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All Journal Medicina E-Jurnal Medika Udayana Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Berkala Ilmu Kesehatan Kulit dan Kelamin ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Biomedika dan Kesehatan Bioscientia Medicina : Journal of Biomedicine and Translational Research Bali Dermatology and Venereology Journal Neurologico Spinale Medico Chirurgico MAHESA : Malahayati Health Student Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran Journal of General Procedural Dermatology and Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal Indonesian Journal of Biomedicine and Clinical Sciences Cermin Dunia Kedokteran
Nyoman Suryawati
Departemen Dermatologi And Venereologi, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Gonococcal and Non-Gonococcal Urethritis in a Global Travel Hub: A Retrospective Analysis of Syndromic Management, Suboptimal Cefixime Monotherapy, and the Public Health Crisis of Patient Retention in Bali, Indonesia Andrew Wicaksono; I Gusti Ayu Agung Elis Indira; Ni Made Dwi Puspawati; Aditya Permana; Nyoman Suryawati
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.v9i11.1447

Abstract

Background: The inexorable rise of antimicrobial resistance (AMR) in Neisseria gonorrhoeae represents a formidable threat to global public health, jeopardizing the efficacy of last-line treatments for gonococcal urethritis (GO). Southeast Asia is a recognized epicenter for the emergence and dissemination of AMR, yet granular surveillance data from many high-risk localities remain critically sparse. This study aimed to provide a comprehensive characterization of the clinical epidemiology, frontline management practices, and patient outcomes of male urethritis at a tertiary referral center in Bali, Indonesia—a major international crossroads for tourism and migration. Methods: A retrospective, cross-sectional analysis was conducted on the medical records of male patients diagnosed with urethritis at the Dermatology and Venereology Polyclinic of Ngoerah Hospital between January 1st, 2021, and December 31st, 2024. A rigorous screening process of 215 initial records was undertaken to identify eligible cases. Data on sociodemographics, behavioral risk factors, clinical presentation, syndromic diagnosis, prescribed pharmacotherapy, and follow-up adherence were systematically extracted and analyzed using descriptive and comparative statistics. Results: From the initial cohort, 58 male patients met the final inclusion criteria. The cohort was predominantly diagnosed with GO (n=39, 67.2%) over non-gonococcal urethritis (NGO) (n=19, 32.8%). Patients were primarily of productive age (25–44 years, 58.6%) and reported high-risk behaviors, including multiple sexual partners (65.5%). A critical deviation from international treatment guidelines was identified: 97.4% (38/39) of GO patients received oral cefixime 400 mg monotherapy, a regimen no longer recommended for first-line use due to AMR concerns. Furthermore, a profound fracture in the care cascade was evident, with an overall loss-to-follow-up rate of 58.6% (34/58). This failure was most pronounced in the GO cohort, where 76.9% (30/39) of patients did not return for scheduled follow-up, a rate significantly higher than the 21.1% (4/19) observed in the NGO cohort (p<0.001). Conclusion: The clinical management of gonorrhoea at this major Indonesian referral center is defined by two systemic failures: the routine prescription of a suboptimal antimicrobial monotherapy and a near-total collapse of patient follow-up. This combination, situated in a high-transience international hub, creates an unmonitored, high-risk environment for the selection, amplification, and global dissemination of antimicrobial-resistant N. gonorrhoeae. These findings signal an urgent imperative to align local therapeutic protocols with evidence-based global standards and to implement robust, innovative strategies to ensure patient retention and verify the cure.
Kadar Transforming Growth Factor- Serum Berkorelasi Positif dengan Kadar Immunoglobulin M Anti-Phenolic Glycolipid-1 pada Narakontak Serumah Pasien Kusta Multibasiler Primasari, Putu Yunita; Rusyati, Luh Made Mas; Karmila, I Gusti Ayu Agung Dwi; Winaya, Ketut Kwartantaya; Suryawati, Nyoman; Karna, Ni Luh Putu Ratih Vibriyanti
Jurnal Biomedika dan Kesehatan Vol 6 No 2 (2023)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2023.v6.146-157

Abstract

Background Leprosy is a chronic progressive infectious disease. Phenolic glycolipid-1 (PGL-1) is an antigen of Mycobacterium leprae, which can trigger the host’s antibody response. Transforming growth factorβ (TGF-β) plays an immunosuppressive role when the host is exposed to PGL-1 antigen or other M. leprae antigens. This study aims to determine the correlation of TGF-β levels with IgM anti-PGL-1 levels in patients with multibacillary leprosy household contacts. Methods Observational analytical study with a cross-sectional approach. The study subjects consisted of 48 household contact subjects and 24 non-household contact subjects aged 15-65 years old who were selected by consecutive sampling based on inclusion and exclusion criteria. 3 mL of venous blood samples were taken and then examined for IgM anti-PGL-1 and TGF-β with the ELISA kit. Data analysis was carried out using SPSS version 23, and a p-value <0.05 was significant. Results The mean level of IgM anti-PGL-1 in the household contact group was 685.46 ± 290.79 u/mL, while in the non-household contact group was 345.50 ± 206.58 u/mL. The mean TGF-β level in household contact groups was 256.69 ± 127.41 pg/mL, while in the non-household contact group was 144.85 ± 36.73 pg/mL (p<0.001). This study found a moderate positive relationship (r=0.450, p<0.001) between levels of TGF-β and IgM anti-PGL-1 household contacts and non-household contacts group. Conclusions The mean level of IgM anti-PGL-1 and TGF-β in household contacts is higher than in non-household contacts, with a significant difference. There is a moderate positive significant relationship between levels of TGF-β and IgM anti-PGL-1 household contacts and non-household contacts group.
Low Serum Vitamin E Levels Positively Correlate with the Severity of Acne Vulgaris Sutiawan, Indry Salonika; Winaya, Ketut Kwartantaya; Suryawati, Nyoman; Rusyati, Luh Made Mas; Karmila, I Gusti Ayu Agung Dwi; Puspawati, Ni Made Dwi
MAHESA : Malahayati Health Student Journal Vol 4, No 10 (2024): Volume 4 Nomor 10 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i10.15882

