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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Sumatera Medical Journal SCRIPTA SCORE Scientific Medical Journal Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED) The Indonesian Journal of General Medicine
Cut Putri Hazlianda
Departemen Ilmu Kesehatan Kulit Dan Kelamin Fakultas Kedokteran Universitas Sumatera Utara/Rumah Sakit Umum Haji Adam Malik Medan
Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Dermatitis Herpetiformis: An Update on Diagnosis And Treatment Hazlianda, Cut Putri; Putri, Desy Sahara
SCRIPTA SCORE Scientific Medical Journal Vol. 5 No. 2 (2024): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v5i2.15636

Abstract

Introduction: Dermatitis herpetiformis is a relapsing skin disease caused by gluten sensitivity, also known as an extraintestinal manifestation of celiac disease. Methods: This article was made by reviewing 14 articles related to dermatitis herpetiformis which obtained from Pubmed, Science Direct, and Google Scholar. Discussion: Dermatitis herpetiformis is characterized by skin lesions vesicles or exoriated papules intensely itchy or excoriated papules on extensor surfaces, scalp, nuchal area, and buttocks. Dermatitis herpetiformis is primarily diagnosed through direct immunofluorescence of granular IgA deposits. However, modern and recent approaches currently use anti-TG3 antibody levels as the main serological diagnostic marker. Recent studies now confirm strict, long-term gluten free diet as the primary treatment modality. The diet is supplemented with sulfonamides as first line drugs treatment, especially dapsone. Proper diagnosis and management are important to improve the quality of life of the patients. Conclusion: Dermatitis herpetiformis is a skin disease related to hypersensitivity which requires comprehensive approach and treatment. Keyword: Celiac Disease, Dapsone, Dermatitis Herpetiformis, Direct Immunofluorescence, Gluten Free Diet Pendahuluan: Dermatitis herpetiformis, juga dikenal sebagai manifestasi ekstraintestinal penyakit celiac. Metode: Artikel ini disusun dengan meninjau 14 artikel berkaitan dengan dermatitis herpetiformis yang didapatkan pada Pubmed, Science Direct, dan Google Scholar. Pembahasan: Dermatitif herpetiformis adalah penyakit kulit yang ditandai dengan vesikel yang gatal atau papula yang terkelupas. Dermatitis herpetiformis didiagnosis terutama melalui imunofluoresensi langsung deposit IgA granular. Namun, pendekatan modern saat ini menggunakan antibodi anti-TG3 sebagai penanda diagnostik serologis utama. Studi terbaru sekarang mengkonfirmasi diet bebas gluten jangka panjang yang ketat sebagai modalitas pengobatan utama. Diet dilengkapi dengan sulfonamida sebagai pengobatan lini pertama, terutama dapson. Diagnosis dan penatalaksanaan yang tepat penting untuk meningkatkan kualitas hidup pasien. Kesimpulan: Dermatitis herpetiformis adalah penyakit kulit yang berkaitan dengan hipersensitivitas dan membutuhkan pendekatan dan tatalaksana yang komprehensif. Kata Kunci: Dapson, Dermatitis Herpetiformis, Diet Bebas Gluten, Imunofluoresensi Langsung, Penyakit Seliak
An In-depth Review of Cutaneous Necrotizing Venulitis: Clinical and Pathological Perspective Hazlianda, Cut Putri; Putri Harahap, Rima Rahmi
SCRIPTA SCORE Scientific Medical Journal Vol. 6 No. 2 (2025): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v6i2.17896

