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All Journal Nexus Kedokteran Komunitas 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 Journal of Social Research Jurnal Locus Penelitian dan Pengabdian MEDICINUS Indonesian Basic and Experimental Health Sciences
Nurrachmat Mulianto
Unknown Affiliation
Aerospace Engineering Humanities Automotive Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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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

Abstract

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

Abstract

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.
Dose- and Time-Dependent Efficacy of Topical Hydroquinone in Establishing a C57BL/6 Mouse Model of Vitiligo Benedikta Lauda; Nurrachmat Mulianto; Endra Yustin Ellistasari; Muhammad Eko Irawanto
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.v10i1.1481

Abstract

Background: Vitiligo is a complex autoimmune depigmenting disorder driven by melanocyte-specific CD8+ T cells, oxidative stress, and genetic susceptibility. The lack of standardized, accessible animal models that recapitulate these pathways hinders therapeutic development. This study aimed to systematically optimize and validate a chemically-induced vitiligo model in C57BL/6 mice. Methods: Eighty (80) male C57BL/6 mice were randomized into ten groups (n=8/group). Experimental groups received once-daily topical applications of hydroquinone (HQ) at 2.5%, 5%, or 10%, or monobenzone (MBZ) at 40% for 8 or 16 days. Vehicle-treated mice served as controls. Efficacy was assessed via quantitative histopathology (Masson-Fontana staining for melanin area), biomolecular assays for oxidative stress (Malondialdehyde [MDA] and Superoxide Dismutase [SOD]), and RT-qPCR for melanogenesis-related (Tyr) and inflammation-related (Tnf) gene expression. Results: A clear dose- and time-dependent depigmentation was observed. The 10% HQ 16-day protocol was maximally effective, inducing a profound reduction in epidermal melanin area (0.06 ± 0.02) compared to 16-day controls (0.40 ± 0.04; p < 0.001). This histopathological finding was significantly correlated with severe cutaneous oxidative stress, evidenced by a 3.75-fold increase in MDA (p < 0.001) and a 50% reduction in SOD activity (p < 0.001) versus controls. Furthermore, this regimen caused a potent suppression of Tyr expression (0.15-fold change; p < 0.001) and a significant upregulation of the pro-inflammatory cytokine Tnf (3.8-fold change; p < 0.001). Conclusion: The 16-day topical application of 10% hydroquinone is a reliable, rapid, and highly reproducible protocol for inducing vitiligo-like depigmentation in C57BL/6 mice. This model successfully recapitulates key pathophysiological pillars of human vitiligo, including melanocytotoxicity, profound oxidative stress, and a pro-inflammatory cutaneous environment, establishing it as a valuable platform for preclinical therapeutic screening.
Physical Stability Evaluation of 5% Curcuma Longa Extract Using the Maceration Extraction Method Arrosyid, Azhar; Mulianto, Nurrachmat; Dharmawan, Nugrohoaji
Journal of Social Research Vol. 4 No. 12 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i12.2879

Abstract

Curcuma longa (turmeric) is a medicinal plant widely used for its anti-inflammatory, antioxidant, and antimicrobial properties. Cream formulations are ideal for topical delivery due to their ease of application, good absorption, and patient acceptability. The maceration method is a simple and cost-effective technique for obtaining plant extracts without compromising bioactive compounds. This study aimed to evaluate the physical stability of a cream formulation containing 5% Curcuma longa extract prepared using the maceration extraction method. The extract was prepared through maceration of dried turmeric rhizome using ethanol, followed by evaporation to obtain the concentrated extract. The cream was formulated with stearic acid, cera alba, vaselin album, triethanolamine, propylene glycol, and distilled water as base components. Physical stability parameters were tested over seven days, including pH, dispersion, and adhesion tests. Statistical analysis was performed using the Friedman test. The pH values ranged from 7.33 to 7.50 (p = 0.006), indicating mild alkalinity but remaining within an acceptable range for topical application. Dispersion remained stable throughout the observation period (p = 0.452), while adhesion increased significantly from 182.71 to 200.04 seconds (p = 0.006), suggesting improved cohesiveness. The 5% Curcuma longa extract cream demonstrated good physical stability, indicating that the maceration method is a viable approach for developing stable topical herbal formulations.
Tatalaksana Platelet Rich Plasma Pada Pasien Chronic Venous Leg Ulcer Adjie, Sugih Primas; Kariosentono, Harijono; Mulianto, Nurrachmat; Dharmawan, Nugrohoaji; Primisawitri, Pratiwi Prasetya
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 12 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i12.4872

