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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Bioscientia Medicina : Journal of Biomedicine and Translational Research Health and Medical Journal JOURNAL LA MEDIHEALTICO Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran Jurnal Locus Penelitian dan Pengabdian MEDICINUS Indonesian Basic and Experimental Health Sciences

Nurrachmat Mulianto

Unknown Affiliation

Author-ID : 324340

Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Health Professions Immunology & microbiology Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

Published : 42 Documents Claim Missing Document

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Ulkus Marjolin yang Berkembang dari Ulkus Trofik Kronis pada Pasien Kusta Adniana Nareswari; Harijono Kariosentono; Nugrohoaji Dharmawan; Muhammad Eko Irawanto; Nurrachmat Mulianto
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Marjolin’s ulcer is a malignant complication of chronic ulcer. Changes in ulcer lesions to malignancy can be caused by chronic irritation, infection, decreased vascular variation, and increased expression of proto-oncogene. The most common histopathological form of Marjolin's ulcer is squamous cell carcinoma. A 55-year-old man, complaining of a protruding wound on his left hand that has not healed since three years ago. The patient was diagnosed with leprosy 30 years ago with a history of incomplete treatment. On physical examination, the left palmar region showed solitary ulcer, ±10x8x1.5 cm in size, nodular surface, reddish, hard consistency, with bulging and irregular edge. Slit-skin smear (SSS) examination with Ziehl-Neelsen staining found abundant acid-fast bacilli. Histopathological examination of the ulcer edge shows appearance of epithelial tumor, with differentiated epidermal cells invading the dermis, tumor cells arranged focally and concentrically with a mass of keratin appeared as horn pearl cells. Fite-Faraco staining found abundant M. leprae acid-fast bacilli. Based on the patient’s medical history and clinical examination, patient was diagnosed with Marjolin's ulcer in multibacillary (MB) leprosy. Patient was treated with MB multidrug therapy for 12 months and below-wrist amputation.

Laporan Kasus Terapi Kombinasi Kuretase dan Cimetidine Oral pada Pasien Moluskum Kontangiosium Annisa Fildza Hashfi; Nurrachmat Mulianto; Winda Wijayanti; Niluh Wijayanti
MEDICINUS Vol. 35 No. 2 (2022): MEDICINUS
Publisher : PT Dexa Medica

Background: Molluscum contagiosum is an infectious disease of the skin caused by poxvirus. The virus may be transmitted through direct skin and mucous membrane contact, including sexual contact, and through contaminated fomites. The prevalence of sexually transmitted molluscum contagiosum has increased in recent years. This disease causes anxiety and discomfort for the patients. Diagnosis of molluscum contagiosum is made based on history taking, physical examination, dermoscopic examination, and histopathological examination. Proper diagnosis and management can help to reduce risk of recurrence. Case: A 26-year-old woman with main complaint of developing shiny white rashes on her thighs and buttocks since 3 months ago. The nodules felt itchy yet painless. At first, only 4 papules appeared on the buttocks. In the last month, the nodules multiplied and spread to the thighs. The patient had tried to squeeze the nodule and rice-like white mass came out. The patient had history of unprotected sexual intercourse. Dermatological examination on the right and left femoral regions and the gluteus, found that there were discrete, multiple shiny white pearl-like papules of 0.1-0.5 cm in size, smooth surface, well-defined, dome-shaped, umbilicated with caseous plug. Dermoscopic examination showed a white to yellow polylobular appearance with crown vessel. Histopathological examination showed an appearance of intracytoplasmic eosinophil inclusion bodies (molluscum bodies). Discussion: Clinical findings such as discrete multiple, pearl-colored, umbilicated dome-shaped papules, are characteristic features of molluscum contagiosum. Dermoscopic examination results and histopathological images also support the diagnosis of molluscum contagiosum. Treatment was carried out using curettage on the lesions and prescription of oral cimetidine 2x800 mg for 2 months. No recurrence was found after 5 months of follow-up

Profile of Candidiasis Patients in RSUD Dr. Moewardi Surakarta January 2016−December 2019 Nurrachmat Mulianto; Siti Efrida Fiqnasyani
MEDICINUS Vol. 35 No. 2 (2022): MEDICINUS
Publisher : PT Dexa Medica

