Hardyanto Soebono
Department Of Dermatology And Venereology, Faculty Of Medicine, Public Health, And Nursing Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta

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The role of Various Factors in the Therapeutic Response of Calcipotriol in Mild to Moderate Plaque Type Psoriasis Patients Siti Aminah Tri Susila Estri Sunardi Radiono Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 02 (2007)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Psoriasis is a chronic skin inflammation and proliferation disease. Natural history of psoriasis depends on the genetic, age, sex, history of treatment and psychosocial stressor. Calcipotriol is suitable for long-term therapy with good efficacy and safety and clinical response variability but its activity is influenced by ultraviolet.Objective: To know the factors that may influence treatment response of calcipotriol ointment on mild to moderate plaque type psoriasis.Method: Longitudinal study of two times daily calcipotriol ointment 0.005% treatment in the psoriasis patients. Factors that may influence the natural course (age, sex, history of psoriasis in family, history of therapy, MED, working location and psychological stressor) were identified. Evaluation of therapy was performed in the 8th weeks and based on the PASI and PDI. Correlation between treatment responses with various factors were analyzed by using student t-test, Pearson and Spearman correlations and multiple linear regression.Result: At the end of study, PASI was shown to decrease 38.45%, while PDI was 28.70% (p
Association between atopy and allergic contact dermatitis in Dr. Sardjito General Hospital Yogyakarta . Fitria; Retno Danarti; Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (521.829 KB) | DOI: 10.19106/JMedScie004502201305

Abstract

Association between atopy and development of allergic contact dermatitis (ACD) remains controversial. T cell disfunctions in a patient with atopy complicate the process of nickel sensitization. On the other, the decrease of the skin barrier function and overexpression of Langerhans cells in the patient facilitate the sensitization.  This study aimed to evaluate the association between atopy and incidence of nickel ACD. A case-control study was carried out in Allergic and Immunology Sub Department of Dermato-Venereology Policlinic, Dr. Sardjito General Hospital, Yogyakarta, involving 54 nickel ACD patients as case group and 74 healthy subjects as control group. All subjects underwent prick test allergens i.e. house dust, dust mite, cockroach, mixed fungi, nuts and egg white. The skin reaction was considered as a positive result if a wheal diameter of at least 3 mm larger than the negative control or a minimum of half of the positive control. The relationship between atopy and the nickel ACD incidence was analyzed using Chi-Square test with confidence interval (CI) of 95%. A significant association between atopy and the nickel ACD incidence was observed in this study. Subjects with atopy to  ≥1 allergen had risk of nickel ACD 3.74 higher than subjects without atopy (odds ratio/OR=3.74; 95%CI = 1.64-8.53).  Furtheremore, subjects with atopy to  ≥2 allergens had risk of nickel ACD 3.74 higher than subjects without atopy (OR=2.08; 95%CI = 1.01-4.29). In conclusion, atopy is a risk factor of nickel ACD.
Association between environmental allergen sensitization with severity of atopic dermatitis in children and young adult at Dr. Sardjito General Hospital, Yogyakarta Herwinda Brahmanti; Niken Trisnowati; Retno Danarti; Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 01 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The important role of aeroallergens and food allergens as the most common environmental allergens in exacerbationof atopic dermatitis (AD) iswell known. Sensitization is an essential processwhich correlateswith clinicalmanifestationof AD. The study of AD in Indonesia, especially in Yogyakarta, has not been reported, yet. The aim of study is toevaluate the association between sensitization of environmental allergens with clinical severity of AD in children andyoung adult at Dr. Sardjito General Hospital, Yogyakarta. An analytic observational cross sectional study wasperformed on 33 children and young adult with AD. The severity of disease was determined by SCORing AtopicDermatitis (SCORAD). Assessment of sensitization was performed using specific IgE serum, atopy patch test, andprick test. Data were analyzed using chi-square or Fisher exact test and prevalence ratio (PR) with significancevalue of p<0.05 and 95%confidence interval (CI). The results showed that specific IgE positivity was associatedwith severity of AD. Percentage of specific IgE positivity to house dust mite was significantly higher in subject withmoderate/severe AD compared to those of mild AD (p=0.049; PR 1.13; 95% CI 1.01-1.59). The result was alsosimilar for cat dander (p=0.041; PR 1.1; 95%CI 1.09-4.98), cow’s milk (p=0.038; PR 1.21; 95% CI 1.02-2.2),and egg white (p=0.027; PR 1.23; 95% CI 1.15-2.97). Whereas specific IgE positivity to fish allergen was notstatistically different in subject with moderate/severe AD compared to those with mild AD (p=0.061; PR 0.8; 95%CI 0.76-2.8). According to atopy patch test and prick test result, no association was found between allergensensitization and severity of AD. If allmethodswere combined to increase the sensitivity of sensitizationmeasurement,then the association was found for all allergens. It could be concluded that environmental allergens sensitization isassociated with severity of AD in children and young adult at Dr. Sardjito General Hospital, Yogyakarta.Key words: atopic dermatitis-disease severity-sensitization-aeroallergen-food allergen
Association between HLA-DQ alleles and Leprosy in Indonesia Javanese population Hardyanto Soebono Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 28, No 01 (1996)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Previous studies showed that susceptibility to leprosy and antibody response toward M. leprae in Javanese population was under control of HLA-DR alleles. To investigate whether this susceptibility was also associated with HLA-DQ, the study had been continued with phenotyping of HLA-DQ alleles and antibody assay to the same population which consisted of 79 leprosy patients, 41 tuberculoid (TT/BT) and 38 lepromatous (LL/BL) type, and 50 healthy controls. The HLA-DQ typing had been performed by using a sequence specific oligonucleotyping (SSO). method, while the anti M. leprae antibody had been tested by ELISA and INHIBITION-ELISA.The results show that HLA-DQB501 is associated with leprosy, either tuberculoid or lepromatous type (OR 3.27; 95% Cl 1.42-7.60). When all HLA-DQ1 alleles are analyzed, a significant association is found only with lepromatous leprosy (OR 9.18; 95% Cl 1.89-86.30). IgG antibody anti 36 kD M. leprae is found to be associated with HLA-DQ102. The level of this antibody is higher in HLA-DQ102 positive individuals compared to those negative one (P). No correlation is found between HLA-DQ alleles and the seropositivity of either IgM or IgG.In conclusion, the susceptibility to leprosy in this population is also controlled by genes in HLA-DQ locus. This study also supports the previous findings that HLA-DQ1 is a universal marker for the susceptibility to lepromatous leprosy, while the infection with M. leprae per se is not controlled by HLA genetic factor.Key words : leprosy - M. /eprae - genetic factor - HLA-DQ - HLA-DQ1 - HLA-DQB501
T cell and B cell reactivities of leprosy patients and their contacts against antigens or epitopes Mycobacterium leprae Hardyanto Soebono Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 27, No 03 (1995)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

