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Interaction between leprosy and HIV infection Prima Sudarsa; Ratih Vibriyanti Karna; Luh Mas Rusyati
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/jh820g57

Abstract

Introduction: Leprosy and Human Immunodeficiency Virus (HIV) infections still count as major health issues worldwide. Starting with the HIV pandemic back in the eighties, leprosy was feared to re-emerge as the HIV cases arose. Co-infections between leprosy and HIV were worried to cause an increase in leprosy cases, with worse clinical manifestation, predominantly toward the lepromatous spectrum, decrease in therapy response, and prolonged therapy period. Unlike its interaction with tuberculosis, HIV infection was turned out to not increasing nor deteriorating the manifestation of leprosy infection. All clinical spectrum of leprosy was found in HIV infection patients without predomination of lepromatous type. Responses to leprosy Multi-Drug Therapy (MDT) regimen were also found similar between leprosy patients with or without HIV. Conclusion: It is recommended to treat co-infective patients both with leprosy MDT and antiretroviral therapy. Manifestation of leprosy as a part of immune reconstitution syndrome need more attention and investigation.
Low plasma level of insulin-like growth factor – I (IGF-I) is a risk factor for multibacillary type of leprosy Luh Made Mas Rusyati; Made Swastika Adiguna; Indra Teguh Wiryo
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 2 (December 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/yk1gk812

Abstract

Introduction: Leprosy is one of infectious diseases with complex issues. The previous study showed poverty, malnutrition, lack of proper food and nutrient intake, as well as low income. Recently, many studies reported insulin-like growth factor-I (IGF-I) as an excellent nutrient marker. Objective: This study aims to prove that low plasma level of insulin-like growth factor-I is a risk factor for the multibacillary type of leprosy. Material and methods: This case-control study design involved 38 patients with leprosy subjects as cases and 38 control subjects. The sample collection is done by consecutive sampling and has fulfilled the inclusion and exclusion criteria, which matched by age and gender in Dermatovenereology Polyclinic of Sanglah Hospital. The collected data was analyzed using SPSS version 23.0 with Pearson Chi-square test to obtain the odds ratio. Results: This study showed that IGF-I plasma levels in the case group were significantly lower than the control group (p<0,05) with Odds ratio for IGF-I plasma 34,61 (95% CI= 7,17-167,01, p<0,001) Conclusion: Low plasma level of insulin-like growth factor-I is a risk factor for the multibacillary type of leprosy.
Bacterial vaginosis as a risk factor of preterm premature rupture of membrane (PPROM) Anak Agung Gde Putra Wiraguna; Luh Made Mas Rusyati; I Dewa Ayu Vanessa Vijayamurthy
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 2 (December 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/0g76d102

Abstract

Introduction: The pathogenesis of PPROM is complex and not fully understood. Recent studies showed that such role of genital tract infection as bacterial vaginosis in the pathogenesis of PPROM turned out to be present. They produce lipase enzymes in which they can form compounds with the fibrous tissue of the amniotic membrane resulting in an increased risk of rupture of the membrane. Objective: This study aims to prove that bacterial vaginosis is a risk factor for preterm premature rupture of membrane. Material and methods: This research used the case-control method. Sampling was using the consecutive sampling method and had fulfilled inclusion and exclusion criteria with age-based matching, then vaginal swab sampling was conducted, painted with gram staining in the Dermatology and Venereology Laboratory of Sanglah Hospital, and Nugent score. Result: Total of 76 pregnant women with 24-36 weeks of gestation were investigated, 38 mothers with PPROM and 38 mothers with normal pregnancy. The average score of Nugent at preterm PROM was 7.18 and in normal pregnancy was 2.37. Bacterial vaginosis risking for PPROM 7 times (OR= 7.0, 95% CI= 1.21-17.68, p= 0.001). Conclusion: Bacterial vaginosis as a risk factor for the occurrence of PPROM.
Selection of topical corticosteroids in children atopic dermatitis Aurelia Stephanie; Prima Sanjiwani Saraswati Sudarsa; Luh Mas Rusyati
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/xmbe0178