Background: Candidiasis is caused by Candida sp. infection, mainly Candida albicans. The skin, mucous membranes, nails, and digestive tract are organs that can be affected by this infection. The risk of infection is higher in immunocompromised individuals. Objective: To determine the profile of candidiasis patients in Dr. Moewardi Hospital Surakarta between January 2016-December 2019. Method: This is a retrospective, descriptive study that evaluate the distribution of sex, age, primary diagnosis, comorbidities, and candidiasis type among candidiasis patients in RSUD Dr. Moewardi. Results: During study period, there were 177 candidiasis patients (147 outpatients and 30 inpatients). Pseudohyphae was seen in all inpatients’ KOH test. Majority of the patients are women (77,97%), age distribution varies between outpatients and inpatients. Cutaneous candidiasis was found in 53,74% outpatients and 66,67% inpatients. Type 2 diabetes mellitus was the most frequent (20%) comorbidity among those patients. Topical miconazole 2% and systemic fluconazole 150 mg were given to 42,37% and 33,90% patients, respectively.

Kromoblastomikosis Penyakit Jamur yang Terabaikan Danu Yuliarto; Achmad Satya Negara; Harijono Kariosentono; Nugrohoaji Dharmawan; Nurrachmat Mulianto
MEDICINUS Vol. 36 No. 1 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i1.116

Chromoblastomycosis is a deep fungal infection of the skin and subcutaneous tissue caused by pigmented or dematiaceous fungi. This disease is endemic in tropical and subtropical regions such as Asia, Africa, and Latin America. Chromoblastomycosis is more common in adult men who work in agricultural areas, work as gardeners, or as carpenters. The diagnosis of chromoblastomycosis is confirmed by the finding of muriform cells or medlar bodies obtained from skin scrapings, microscopic culture, or tissue histopathological examination. The clinical feature varies, the initial lesion is a papule that spreads slowly over several months or years, and then this lesion will form a plaque with atrophic center. Many patients go undiagnosed at the early stage of the disease because this stage is rarely seen. Treatment of chromoblastomycosis includes surgery for the initial lesion and pharmacological therapy using antifungal agent such as itraconazole, the most commonly used drug for the treatment of chromoblastomycosis. The prognosis for chromoblastomycosis is poor, except on new lesions.

Profile of Generalized Pustular Psoriasis Inpatient Installation at Dr. Moewardi General Hospital Surakarta from January 2018-December 2022 Hidayati, Nurul; Mulianto, Nurrachmat; Noviani, Laura; Lidjaja, Lifesia Natali
Journal La Medihealtico Vol. 5 No. 4 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i4.1584

Generalized pustular psoriasis (GPP) is a form of psoriasis characterised by the presence of sterile pustules. Its prevalence is between 2 and 3.5% of the population worldwide and in Indonesia it is 2.5% of the population. It can cause severe physical and psychosocial distress affecting the patient's quality of life. Objective: To describe the profile of GPP patients treated in the inpatient installation of Dr. Moewardi Hospital, Surakarta in the period of January 2018-December 2022. A retrospective descriptive study was conducted using the secondary data of medical records of GPP patients treated in the inpatient installation of Dr. Moewardi Hospital from January 2018 to December 2022. Results: In the 5-year period, there were 23 GPP inpatients, predominated by female (78.26%) with the age ranged from 5 to 74 years old. Generalised pustular psoriasis mostly affected the age group of 41- 50 years old (26.04%). Most patients were hospitalized for 6–10 days (39.13%). The most common therapy was immunosuppressant (65.2%) followed by oral corticosteroids (26.1%) and zinc (17.4%). Most patients also received moisturizer therapy (56.5%). Generalised pustular psoriasis mostly affects people aged between 41 and 50 years old. Females are more prone to GPP. The therapy given are oral immunosuppressive regimens, oral corticosteroids, zinc, topical corticosteroids and moisturizers.

Modalitas Terapi Veruka Vulgaris Dita Eka Novriana; Nurrachmat Mulianto
MEDICINUS Vol. 38 No. 1 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/26szjs56

Veruka vulgaris adalah lesi jinak akibat infeksi human papillomavirus (HPV) dengan lesi berupa papul verukosa dengan permukaan keratotik. Beberapa modalitas terapi dapat diberikan pada veruka vulgaris, antara lain berupa terapi destruktif, terapi antivirus, imunoterapi, dan pembedahan, dengan hasil yang bervariasi. Veruka vulgaris memiliki risiko kekambuhan yang cukup tinggi karena terdapat kemungkinan adanya sisa partikel HPV pascaterapi.