Abstract

Background: Cutaneous Necrotizing Venulitis (CNV) is a complex multisystem disorder primarily affecting small skin vessels, particularly postcapillary venules. Objective: This article aims to discuss about cutaneous necrotizing venulitis (CNV). Methods: This article was written by reviewing book and articles related with cutaneous necrotizing venulitis (CNV) which are obtained from several search engines such as Pubmed, Science Direct, and Google Scholar. Discussion: CNV usually manifests as palpable purpura on the skin and may also involve multiple organ systems, including the kidneys, gastrointestinal tract, pericardium, and nervous system. The etiology of CNV remains incompletely understood but is often associated with infections, drug reactions, systemic inflammatory diseases, and malignancies. Clinical manifestation of CNV is mainly palpable purpura, which is red purpura that does not disappear when the skin is pressed. Other lesions such as erythematous macules, papulonodular lesions, urticaria, angioedema, pustules, hemorrhagic vesicles and bullae, necrosis, ulcers, subcutaneous edema and livedo reticularis can also be found in CNV cases. Conclusion: Cutaneous Necrotizing Venulitis (CNV) is a complex disease primarily affecting the skin and mucous membranes. Diagnosis of CNV involves clinical evaluation and histopathological examination. Treatment strategies of CNV aim to address underlying triggers, manage systemic involvement, and suppress inflammatory responses using topical and systemic therapies such as corticosteroids, NSAIDs, and immunosuppressive agents. Treatment strategies of CNV aim to address underlying triggers, manage systemic involvement, and suppress inflammatory responses using topical and systemic therapies such as corticosteroids, NSAIDs, and immunosuppressive agents and CNV often exhibits a favorable prognosis with appropriate management.   Latar Belakang: Cutaneous necrotizing venulitis (CNV) adalah gangguan multisistem yang kompleks, terutama menyerang pembuluh darah kecil di kulit, khususnya venul postkapiler. Tujuan: Artikel ini bertujuan untuk memberikan analisis mendalam mengenai patogenesis, manifestasi klinis, diagnosis, dan strategi pengobatan CNV. Metode: Artikel ini didasarkan pada tinjauan literatur dari berbagai sumber ilmiah yang relevan, termasuk jurnal dan buku yang diakses melalui PubMed, ScienceDirect, dan Google Scholar. Pembahasan: CNV biasanya bermanifestasi sebagai purpura teraba pada kulit dan dapat melibatkan berbagai sistem organ, termasuk ginjal, saluran gastrointestinal, perikardium, dan sistem saraf. Etiologi CNV masih belum sepenuhnya dipahami, tetapi sering dikaitkan dengan infeksi, reaksi obat, penyakit inflamasi sistemik, dan keganasan. Manifestasi klinis utama CNV adalah purpura teraba, yaitu purpura berwarna merah yang tidak menghilang saat kulit ditekan. Lesi lain yang dapat ditemukan pada kasus CNV meliputi makula eritematosa, lesi papulonodular, urtikaria, angioedema, pustula, vesikel dan bula hemoragik, nekrosis, ulkus, edema subkutan, serta livedo reticularis. Kesimpulan: Cutaneous necrotizing venulitis (CNV) adalah penyakit kompleks yang terutama mempengaruhi kulit dan selaput lendir. Diagnosis CNV melibatkan evaluasi klinis dan pemeriksaan histopatologi. Strategi pengobatan CNV bertujuan untuk mengatasi pemicu yang mendasari, mengelola keterlibatan sistemik, serta menekan respons inflamasi menggunakan terapi topikal dan sistemik, seperti kortikosteroid, NSAID, dan agen imunosupresif. CNV umumnya memiliki prognosis yang baik dengan penanganan yang tepat.  Keywords: angiitis nekrotikans, vaskulitis, venulitis, venulitis nekrotikans kutan
Breaking Through the Blister : Exploring Chronic Bullous Disease of Chidhood Revinanda Venincia Pangaribuan; Cut Putri Hazlianda
SCRIPTA SCORE Scientific Medical Journal Vol. 6 No. 2 (2025): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v6i2.18780