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically starts in childhood with classic symptoms of dry and itchy skin that occurs continuously and recurrences and even causes sleep disorders and skin that is susceptible to infection. AD sufferers often have atopic comorbidities such as asthma and allergic rhinitis in themselves and their families. The effects of this itching cycle result in growth disturbance and decreased quality of life for AD patients and their parents. Moderate and severe AD have an impact on parents, the stress in medication, and care, which takes up time and money. Atopic dermatitis is due to damage to the skin barrier, so the principle of management is to improve the skin barrier so that the inflammatory process can be avoided. The course of AD is chronic and relapsing; generally, patients come for treatment with an acute phase that sometimes requires topical corticosteroids. However, topical corticosteroids (TC) are used only to treat the acute phase for a short period. After the acute lesions have subsided, corticosteroids can be stopped immediately to prevent side effects and continue with daily skincare. Conclusion: Topical corticosteroids are first-line therapy in the acute phase. The choice of TC is based on age, body location, dosage, and severity of AD. If the acute lesion has subsided, then corticosteroids can be stopped and substituted with other antipruritic therapy and moisturizer.
Negative correlation between interleukin-2 (IL-2) serum with bacterial index in leprosy Patricia Dian Putri; Luh Made Mas Rusyati; Made Swastika Adiguna
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 3 No. 1 (June 2020)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/zngnct18

Abstract

Background: Leprosy is strongly influenced by the host immunity response. One of the cytokines that play a role in cellular immunity is IL-2. IL-2 will stimulate macrophages to activate phagocytosis and form granulomas, and this occurs in the leprosy tuberculoid type. Aim of this study was to verify the IL-2 serum levels are negatively correlated or not with bacterial index in leprosy. Methods: This study was a cross-sectional observational analytic study involving 50 leprosy subjects (41 MB and 9 PB types). Study was conducted at Dermatolovenerology Polyclinic of Sanglah General Hospital from December 2019 to March 2020. Ridley’s scale was used to determine bacterial index (BI). IL-2 serum levels were measured by ELISA. Result: The mean of IL-2 serum in PB was 75.53±10.32 pg/mL and in MB was 37.59±17.13 pg/mL. Strong negative correlation (r= -0.67; p<0.001) between serum IL-2 levels with bacterial index (CI 95%= 25.96–49.93; p<0.001) was found. Every 1 pg/mL increase in IL-2 serum levels will be accompanied by a decrease in the bacterial index of 0.039 and vice versa. Determinant coefficient shows that 42.2% of the BI is affected by the IL-2 serum levels. Low IL-2 serum levels were the risk factor of high BI 2.8 times (PR= 2.8; CI 95%= 1.444–5.519; p<0.001). Conclusion: IL-2 serum levels were found to be higher in PB than MB. There was a negative correlation between IL-2 serum levels with bacterial index. Low IL-2 serum levels were the risk factor of a high bacterial index in leprosy patients.
Ecthyma Contagiosum (Orf Virus) Masquerading as Subcorneal Pustular Dermatosis: A Diagnostic Pitfall in an Adolescent Lisa Alverina; Luh Made Mas Rusyati; Suharmono Hadi; Herman Saputra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1485

Abstract

Background: Ecthyma contagiosum (Orf) is a zoonotic viral infection caused by a Parapoxvirus, typically presenting as a self-limiting, solitary cutaneous lesion on the hands of occupationally exposed individuals. Atypical, multifocal, or pustular presentations can pose a significant diagnostic challenge, mimicking various inflammatory dermatoses. Case presentation: We present the case of a 17-year-old female with no direct animal contact who developed a progressive, widespread, and painful pustular eruption on her extremities over three weeks. The clinical presentation was highly suggestive of Subcorneal Pustular Dermatosis (SPD), prompting treatment with systemic corticosteroids, which led to clinical worsening. A delayed epidemiological history revealed an environmental link to a nearby goat farm and a family cluster of similar, milder lesions. A diagnostic punch biopsy was pivotal, revealing viral cytopathic effects, including extensive ballooning degeneration and epidermal necrosis, inconsistent with SPD. Subsequent bacterial culture confirmed superinfection with Enterobacter cloacae ssp. cloacae. The diagnosis was established by the pathognomonic histopathological findings. Conclusion: The patient’s steroid therapy was immediately ceased, and targeted antibiotic therapy was initiated, leading to complete resolution. This case highlights the Orf virus as a critical clinical chameleon and a diagnostic pitfall for generalized pustular eruptions. It underscores the necessity of a high index of suspicion for zoonoses, even in non-occupational settings, and confirms the indispensable role of histopathology in differentiating viral cytopathy from sterile neutrophilic dermatoses to prevent iatrogenic harm from inappropriate immunosuppression.
Pengaruh Pemberian Penyuluhan terhadap Stigma Penyakit Kusta pada Pasien dan Keluarga Kontak: Suatu Pre - Post Study Sari, Luh Putu Sustiana Kartika; Karna, N. L. P Ratih Vibriyanti; Rusyati, Luh Made Mas; Karmila, I. G. A. A Dwi; Puspawati, Ni Made Dwi; Winaya, Ketut Kwartantaya
Jurnal Biomedika dan Kesehatan Vol 8 No 3 (2025)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2025.v8.317-328