Abstract

Latar belakang: Ulkus kronis pada ekstremitas bawah salah satunya yaitu ulkus venosum. Ulkus venosum didefinisikan sebagai lesi terbuka antara sendi lutut dan pergelangan kaki yang terjadi karena penyakit vena. Tantangan dalam mengobati VLU adalah kekambuhan yang sering terjadi maka terapi luka tingkat lanjut harus dipertimbangkan. Platelet rich plasma (PRP) sebagai terapi adjuvan pengobatan ulkus venosum dan menunjukkan hasil yang menjanjikan. Kasus: Seorang laki-laki berusia 55 tahun dengan keluhan luka yang sulit sembuh sejak dua tahun yang lalu. Pemeriksaan status dermatovenereologi pada regio ekstremitas inferior desktra nampak ulkus multipel dengan ukuran terbesar 9 cm x 5 cm x 0.5 cm, dengan dasar eritem dan serum tanpa disertai pus, nekrosis, nekrotik dan darah. Pasien memiliki riwayat hipertensi dan obesitas derajat II dengan Indeks Masa Tubuh (IMT) 44,29. Pasien diberikan terapi Platelet Rich Plasma (PRP) setiap tujuh hari, Kompres luka dengan cairan NaCl 0,9% selama 10 menit dilanjutkan dengan mupirosin 2% salep dan ditutup dengan menggunakan plester hidrokoloid yang dilakukan per 24 jam. Evaluasi pada minggu ke-6 terapi PRP, pasien menunjukkan adanya perbaikan klinis pada luka. Diskusi: Kandungan PRP terdiri dari banyak faktor pertumbuhan untuk mempercepat penyembuhan luka dan angiogenesis. Trombosit mengandung faktor pertumbuhan yang memicu efek biologis yang merupakan kunci dalam proses perbaikan dan regenerasi jaringan.
Hubungan Derajat Keparahan dengan Status Psikososial Pasien Melasma : Studi Cross-sectional Sambodo, Shelly Lavenia; Ellistasari, Endra Yustin; Kusumawardani, Arie; Irawanto, Muhammad Eko; Mulianto, Nurrachmat
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 12 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i12.4993

Abstract

Melasma tidak hanya berdampak pada aspek fisik berupa hiperpigmentasi, tetapi juga menimbulkan gangguan psikososial yang signifikan. Hubungan antara tingkat keparahan klinis melasma dengan derajat gangguan psikososial belum banyak diteliti di populasi Indonesia. Menganalisis hubungan antara tingkat keparahan melasma menggunakan Melasma Area and Severity Index (MASI) dengan derajat status psikososial menggunakan Melasma Quality of Life (MELASQOL). Studi cross-sectional dilakukan pada 15 pasien wanita dengan melasma di RSUD Dr. Moewardi Surakarta. Tingkat keparahan dinilai menggunakan skor MASI, sedangkan status psikososial dinilai menggunakan kuesioner skor MELASQOL. Analisis korelasi Pearson dan regresi linear sederhana digunakan untuk mengevaluasi hubungan antar variabel.  Rerata skor MASI adalah 5,95±1,15 dengan 53,3% pasien memiliki tingkat keparahan sedang dan 46,7% dengan tingkat derajat berat. Rerata skor MELASQOL adalah 40,33±6,22 dengan distribusi yang sama. Terdapat korelasi positif sangat kuat antara skor MASI dan MELASQOL (r=0,988; p<0,001; R²=0,977). Persamaan regresi menunjukkan MELASQOL = 8,62 + 5,33 × MASI. Terdapat hubungan positif yang sangat kuat antara tingkat keparahan melasma dengan derajat gangguan psikososial.
Evaluating the Serofast State in Syphilis: A Study of Clinical Characteristics, Immunological Markers, and HIV Status Lidjaja, Lifesia Natali; Ellistasari, Endra Yustin; Irawanto, Muhammad Eko; Kusumawardani, Arie; Mulianto, Nurrachmat
Journal of Social Research Vol. 5 No. 4 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i4.3097