Abstract

ABSTRACT Acne vulgaris (AV) is a common disorder of the pilosebaceous, especially prevalent in adolescents. Acne vulgaris ranks among the top ten most prevalent diseases globally. Although AV may resolve spontaneously, sequelae such as scar formation can persist, causing aesthetic and psychological disturbances. There is an antioxidant to counteract acne-causing oxidative stress, vitamin E, which is an important antioxidant in the human body. Therefore, vitamin E in the skin can reduce the formation of squalene peroxide and prevent the occurrence of AV. This is an analytical observational study using a cross-sectional design. The investigation was conducted at the Dermatology and Venereology Clinic of Prof. Dr. I.G.N.G. Ngoerah Denpasar Hospital and the laboratory of the Faculty of Medicine, Udayana University, from February 2024 until the sample size was fulfilled. The sample consisted of patients aged 12-45 years with acne vulgaris who visited the clinic and were then selected through consecutive sampling according to the inclusion and exclusion criteria. In the non-AV group, the mean serum vitamin E level was 19.3 ± 0.99 µg/ml, whereas in the AV group, it was 4.49 ± 19.1 µg/ml, indicating a significant variance. There was a positive correlation between low vitamin E levels and the severity of AV. The linearity graph shows the direction of the relationship between serum vitamin E levels and the severity of AV, which leads to the lower right, indicating that the higher the severity of AV, the lower the serum vitamin E levels. The mean levels differed significantly between the non-AV and AV groups. A favorable association was found between low vitamin E levels and the severity of AV. Keywords: Acne Vulgaris, Severity, Serum Vitamin E, Reactive Oxygen Species (ROS)
Necrotic lower extremities ulcers caused by calciphylaxis in chronic renal failure patient Nyoman Suryawati; Herman Saputra
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 1 (June 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vcjd9e41

Abstract

Introduction: Lower extremity ulcers often create diagnostic challenges and influence patient morbidity and mortality. The most common causes are venous insufficiency, arterial insufficiency, and neuropathic. Ulcers associated with systemic condition often face diagnostic and therapeutic challenge. We report a necrotic lower extremity ulcer caused by calciphylaxis in a patient with chronic renal failure. Case: We reported a 48-year-old Javanese woman, complained of painful lower extremities ulcers since 1.5 months ago. The patient had a history of renal failure and hypertension, undergone routine hemodialysis since 13 years ago, and used Continuous Ambulatory Peritoneal Dialysis (CAPD) since one year ago. Dermatology status on dorsum pedis sinister as well as cruris dexter and sinister showed multiple ulcers on livid skin covered by black eschar, accompanied by tenderness. Laboratory results showed anemia (Hb 7.6), hypoalbuminemia (2.7), increased serum urea level (170.4 mg/dl), increased serum creatinine (11.23 mg/dl), increased calcium (10.4 mg/dl), high inorganic phosphorus (8.5 mg/dl) and high parathyroid hormone (2,164). BOF examination showed abdominal calcification, while radiographic examination on cruris dexter et sinister showed soft tissue calcification and osteoporosis. Histopathology result supported the presence of calciphylaxis. The patient was diagnosed with stage V chronic renal failure, hypertension, and calciphylaxis caused by secondary hyperparathyroidism. She was managed by low calcium and phosphate diet, lanthanum, paracetamol, folic acid, adalat oros, captopril and wound debridement. Conclusion: Calciphylaxis is rare phenomenon of cutaneous necrosis associated with end-stage renal disease. Control of end-stage renal disease may be an important factor for treatment of calciphylaxis and patient with calciphylaxis usually had a poor prognosis.
Maculopapular drug eruption with histopathological features of psoriasiform drug eruption in a patient with psoriasis vulgaris: a case report Djuanda, Kevin Jonathan; Nyoman Suryawati; I. G. A. A. Elis Indira; Herman Saputra
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.23282