Abstract

Background Stigma toward leprosy patients remains a barrier to efforts to control this disease. Educational interventions are needed to increase public knowledge and reduce prejudice toward patients. This study aims to evaluate the effect of education on leprosy stigma among patients and their family contacts at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Methods This study used a quasi-experimental design with a one-group pretest-posttest approach. The study was conducted at the Dermatology and Venereology Polyclinic of Prof. Dr. I.G.N.G. Ngoerah General Hospital in Denpasar, Bali, from February to July 2025. Data analysis was performed using SPSS version 26.0 at a significance level of α = 0.05. Results A total of 50 respondents were included, comprising 37 leprosy patients and 13 family members. A significant relationship was observed between stigma before and after health education (p = 0.031). Educational level (p = 0.001), clinical presentation (p = 0.002), and economic level (p = 0.029) were also significantly associated with stigma after health education. Respondents with higher education showed a significant decrease in stigma (OR = 11.245; 95% CI: 2.044–61.862; p = 0.005). Similarly, respondents with non-neurological disorders showed lower levels of stigma (OR = 12.415; 95% CI: 2.208–69.808; p = 0.004). Conclusions The findings of this study indicate that health education significantly reduced leprosy-related stigma, with educational level and clinical presentation identified as key determinants.
The Silent Saboteur: Chronic Refractory Erythema Nodosum Leprosum Perpetuated by Neglected Odontogenic Foci in a Post-RFT Borderline Lepromatous Patient Antonio Orson Ongkowidjojo; Luh Made Mas Rusyati; Stefanus Soewito Sutanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1523

Abstract

Background: Erythema nodosum leprosum (ENL) is a severe, immune-complex mediated complication of lepromatous leprosy that can manifest before, during, or after multidrug therapy (MDT). While the primary etiology involves the release of Mycobacterium leprae antigens, the chronicity of ENL is frequently driven by secondary, often occult, triggers. Focal infections, particularly of odontogenic origin, are frequently overlooked in standard dermatological assessments, leading to refractory clinical courses. Case presentation: We report the case of a 32-year-old male with a history of borderline lepromatous (BL) leprosy who had achieved release from treatment (RFT). The patient presented with severe, chronic, and recurrent ENL characterized by painful erythematous nodules, high-grade fever, and acute neuritis, occurring more than one year post-RFT. Laboratory evaluation revealed significant inflammatory markers, including a C-Reactive Protein level of 172.7 mg/L and leukocytosis. Crucially, intraoral examination identified neglected chronic dental caries (gangrene radix) and generalized periodontal inflammation. Despite medical advice, the patient refused dental intervention. The reactional state was managed with a combination of intravenous methylprednisolone and high-dose oral clofazimine. While cutaneous symptoms improved, the persistence of the focal infection poses a substantial risk for further recurrence. Conclusion: This case highlights the critical and often underestimated role of odontogenic focal infections as perpetuating factors in chronic ENL. It underscores the necessity for a multidisciplinary approach integrating dentistry and dermatology. We propose that recalcitrant ENL in post-RFT patients should trigger mandatory screening for occult dental infections to disrupt the cycle of systemic inflammation.
Anemia on Chronic Disease in Leprosy Before and After Completing Multi Drug Therapy Ni Kadek Setyawati; Luh Made Mas Rusyati; I Gusti Ayu Agung Elis Indira; I Gusti Ayu Agung Praharsini; I Gusti Nyoman Darmaputra; I Gusti Ayu Agung Dwi Karmila
Eduvest - Journal of Universal Studies Vol. 4 No. 9 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i9.1500