Abstract

Background : One of the autoimmune disease occurs on the first decade of life is Linear Immunoglobulin A Bullous Disease that initially referred to as Chronic Bullous Disease of Childhood is an infrequent and nonhereditary skin disorder defined by a linear accumulation of immunoglobulin A. The lesions present as clear or hemorrhagic vesicles (or both) or bullae that emerge from otherwise normal skin, occasionally accompanied by an erythematous or urticarial base. The bullae or vesicles are typically tense, vary in size, and often develop into annular or polycyclic plaques as a result of the lesions merging together. CBDC is a self-limiting disease, with most children experiencing recovery within two years of the symptom beginning, in some cases, the disease continues into puberty, but it is typically less severe than the initial eruption. Objective : This literature review aims to provide a comprehensive understanding of CBDC, including its pathogenesis, diagnosis and appropriate therapeutic approaches for managing the disease. Methods : Herein, using the key terms: “Chronic Bullous Disease of Chidhood”, “Linear Immunoglobulin A Bullous Disease”, “autoimmune bullous disease”, we carried out a review of the literature, using Google Scholar, PubMed and book in last 10 years. Conclusion : CBDC is a chronic bullous disease that appears in pediatric age. The pathogenesis of this disease is not yet known with certainty. Although the disease is capable of self-healing, dapsone is the recommended first-line treatment. If spontaneous recovery takes place, the prognosis is often optimistic. Accurate diagnosis and therapy are important for a prognosis. Latar belakang : Salah satu penyakit autoimun bulosa yang muncul pada decade pertama kehidupan adalah Penyakit Linear Immunoglobulin A yang awalnya disebut Chronic Bullous Disease of Childhood, merupakan kelainan kulit yang jarang terjadi dan tidak bersifat keturunan ditandai dengan akumulasi linear IgA. Lesi muncul sebagai vesikel bening atau hemoragik (atau keduanya) atau bula yang muncul dari kulit normal, kadang-kadang disertai dengan dasar eritematosa atau urtikaria. Bula atau vesikel biasanya tegang, ukurannya bervariasi, dan sering berkembang menjadi plak anular atau polisiklik akibat bergabungnya lesi. CBDC merupakan penyakit yang dapat sembuh dengan sendirinya, dengan sebagian besar anak mengalami pemulihan dalam waktu dua tahun sejak gejala muncul, dalam beberapa kasus, penyakit ini berlanjut hingga masa pubertas, namun biasanya tidak separah gejala awal. Tujuan : Tinjauan pustaka ini bertujuan untuk memberikan pemahaman yang komprehensif tentang CBDC, termasuk patogenesis, diagnosis dan pendekatan terapi yang tepat untuk penyakit ini. Metode : Dalam penelitian ini, menggunakan istilah kunci: “Penyakit Bulosa Kronis pada Anak”, “Penyakit Bulosa Imunoglobulin A Linear”, “penyakit bulosa autoimun”, kami melakukan telaah pustaka, menggunakan Google Scholar, PubMed dan buku dalam 10 tahun terakhir. Kesimpulan: CBDC merupakan penyakit bulosa kronis yang muncul pada usia anak-anak. Patogenesis penyakit ini belum diketahui secara pasti. Meskipun penyakit ini mampu sembuh sendiri, dapson merupakan pengobatan lini pertama yang direkomendasikan. Jika terjadi pemulihan spontan, prognosisnya sering kali optimis. Diagnosis dan terapi yang akurat penting untuk prognosis.
The Role of Gut-Brain-Skin Axis in Guttate Psoriasis caused by Enterobacter cloacae Hazlianda, Cut Putri; Dewi, Molla Andriska
SCRIPTA SCORE Scientific Medical Journal Vol. 7 No. 2 (2026): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v7i2.20183

Abstract

Background: Background: Psoriasis is a chronic inflammatory skin condition often manifesting as erythematous plaques with white scales. Guttate psoriasis (GP), a specific variant, presents as sudden-onset red, water-drop-like spots typically triggered by infections. The gut-brain-skin axis highlights the role of gut microbiota in modulating skin inflammation. Objectives: To present a case report of guttate psoriasis and the interplay between gut-brain-skin axis in guttate psoriasis. Case Presentation: A 28-year-old woman presented with itchy raised red patches covered by thick white scales. Symptoms began a month earlier, with red spots first appearing on her chest and spreading. A week prior, she experienced fever, sore throat, nausea, vomiting, and diarrhea. Physical examination revealed erythematous papules and plaques with positive Auspitz and Karsvlek signs. A throat swab identified Enterobacter cloacae. Treatment included cetirizine, hydrocortisone cream, desoximetasone cream, and ketoconazole shampoo. Discussion: The gut-brain-skin axis suggests that gut microbiota, like Enterobacter cloacae, can affect skin inflammation through immune modulation. Dopamine produced by gut bacteria may exacerbate psoriasis by influencing T cells and keratinocytes. Stress also plays a role in psoriasis flare-ups. This patient’s history of bacterial infection and stress supports this theory. Conclusion: This case illustrates the intricate interplay between gut microbiota, stress, and immune mechanisms in GP, emphasizing the need for holistic treatment approaches in managing psoriasis. Keyword: Enterobacter cloacae, Gut, Guttate psoriasis, Microbiota, Skin axis Latar Belakang: Psoriasis adalah kondisi peradangan kulit kronis yang sering bermanifestasi sebagai plak eritematosa dengan sisik putih. Psoriasis gutata (GP) adalah varian khusus yang muncul sebagai bintik merah yang menyerupai tetesan air dengan onset tiba-tiba yang biasanya dipicu oleh infeksi. Tujuan: Untuk mempresentasikan laporan kasus psoriasis gutata dan hubungan pola antara aksis saluran pencernaan-otak-kulit di psoriasis gutata. Presentasi kasus: Seorang wanita berusia 28 tahun datang dengan keluhan bercak merah gatal yang menonjol dan tertutup sisik putih tebal. Gejala muncul sejak satu bulan sebelumnya, dimulai dengan bintik merah di dada yang kemudian menyebar. Seminggu sebelum munculnya lesi, pasien mengalami demam, sakit tenggorokan, mual, muntah, dan diare. Pemeriksaan fisik menunjukkan papul dan plak eritematosa dengan tanda Auspitz dan Karsvlek yang positif. Hasil kultur usap tenggorokan mengidentifikasi Enterobacter cloacae. Pasien diberikan terapi berupa cetirizine, krim hidrokortison, krim desoximetasone, dan sampo ketokonazol. Pembahasan: Aksis saluran pencernaan-otak-kulit menunjukkan bahwa mikrobiota usus, seperti Enterobacter cloacae, dapat memengaruhi inflamasi kulit melalui modulasi sistem imun. Dopamin yang diproduksi oleh bakteri usus berpotensi memperburuk psoriasis dengan memengaruhi sel T dan keratinosit. Stres juga berperan dalam kekambuhan psoriasis. Riwayat infeksi bakteri dan stres pada pasien ini mendukung teori tersebut. Kesimpulan: Kasus ini menggambarkan hubungan antara mikrobiota usus, stres, dan mekanisme imun dalam GP, sehingga menekankan pentingnya pendekatan terapi holistik dalam tata laksana psoriasis. Kata Kunci: Aksis kulit, Enterobacter cloacae, Mikrobiota, Psoriasis gutata, Usus
Dermatomyositis: Current Insights into Pathogenesis, Diagnosis, and Dermatologic Management Helen Anastasya; Cut Putri Hazlianda
The Indonesian Journal of General Medicine Vol. 32 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/g0ffq828