Abstract

Syphilis remains a significant global health burden, particularly among high-risk populations such as men who have sex with men (MSM). A major challenge in management is the serofast state, where patients fail to achieve serological cure despite adequate treatment. The immunological mechanisms driving this, especially in the context of HIV co-infection, remain unclear. This study aims to evaluate clinical and immunological factors associated with serofast status versus serological cure. A retrospective cohort study was conducted on 40 patients diagnosed with syphilis (early latent, late latent, or secondary). Data on demographics, HIV status, CD4/CD8 counts, and pre- and post-treatment VDRL titers were analyzed. Bivariate and multivariate logistic regression analyses were performed to identify predictors of the serofast outcome. The cohort was predominantly males (90.0%) and unmarried (80.0%). HIV co-infection was identified as the sole independent predictor of the serofast state (aOR = 10.94; 95% CI: 1.72-69.65; p=0.011). While post-treatment VDRL titers significantly decreased in the total cohort, the serofast group retained significantly higher antibody levels compared to the serological cure group (p<0.001). However, no statistically significant differences were found in CD4 counts, CD8 counts, or CD4/CD8 ratios between the two groups. HIV co-infection is a strong predictor of the serofast state in syphilis patients. The lack of significant differences in quantitative cellular immune markers suggests that the persistence of antibodies may be driven by functional immune dysregulation rather than absolute T-cell depletion. These findings emphasize the need for vigilant serological monitoring in HIV-syphilis co-infected individuals.
The Effect of Oral Bromelain on Interleukin-6 Levels in Tissue of Acne Vulgaris Model Rats noviani, Laura; Irawanto, Muhammad Eko; Ellistasari, Endra Yustin; Kusumawardani, Arie; Mulianto, Nurrachmat
Journal of Social Research Vol. 5 No. 4 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i4.3102

Abstract

Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit associated with Cutibacterium acnes colonization and activation of the Toll-like receptor–NF-?B pathway, which upregulates production of inflammatory mediators such as interleukin-6 (IL-6). Bromelain, a proteolytic enzyme derived from pineapple (Ananas comosus), is known to possess anti-inflammatory properties; however, experimental evidence regarding its effect on inflammatory cytokines in acne remains limited. This study aimed to evaluate the effect of oral bromelain administration on IL-6 levels in the tissue of acne vulgaris model rats. This in vivo laboratory experimental study employed a posttest-only control group design. Fifteen male Sprague-Dawley rats induced with C. acnes were divided into three groups: normal control (K1), negative control (K2), and treatment group (P) receiving oral bromelain at 88 mg/kgBW/day for 21 days. Tissue IL-6 levels were measured by enzyme-linked immunosorbent assay (ELISA). Data were analyzed using one-way ANOVA followed by a post hoc least significant difference (LSD) test. C. acnes induction significantly elevated tissue IL-6 levels compared to the normal control (p<0.001). One-way ANOVA revealed statistically significant differences in IL-6 levels between groups (p<0.001). The lowest IL-6 levels were observed in K1 (36.50±0.43) and the highest in K2 (94.01±0.57). The treatment group (P; 47.46±0.83) demonstrated significantly lower IL-6 levels than K2 and approximated K1 values. The post hoc LSD test confirmed statistically significant differences across all pairwise group comparisons (p<0.001). Oral bromelain administration effectively reduced IL-6 levels in the tissue of acne vulgaris model rats, demonstrating significant anti-inflammatory activity. These findings suggest that bromelain has potential as an adjunct therapy for inflammatory control in acne vulgaris.
Correlation Between Serum Il-24 Level in Acne Vulgaris Patients of Varying Clinical Severity Evanti, Annisa Marsha; Irawanto, Muhammad Eko; Mulianto, Nurrachmat; Kusumawardani, Arie; Ellistasari, Endra Yustin
Journal of Social Research Vol. 5 No. 4 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i4.3104