Abstract

Leprosy infection can cause anemia due to chronic disease (ACD). Multidrug therapy (MDT) for leprosy patients can overcome the infection. This study aims to determine the comparison in the incidence of ACD before and three months after MDT to leprosy patients at Prof. Dr. I G.N.G. Ngoerah Central General Hospital. A cross-sectional analytical observational study was conducted using secondary data from medical records of leprosy patients. A total of 142 samples were taken through total sampling. Data taken included gender, domicile, type of leprosy suffered, incidence of ACD, hemoglobin levels, and erythrocyte index before and three months after completing MDT leprosy therapy. Data analysis was carried out with SPSS version 21 using chi-square and paired t tests (dependent t-test), p value <0.05 means significant. The incidence of ACD was significantly higher before leprosy MDT therapy compared to 3 months after completing leprosy MDT therapy (49.3% vs. 16.2%; p value <0.001) with a prevalence ratio of 3.043 (2.021-4.584) CI95%. The mean hemoglobin levels, MCV, MCH, and MCHC levels 3 months after MDT leprosy therapy were significantly higher than before receiving MDT therapy (13.73 ± 1.47 vs. 12.40 ± 2.06 g/dL; p value <0.001), (88.18±7.22 vs. 84.07±9.55 fl; p value<0.001), (28.32±2.76 vs. 26.72±3.17 pg/cell; p value <0.001), (32.03±1.30 vs. 31.69±1.47%; p value<0.001). The incidence of ACD was significantly higher before MDT compared to 3 months after MDT. Mean hemoglobin, MCV, MCH, and MCHC levels were found to be significantly higher 3 months after MDT compared to before receiving MDT.
the Correlation Between Erythrocyte Index Levels with The Anemia Morphology in Leprosy Patients Before Therapy: A Secondary Data Research Marrietta Sugiarti Sadeli; Luh Made Mas Rusyati; Ni Luh Putu Ratih Vibriyanti Karna
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.5826