Abstract

Maculopapular drug eruption in patient with psoriasis are rarely reported and require close monitoring during oral corticosteroid therapy due to the potential risk of flare following dose reduction or discontinuation. A 47-yo male with a history of psoriasis vulgaris on cyclosporine therapy developed erythematous patches with scaling following the administration of amoxicillin, mefenamic acid, and antitetanus injection after a nail puncture injury. Vital signs were within normal limits. Dermatological examination revealed multiple well-demarcated erythematous macules, patches, and papules with geographic patterns measuring 0.6×0.9 cm to 2.5×4 cm, some confluent, accompanied by white scales and desquamation. Histopathological findings were consistent with psoriasiform drug eruption. The Naranjo score for amoxicillin was 4, showed a possible correlation. A diagnosis of maculopapular drug eruption suspected to be induced by amoxicillin was established. Clinical improvement observed following the administration of oral corticosteroids, cyclosporine, antihistamines, and emollients. The diagnosis of maculopapular drug eruption requires correlation of rash onset and drug initiation as well as monitoring of symptom resolution after drug discontinuation the suspected drug. Histopathological examination may support the diagnosis, with the presence of eosinophils serving as an indicator of drug-induced etiology. Management of maculopapular drug eruption in patients with psoriasis includes withdrawal of the suspected causative agent, symptomatic therapy, systemic corticosteroids, and immunosuppressive treatment as indicated.
Characteristics of Cutaneous Lupus Erythematosus Patients in Dermatology and Venereology Outpatient Clinic Suryawati, Nyoman; Praharsini, I Gusti Ayu Agung; Elis Indira, I Gusti Ayu Agung; Darmaputra, I Gusti Nyoman
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.V37.3.2025.153-162

Abstract

Background: Cutaneous lupus erythematosus (CLE) is a specific skin manifestation of lupus erythematosus. This condition can be accompanied by systemic involvement that affect patient therapy and prognosis. The characteristics of CLE patients in Indonesia have not been widely reported. This study aims to determine the prevalence and characteristics of CLE patients at Dermatology and Venereology Outpatient Clinic of Allergy and Immunology Division at Ngoerah Hospital. Methods: This research used descriptive analysis with a cross-sectional design and total sampling method. Result: The total number of patients was 34, with prevalence of 6.7 cases per 1,000 patients. The majority of patients were female (85.3%), Balinese ethnicity (70.6%), unemployed (53%), with a high school/vocational high school education (56%), and risk factors of sun exposure (80.0%). Most patients had no family history of Lupus erythematosus (LE) (65.7%). The most frequent skin manifestation was chronic type CLE (28.6%). Based on The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) score, 27 patients (77.1%) met Systemic lupus erythematosus (SLE) criteria. Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) activity, damage, and Mexican Systemic Lupus Erythematosus Disease Activity (MEX-SLEDAI) scores were 3.35±4.52, 0.88±1.96, and 7.5±5.09. Systemic therapy included methylprednisolone (47%) and hydroxychloroquine (35.2%), topical treatment included high to very high-potency steroids (67.6%), and sunscreen (14.7%). Response therapy was generally good in 68.6% of patients. Conclusion: The most common type of CLE is chronic cutaneous lupus erythematosus. Most patients improved, with the majority using systemic methylprednisolone and topical high-potency corticosteroids. Oral treatment responses tend to be good.
Co-Authors Aditya Permana Aditya Permana Anang Endaryanto Andrew Wicaksono Aurelia Stephanie Bagus Bagus Bharata, Putu Evindya Vipascitadewi Nandanaya Christiana Paramita Cita Rosita Sigit Prakoeswa Darmaputra, I Gusti Nyoman Djuanda, Kevin Jonathan Duarsa, Putu Laksmi Anggari Putri Elis Indira, I Gusti Ayu Agung Evy Ervianti Gede Mahadika Pradipta Atmaja Gunawan, Regina Hasri Dewi Herman Saputra Herman Saputra Herman Saputra I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Nyoman Darmaputra I. G. A. A. Elis Indira Ida Ayu Uttari Priyadarshini IGAA Ellis Indira IGAA Praharsini Indira, I Gusti Ayu Agung Elis Indira, IGAA Ellis Jason Jonathan Jihan Prani Wibowo Juliari, Gusti Ayu Made Juliyanti Juliyanti - Juliyanti -, Juliyanti Ketut Kwartantaya Winaya Khathreen, Corry Laksmi, I Gusti Ayu Agung Mini Linda Astari, Linda Luh Gede Melia Puspita Sari Luh Made Mas Rusyati Made Martina Windari Made Swastika Adiguna Made Wardhana Mohana Naravenah Ni Kadek Yunita Arsita Dewi Ni Luh Putu Ratih Vibriyanti Karna Ni Made Dwi Puspawati Ni Putu Melda Dharmahayu Nyoman Upadana Nyoman Yoga Maya Pramita Paramahamsa, Shirdi Paramita, Christiana Praharsini, IGAA Pramita, I Gusti Ayu Sattwika Prima Saraswati Sanjiwani Sudarsa Primasari, Putu Yunita Putu Yonika Budiarisma Ricky Fernando Maharis Sanjiwani, Saraswati Prima Saraswati Prima Sanjiwani Saraswati Sudarsa, Prima Sanjiwani Sutiawan, Indry Salonika Wicaksono, Rafael Lilik Winaya, Ketut Kwartantaya