An Unusual Case of Pemphigus Foliaceus Arising in a Patient with Psoriasis Vulgaris Nurrachmat Mulianto; Osdatilla Esa Putri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (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.v9i2.1190

Background: Pemphigus foliaceus (PF) is a rare autoimmune blistering disease characterized by superficial, fragile blisters. Psoriasis vulgaris, a chronic inflammatory skin condition, has been rarely associated with PF. This case report presents an unusual instance of PF developing in a patient with a history of psoriasis vulgaris. Case presentation: A 54-year-old Indonesian woman presented with a one-year history of scaly skin and reddish spots across her body, worsening over the past week. She had a prior diagnosis of psoriasis vulgaris and was undergoing methotrexate therapy (15 mg/week) without significant improvement. Three months prior, she developed loose blisters on her back that spread to her hands, rupturing easily and leaving painful sores. The patient denied any mucosal involvement. One week before her presentation, her symptoms worsened following relocation-related stress. Dermatological examination revealed generalized multiple erythematous patches with scales, some with ruptured blisters leaving erosions, and a positive Nikolsky sign. Histopathological examination confirmed PF. The patient was treated with intravenous methylprednisolone, oral erythromycin and paracetamol, topical mupirocin, and clobetasol. After one month, due to a lack of improvement, azathioprine was added, leading to lesion improvement without side effects. Conclusion: This case highlights the rare but potential development of PF in patients with psoriasis vulgaris. The complex interplay between these two conditions warrants further investigation. Early diagnosis and appropriate treatment are crucial for managing PF and improving patient outcomes.

Deep Mycosis in Central Java, Indonesia: Occupational Risk Factors and Diagnostic Challenges in a Single Center Dr. Moewardi General Hospital Nurrachmat Mulianto; Ivani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (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.v9i2.1192

Background: Deep mycosis, a spectrum of invasive fungal infections affecting deeper tissues, poses significant diagnostic and therapeutic challenges, particularly in tropical regions like Central Java, Indonesia. This study aimed to investigate the epidemiological trends, occupational risk factors, and diagnostic challenges associated with deep mycosis in this region. Methods: A retrospective study was conducted at a single center, Dr. Moewardi General Hospital, in Central Java, Indonesia, analyzing medical records of patients diagnosed with deep mycosis between 2019 and 2024. Data on demographics, occupation, clinical presentation, diagnostic methods, and treatment outcomes were collected and analyzed. Results: A total of 12 cases of deep mycosis were identified. The majority of patients were male (75%) and engaged in agricultural activities (50%). Chromoblastomycosis (66.7%) and maduromycosis (25%) were the most common clinical diagnoses. Diagnostic delays were frequent (mean delay: 5.1 months), primarily due to non-specific clinical presentations and limited access to diagnostic facilities. Conclusion: Deep mycosis predominantly affects individuals involved in agriculture in Central Java, highlighting the need for enhanced awareness and preventive strategies among high-risk occupational groups. Improved diagnostic facilities and healthcare infrastructure are crucial for timely diagnosis and effective management of deep mycosis in resource-constrained settings.

Retrospective Study of Decubitus Ulcer in Hospitalized Patients Rosmarwati, Ervina; Mulianto, Nurrachmat
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 35 No. 1 (2023): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V35.1.2023.46-51

Background: Decubitus ulcer is an area of necrotic tissue due to compression of protrusion because of prolonged immobilization. Decubitus ulcer is complication that often occur due to prolonged bed rest. Decubitus ulcer can interfere with patient's recovery process and prolonged hospital stay. Purpose: To investigate profile of decubitus ulcer in hospitalized patients in Dr. Moewardi General Hospital Surakarta during 2017- 2020. Methods: This descriptive retrospective study was conducted by using medical record of decubitus ulcers (ICD 10 L89.0, L89.1, L89.2, L89.3) in Dr. Moewardi General Hospital Surakarta during 1st January 2017-31st December 2020. Result: There were 375 decubitus ulcer patients, mostly aged 70 years or more (29.1%) and dominated by women (56%). Patients with decubitus ulcers often hospitalized in the regular ward (75.2%) with the longest length of stay being around 0-10 days (49.6%) and the most common comorbidities was malignancy (20.5%). Systemic antibiotic ceftriaxone was most often given to decubitus ulcer patients (21.6%). Most of the patients with decubitus ulcers had stage 2 decubitus ulcers (53.6%) with a predisposition to the affected area being the sacrum area (33%). The most frequently used therapy for decubitus ulcers was hydrogel dressing (33.9%). Conclusion: Decubitus ulcers are often found in patients over 70 years of age with comorbid malignancies. The most common diagnosis was stage 2 decubitus ulcers, predisposing to the sacral region and the most frequently used therapy was hydrogel dressing with ceftriaxone as a systemic antibiotic.

Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Retrospective Study on Causative Agents and Patient Profiles in an Indonesian Hospital Setting Nurrachmat Mulianto; Lidjaja, Lifesia Natali
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1327

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent rare, severe mucocutaneous adverse drug reactions characterized by extensive epidermal necrosis and significant morbidity and mortality. Understanding the specific causative agents and patient profiles within local populations is crucial for early diagnosis and management. This study aimed to characterize SJS/TEN cases in a tertiary hospital setting in Indonesia. Methods: A retrospective descriptive study was conducted using secondary data from medical records of patients diagnosed with SJS, SJS/TEN overlap, and TEN admitted to the inpatient installation of Dr. Moewardi General Hospital, Surakarta, Indonesia, between January 2022 and December 2024. Data collected included demographics (age, gender), comorbidities, diagnosis classification (SJS, SJS/TEN overlap, TEN), suspected causative drugs, length of hospital stay, SCORTEN score, and patient outcome (discharged alive or deceased). Total sampling was employed, excluding records with incomplete data. Data were compiled and analyzed descriptively. Results: Fifty-one patients were included, with a slight female predominance (52.94%). The largest age group affected was 19-59 years (60.78%). The distribution of diagnoses was SJS (41.18%), SJS/TEN overlap (31.37%), and TEN (27.45%). The mean SCORTEN score for the cohort was 2. The most common suspected causative drug classes were antibiotics (25.71%), followed by analgesic-antipyretics (24.29%), and anticonvulsants (22.86%). Carbamazepine (11.43%) and amoxicillin (10%) were frequent individual culprits. Epilepsy (13.73%) and diabetes mellitus (11.76%) were common comorbidities, although a significant portion (33.33%) had no recorded comorbidity. The mean length of stay was 9 days. Overall mortality was 15.68%, with higher rates observed in TEN (28.57%) compared to SJS (9.52%) and SJS/TEN overlap (12.5%). Conclusion: SJS/TEN affected predominantly adults, with antibiotics, analgesics, and anticonvulsants being the most implicated drug classes. While mortality was considerable, it appeared lower than some international reports, particularly for TEN. Recognizing common causative agents and patient risk factors, such as specific comorbidities like epilepsy and diabetes, can aid clinicians in early identification and prompt management of these life-threatening conditions.

Co-Authors . Hardjono Achmad Satya Negara Adjie, Sugih Primas Adniana Nareswari Ahmad Fiqri, Ahmad Ambar Aliwardani Annisa Fildza Hashfi Arie Kusumawardani Arrochman, Ferry Astrid Astari Aulia Aulia Rahman Azhar Arrosyid Benedikta Lauda Betaubun, Ance Imelda Bobby Febrianto Damayanti, Willa Danu Yuliarto Dhamayanti, Marsita Endy Dharmawan, Nugrohoaji Diana, Rina Dita Eka Novriana Ellistasari, Endra Yustin Endra Yustin Ellistasari Farida Mustifah, Etty Fatiharani Dewi, Putty Fiska Rosita Harijono Kariosentono Indah Julianto Indah Julianto, Indah Irawanto, Muhammad Eko Ivani Kamilah, Lian Kariosentono, Harijono Kusumawardani, Arie Lidjaja, Lifesia Natali Mardiana - Mochtar, Moerbono Muhammad Eko Irawanto Murasmita, Alamanda Niluh Wijayanti Noviani, Laura Nugraha, Wibisono Nur Ismi Mustika Febriani Nurul Hidayati Oktaviani, Trya Oktriana, Putri Osdatilla Esa Putri Paramita Sari, Anggana Rafika Prasetyadi Mawardi Pratiwi Prasetya Primisawitri Primisawitri, Pratiwi Prasetya Putti Fatiharani Rafika Paramitasari, Anggana Rieka Sulaikha, Khalida Rinandari, Ummi Rini Hastuti Risman, Muhammad Rosmarwati, Ervina Satya Negara, Achmad Sesia Pradestine Shelly Lavenia Sambodo Siti Efrida Fiqnasyani Suci Widhiati Toha, Synthia Sari Tri Ifanti, Rakhma Tri Irfanti, Rakhma TUTIK RAHAYU Wibisono Nugraha Winda Wijayanti Wirawan, Eka Putra

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