Abstract

Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae. Chronic infection can cause anemia of chronic disease which is characterized by normochromic normocytic morphology. This study was conducted to assess the relationship between erythrocyte index levels (MCV, MCH, and MCHC) with the morphology of anemia that occurs in leprosy patients before treatment. A cross-sectional study using secondary data from medical records and management information system applications at Sanglah Hospital. The variables of this study were age, sex, hemoglobin levels, and erythrocyte index levels (MCV, MCH, and MCHC). Data were collected after permission was granted and ethical clearance was completed. Of the 156 study samples, 106 patients were diagnosed with leprosy who had not received therapy and 50 patients were not leprosy. The mean age of the patients was 39.15 ± 12.218 years and male patients were more common than female patients. There was a positive correlation between anemia, normal erythrocyte index levels, and the leprosy group. Following are the p-values, prevalence ratios, and confidence intervals; anemia [p= 0.017; PR(95% CI)= 1,458(1.034-2.056)], MCV, MCH, and MCHC [p= 0.020; PR(95% CI)= 1,268(1.010-1.591); p= 0.015; PR(95% CI)= 1,293(1,021-1,639); p= 0.009; PR(95% CI)= 1,297(1,036-1,624)]. The results of the analysis were statistically significant and clinically important. Leprosy patients had anemia before therapy with normochromic normocytic anemia morphology in accordance with anemia of chronic disease.
Co-Authors A.A.N.B. Adhitya Wirakusuma Aanak Agung Gde Putra Wiraguna Adeline Santoso Agnes Sri Siswati Agung Bagus S. Satyarsa Anak Agung Bagus Putra Indrakusuma Anak Agung Gde Putra Wiraguna Andrew Wicaksono Angela Sandi Tagaroi Rahasia Antonio Orson Ongkowidjojo Anum, Qaira Arim Sadeva, I Gede Krisna Aurelia Stephanie Aurelia Stephanie Aurelia Stephanie Bagus Haryo Kusumaputra Cita Rosita Sigit Prakoeswa Desak Made Wihandani Desak Nyoman Trisepti Utami Dewa Made Rendy Sanjaya Dewi Gotama Dhelya Widasmara Dian Galih SIliwangi Edward Wijaya, Edward Elice Wijaya Elice Wijaya Febrina D Pratiwi Fifa Argentina Firly Clarissa Suyanto Gde Ngurah Arya Ariwangsa Gede Made Cahya Trisna Pratama Gede Mahadika Pradipta Atmaja GK Darmaputra Gotama, Dewi Haikal Hamas Putra Iqra Handelia Phinari Herman Saputra I Dewa Ayu Vanessa Vijayamurthy I Dewa Ayu Vanessa Vijayamurthy I Dewa Made Rendy Sanjaya I G. P. Supadmanaba I Gede Agus Bhakti Suputra I Gede Krisna Arim Sadeva I Gede Raditya Narayana I Gede Wahyu Toya Pratama I Gusti Amanda Jaya I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Ayu Tika Indriani I Gusti Ketut Darmada I Gusti Ketut Darmada I Gusti Nyoman Darmaputra I Gusti Nyoman Sri Wiryawan I Komang Arimbawa I Made Oka Adnyana I Made Swastika I Pt Agus Suryantara P I Putu Arie Sasmita I Putu Eka Widyadharma I Putu Gilang Iswara Wijaya I.G.A. Karmila I.G.K Darmada I.G.K. Darmada Ida Ayu Diah Purnama Sari Ida Ayu Uttari Priyadarshini Ida Ayu Widya Anjani IGK Darmada Indra Teguh Wiryo Indra Teguh Wiryo Indrakusuma, Anak Agung Bagus Putra Indry Salonika Sutiawan Intizam, Marwa Humaira Jason Jonathan Jayawarsa, A.A. Ketut Jusuf, Pierre Joshua Kadek Ayu Rima Mahadewi Kadek Yuda Sujana Karmila, I. G. A. A Dwi Karna, N. L. P Ratih Vibriyanti Ketut Kwartantaya Winaya Ketut Kwartantaya Winaya Ketut Wida Komalasari Komang Ayu Kristiana Dewi K Laksmi, I Gusti Ayu Agung Mini Limanda, Claudia Felicia Lisa Alverina Lubis, Ramona Sari Luciana Luciana M. Yulianto Listiawan Made Hermina Laksmi Made Martina Windari Made Swastika Adiguna Made Wardhana Mamuaja, Enricco Hendra Mario Korwa Marrietta Sugiarti Sadeli Martima W Medhi Denisa Alinda, Medhi Denisa Muchtar, Vitayani Nandya Dwizella Nevristia Pratama Ni Kadek Setyawati Ni Luh Putu Ratih Vibriyanti Karna Ni Made Dwi Puspawati Ni Made Dwi Puspawati Ni Made Linawati Nyoman Raditya Adiprayoga Nyoman Suryawati Nyoman Suryawati Patricia Dian Putri Praharsini, I Gusti Agung Prima Saraswati Sanjiwani Sudarsa Prima Sudarsa Prima Sudarsa Prima Sudarsa Primasari, Putu Yunita Puspawati . Putri Ayu Wulandari Putri Ayu Wulandari, Putri Ayu Putri, Patricia Dian Putri, Putu Winna Deyanti Putu Ayu Saraswati Putu Diah Pratiwi Putu Gde Hari Wangsa Putu Raisha Vishkariana Dewi Ratih Vebrianti Ratih Vibriyanti Karna Regitta Indira Agusni Renni Yuniati Riyana Noor Oktaviyanti Sadeli, Marrietta Sugiarti Santoso, Adeline Saravanan Krishnan Sari, Luh Gede Melia Puspita Sari, Luh Putu Sustiana Kartika Sissy Sissy Sissy, Sissy Sofyan Faridi Sri L. Menaldi Stefanus Soewito Sutanto Stephanie, Aurelia Sudarsa, Prima Suharmono Hadi Suryawati . Sutiajaya, Nikita Lestari Tanujaya, Monica Aprilia Thiodorus, Robert Tiara Evangelista Trisna Yuliharti Tersinanda Vijayamurthy, I Dewa Ayu Vanessa Widya Anjani, Ida Ayu Winaya, Ketut Kwartantaya Wiryo, Indra Teguh Wisnu Triadi Nugroho Yara Egyptha Saraswati