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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana E-Jurnal Udayana Medica Berkala Ilmu Kesehatan Kulit dan Kelamin ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Biomedika dan Kesehatan Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Bali Dermatology and Venereology Journal Indonesian Journal of Global Health research Essential: Essence of Scientific Medical Journal Indian Journal of Forensic Medicine & Toxicology MAHESA : Malahayati Health Student Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Global Pharma Technology Eduvest - Journal of Universal Studies Neurona Bali Dermatology Venereology and Aesthetic Journal
Luh Made Mas Rusyati
Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Udayana/RSUP Prof. Dr. I G. N. G. Ngoerah, Denpasar, Bali, Indonesia
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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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.
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.
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.
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.
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 Darmaputra, I Gusti Nyoman 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 Elis Indira 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 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 Indira, I Gusti Ayu Agung Elis 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 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 Martima W Medhi Denisa Alinda, Medhi Denisa Muchtar, Vitayani Mulianto, Nur Rachmat Nandya Dwizella Nevristia Pratama Ni Kadek Setyawati, Ni Kadek Ni Luh Putu Ratih Vibriyanti Karna Ni Made Dwi Puspawati Ni Made Linawati Nyoman Raditya Adiprayoga 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 Sutiawan, Indry Salonika 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