Abstract

INTRODUCTION: Dermatomyositis (DM) is a rare, heterogeneous, systemic autoimmune myopathy characterized by hallmark cutaneous manifestations and, typically, symmetric proximal muscle weakness. It’s clinical significance is profound, extending beyond the skin and muscle to involve systemic complications such as interstitial lung disease (ILD) and a strong association with internal malignancy, both of which confer significant morbidity and mortality. The field is currently undergoing a paradigm shift, moving from a monolithic clinical diagnosis to a "clinico-serological" classification based on myositis-specific autoantibodies (MSAs). This modern approach is essential for accurate prognosis and the selection of targeted therapies. METHODS: This article presents a comprehensive narrative literature review based on a targeted search of scientific databases, including PubMed/MEDLINE, Google Scholar, and Scopus. The search prioritized literature published between 2020 and 2024 to capture the most current insights. Key search terms included "Dermatomyositis," "pathogenesis," "diagnosis," "treatment," "myositis-specific autoantibodies," "Type I interferon," "Janus Kinase inhibitors," "malignancy screening," and "interstitial lung disease." Selected foundational articles were included for essential context, and all literature was synthesized to build an integrated framework. LITERATURE REVIEW: Recent advances have solidified the central role of the Type I interferon (IFN-I) pathway in DM pathogenesis, creating a "Type I IFN signature" in affected skin, muscle, and blood. This discovery provides a direct mechanistic rationale for emerging targeted therapies. The identification of MSAs has revolutionized the diagnostic and prognostic landscape. These autoantibodies define distinct, clinically relevant phenotypes, such as anti-MDA5-positive DM, which is associated with rapidly progressive ILD (RP-ILD) (Lu, Peng and Wang, 2024), and anti-TIF1-γ-positive DM, which carries a very high risk of concurrent malignancy. Diagnosis now integrates clinical findings, serological profiling, and imaging, with new 2024 IMACS guidelines providing a risk-stratified, MSA-driven protocol for malignancy screening. Dermatologic management follows a stepwise algorithm, beginning with foundational photoprotection and antimalarials, escalating to conventional immunosuppressants (e.g., mycophenolate mofetil, methotrexate), and advancing to intravenous immunoglobulin (IVIG) and rituximab for refractory disease. Janus kinase (JAK) inhibitors represent the most promising emerging therapy, as they directly target the pathogenic IFN-STAT signaling pathway. CONCLUSION: The modern management of DM is a multidisciplinary, personalized endeavor guided by a patient's specific clinico-serological profile. This approach enables vital risk stratification for ILD and malignancy, guiding both screening and therapeutic selection. While significant therapeutic gaps remain, particularly for anti-MDA5+ RP-ILD and refractory cutaneous disease, the development of pathway-specific therapies like JAK inhibitors heralds a new, more targeted era for DM treatment. Future research must focus on validating these new therapies in randomized controlled trials and refining classification criteria to include skin-predominant disease.
Co-Authors Akmal, Mohammad Anis Astarina, Awalia Berlian, Guntur Dalimunthe, Dina A Dewi, Molla Andriska Dhillon, Jesryn Diamanda, Ika Dina Arwina Dalimunthe, Dina Arwina Helen Anastasya Hutagalung, Patricia Isma Aprita Lubis Kamaliah Muis Lubis, Flora Marita Nasution, Namira Afifah Putri Harahap, Rima Rahmi Putri, Desy Sahara Revinanda Venincia Pangaribuan Rina Amelia Rusdiana Rusdiana Salsabila, Vanny Siahaan, Ade Gustina Sinaga, Riana Miranda Sitepu, Josapat Bima Sakti