an overview of skin toxicities such as acneiform eruptions, palmar-plantar erythrodysesthesia (PPE), and paronychia. Therapy, in this case, aims at clinical improvement. The combination of lapatinib and capecitabine has a side effect profile like each drug. Combined use of the two agents increases the incidence of skin side effects, including acneiform eruptions, PPE, and paronychia, compared to monotherapy. Early awareness of the side effects of chemotherapeutic agents is needed for early treatment to prevent the worsening of the condition and discontinuation of chemotherapeutic agents due to drug side effects.
Allergen profile of facial ACD to cosmetics among patients at Tertiary Referral Hospital in Yogyakarta Alfieri, Alessandro; Indrastuti, Niken; Febriana, Sri Awalia; Pudjiati, Satiti Retno; Waskito, Fajar
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Cosmetics are a part of life for most of the population and may cause allergic contact dermatitis (ACD), especially on the face, as the primary exposure of cosmetics is on the face area.Methods: This research was conducted retrospectively using secondary data. The research subjects and demographic data were taken from the registered list of patients at Dermatology and Venereology Outpatient Clinic Dr. Sardjito General Hospital with a clinical picture of facial ACD due to cosmetics. Patch tests were carried out from January 2017 to December 2020.Results: From three years period, 26 patients were diagnosed with suspected facial ACD due to cosmetics and underwent patch tests. Of the total 26 patients, 3 patients did not show any reaction to the patch test. On the 23 patients who had reactions on the patch test, there were 66 points on the skin that showed a reaction to allergens. Of the 66 points, 37 points gave a positive reaction picture, with the most common allergen causing the reaction being cobalt(II) chloride hexahydrate (n=4, 10.8%). Then, from 29 points that gave doubtful reactions, the allergen that caused the most reactions was potassium dichromate 0.5% (n=4, 13,8%).Conclusion: The allergens that most often give a positive or doubtful reaction on the patch test of this study are metal compounds (cobalt and potassium dichromate). This study only looks at the patch test that gives a reaction without looking at the clinical relevance related to cosmetics use.
Validity and Reliability of the Indonesian Version of Nordic Occupational Skin Questionnaire 2002 (NOSQ-2002) Paramita, Listya; Waskito, Fajar; Prawiratama, Dikky; Indrastuti, Niken; Rayinda, Tuntas; Febriana, Sri Awalia
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Epidemiological data on occupational hand eczema in Indonesia is still limited, partly because there are no valid and reliable instruments in the Indonesian language as a means of survey. This study aims to translate the Nordic Occupational Skin Questionnaire 2002 (NOSQ-2002) into the Indonesian language and assess the validity and reliability of the Indonesian NOSQ-2002 as an instrument for epidemiological surveys and screening of occupational hand eczema. Methods: The original English version of NOSQ-2002 was translated into the Indonesian language following the standard procedure of translation. The Indonesian NOSQ-2002 version, which had been collectively approved, was subsequently completed by a group of 194 textile employees from PT. Panca Persada Mulia-PANDATEX in Magelang, Central Java, Indonesia. Validity was assessed using Pearson correlation for each question with the total score. Reliability was evaluated using Cronbach's alpha values. The sensitivity and specificity of the Indonesian NOSQ-2002 screening were determined by comparing results with those of examination by the examining physician as the gold standard. Results: Pearson correlation values for each question range from 0.252 to 0.905, all surpassing the r table value, indicating questions in NOSQ-2002 are valid. Reliability NOSQ-2002 rated good (reliable), with a Cronbach's alpha of 0.933. The Indonesian NOSQ-2002 version demonstrates a sensitivity of 93.3% and specificity of 98.8% for screening occupational hand eczema. Conclusion: The Indonesian version of NOSQ-2002 is a valid and reliable instrument for use in epidemiological surveys and screening of occupational hand eczema.
The Effect of 0.2% Hyaluronic Acid Cream on the Severity of Acute Radiodermatitis in Breast Cancer Patients: a Double-Blind Randomized Controlled Trial Muchamad Apriyanto; Sigid Santosa, Novita Permatasari; Mira Oktarina, Dyah Ayu; Ekaputra, Ericko; Trisnowati, Niken; Budiyanto, Arief; Soebono, Hardyanto; Waskito, Fajar; Indrastuti, Niken
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 37 No. 3 (2025): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikkk.V37.3.2025.195-202

Abstract

Background: Radiotherapy is an essential treatment in reducing the risk of breast cancer but can cause side effects such as acute radiodermatitis. This condition is the result of ionizing radiation damaging deoxyribonucleic acid (DNA) through reactive oxygen species (ROS) and inducing inflammatory responses, which lead to variable degrees of skin damage. Hyaluronic acid (HA) plays a role in triggering cell proliferation and keratinocyte differentiation while inhibiting lipid peroxidation caused by oxidative stress. Purpose: This study aims to determine the effectiveness of hyaluronic acid in reducing the degree of acute radiodermatitis using the Radiation Therapy Oncology Group (RTOG) score in breast cancer patients undergoing radiotherapy. Methods: This study was a double-blind randomized controlled trial. The samples were from patients diagnosed with breast cancer receiving radiotherapy. The treatment group received 0.2% HA cream, while the control group received a placebo The clinical appearance was evaluated weekly from the beginning of radiotherapy until two weeks post-radiotherapy using the RTOG score. Result: A total of 41 subjects were divided into two groups. RTOG score evaluation with intention-to-treat analysis and per-protocol analysis at weeks 3, 4, and 5 showed that the hyaluronic acid cream group experienced delayed onset of acute radiodermatitis compared to the placebo group. The log-rank test showed a significant difference in effectiveness between 0.2% HA cream compared to base cream in reducing the degree of acute radiodermatitis (p=0.035). Conclusion: The use of 0.2% HA cream was effective in reducing the severity of acute radiodermatitis in breast cancer patients undergoing radiotherapy.
Co-Authors Alfieri, Alessandro Anik Murwaningsih Arief Budiyanto Ekaputra, Ericko Fajar Waskito Febriana, Sri Awalia Hardyanto Soebono Marsetyawan HNE Soesatyo Mira Oktarina, Dyah Ayu Moh Hakimi Muchamad Apriyanto Niken Trisnowati Nita Damayanti Sulistianingrum Paramita, Listya Prawiratama, Dikky Rayinda, Tuntas Rosmarini Estri Sih Hananti Satiti Retno Pudjiati Satiti Retno Pudjiati Sigid Santosa, Novita Permatasari Yohanes Widodo Wirohadidjojo