Abstract

Background: Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous unit that significantly impacts patients' quality of life. The inflammatory process involves immune responses partially regulated by IL-24, suggesting its potential role in AV pathophysiology and clinical severity. However, data on serum IL-24 levels based on AV severity remain limited, particularly in Indonesia. This study aims to evaluate the relationship between serum IL-24 levels and acne vulgaris severity to further elucidate its molecular mechanisms. Methods: This observational analytical study with a cross-sectional design was conducted at Dr. Moewardi General Hospital, Surakarta, Indonesia, from November 2025 to January 2026, involving healthy individuals and acne vulgaris patients. AV severity was assessed using the Lehmann classification, and serum IL-24 levels were measured by ELISA. Results: A total of 60 subjects were involved, consisting of 15 healthy controls, 15 patients with mild AV, 15 with moderate AV, and 15 with severe AV. Pearson correlation analysis showed no significant relationship between serum IL-24 levels and AV severity (p = 0.186). However, there was a trend towards increasing serum IL-24 levels along with acne severity. In the healthy control group, IL-24 levels were lower than in the AV group. Conclusions: Serum IL-24 levels are not associated with acne vulgaris severity. This is likely due to its effect on local keratinocyte proliferation. Further research is needed to elucidate the pathophysiology using histopathological examination of skin tissue from patients with AV
Concomitant Erythema Nodosum Leprosum and Bullous Dapsone Hypersensitivity Syndrome in Relapsed Multibacillary Leprosy: Pathophysiological Insights and Therapeutic Strategy Nurrachmat Mulianto; Ivani; Pratiwi Prasetya Primisawitri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (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.v10i5.1588

Abstract

Background: Multibacillary leprosy management is frequently complicated by severe immunological reactions and adverse drug events. Erythema nodosum leprosum is an immune-complex-mediated complication, while dapsone hypersensitivity syndrome is an idiosyncratic, potentially life-threatening drug reaction. The concomitant presentation of these distinct entities, especially with bullous eruptions, creates a profound diagnostic and therapeutic dilemma. Case presentation: A 42-year-old male with a history of relapsed borderline lepromatous leprosy and rheumatoid arthritis presented with exquisitely painful erythematous nodules, high-grade fever, and bullous eruptions exactly 72 hours after the re-initiation of multidrug therapy. Physical examination recorded a Visual Analog Scale pain score of 9. Expanded histopathological evaluation confirmed a dual pathology: extensive dermal neutrophilic infiltration characteristic of Erythema Nodosum Leprosum, occurring alongside pronounced subepidermal blistering and marked eosinophilic exocytosis indicative of a dapsone-induced bullous eruption. Standard multidrug therapy was immediately discontinued. A modified regimen comprising rifampicin, clarithromycin, and carefully titrated immunosuppressants (methylprednisolone and azathioprine) was initiated. Conclusion: The substitution of dapsone with clarithromycin facilitated rapid clinical resolution of both the bullous eruptions and recurrent immune reactions. This case underscores the critical need for precise temporal tracking, individualized therapeutic modifications, and comprehensive histopathological evaluation in leprosy patients demonstrating complex, overlapping hypersensitivity syndromes.
Co-Authors . Hardjono Achmad Satya Negara Adjie, Sugih Primas Adniana Nareswari Ahmad Fiqri, Ahmad Ambar Aliwardani Annisa Fildza Hashfi Annisa Marsha Evanti Arie Kusumawardani Arrochman, Ferry Arrosyid, Azhar Astrid Astari Aulia Aulia Rahman Ayu Kusuma Dewi 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 Murastami, Ammarilis Niluh Wijayanti Novan Adi Setyawan 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 Utama, Rahmat Firdaus Dwi Wibisono Nugraha Winda Wijayanti Wirawan, Eka Putra