This study was aimed at evaluating the T cell and B cell reactivity against Mycobacterium leprae antigens or epitopes among leprosy patients and their household contacts in the Indonesian population. Through this study, M. leprae epitopes (either protective or suppresive) will be identified and hopefully proved useful for the development of an effective leprosy vaccine in the future.Fifty-nine leprosy patients consisting of 34 tuberculoid type (TT/BT) and 24 lepromatous type (LUBL) at Dr. Sardjito General Hospital Yogyakarta and 50 household contacts were recruited for this study. After the informed consent was given, 20 ml venous blood was drawn from each subject for assays of the T cell and B cell reactivities. The T cell reactivity was tested by lymphocyte transformation (LTT) and the B cell reactivity was tested serologically by EUSA. M. leprae antigen, PGL-1 and some recombinant proteins (65 kD, 30 kD, 45 kD and 43 kD) were used as antigens in both assays. In addition, Phytohemagglutinin (PHA) and lnterleukin-2 (IL-2) were used as mitogens in the LTT. Statistical analysis was done by using One way ANOVA and Chi-square tests.The results showed that cellular immune deficiency in LUBL patients was found to be specific to the M. leprae antigen, but not to mitogens and other antigens. The T-lymphocyte of the patients (either TT/BT or LUBL) and healthy contacts demonstrated very low reactivities againts all recombinant antigens. On the other hand, the sera of LL/BL leprosy patients reacted significantly against all antigens, most strikingly against PGL-I and 43 recombinant protein of M. leprae. Whereas, the sera of TT/BT patients and healthy contacts showed no or least reactivity against those antigens. These data indicate that although in a small proportion M. leprae recombinant proteins of 65 kD, 30 kD, 45 kD and 43 kD are recognized by T-cell of leprosy patients and healthy contacts. These antigens contain more B-cell epitopes rather than T-cell epitopes. So, these antigens should be eliminated. as soon as a possible candidate in the development of any leprosy vaccine.Key words: leprosy - T-cell and B-cell - Mycobacterium leprae antigen - ELISA - tuberculoid and lepromatouse types
The effect of mitomycin-c in keloid fibroblast cultures Ishandono Dachlan; Teguh Aryandono; Mae Sri Hartati Wahyuningsih; Hardyanto Soebono; Yohanes Widodo Wirohadidjojo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 3 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (729.667 KB) | DOI: 10.19106/JMedSci004803201605

Abstract

ABSTRACTKeloid occurs due to hyperactivity of keloid fibroblast (KF) in proliferation, migration, collagen deposition, together with low rates of collagen degradation. These are under the responsibility of TGF-b. Mitomycin C (MC) is used for treating keloid by a topical application during surgery at the level of 0.02% to 0.08%. Unfortunately, the lowest effective level of MC for keloid has not been determined yet. We aimed to determine the lowest effective level of MC in the suppression of KF activities. Various levels of MC diluted in growth medium were administered on KF that were isolated from six patients. After 24 hours and 72 hours of incubation, cellular proliferation, collagen deposition, cellular migration and level of TGF-b, were analyzed. Application of 120 uM MC on KF culture for 24 hours could significantly reduce TGF-b production from 1265.74 ± 274.81 pg/mL to 265.17 ± 12.20 pg/mL; proliferation index from 100% to 84.01 ± 12.91%; inhibit cellular migration to 64.38 ± 3.66%; but reduce collagen depositions from 100% to only 91.13 ± 10.19%. The lowest MC level is on 30 uM or equal with 0.001%. In conclusion, the lowest level of MC can suppress the activities of KF is 0.001%. Moreover, due to low activity in inhibiting collagen deposition, MC would be better as an adjuvant drug for keloid surgery.
Association between HLA-B alleles and nevirapine-induced allergies among Indonesian HIV patients Angela Satiti Retno Pudjiati; Dyah Ayu Mira Oktarina; Hardyanto Soebono; Saihas Sauda; Dewi Kartikawati Paramita; Iwan Dwiprahasto; Zubairi Djoerban
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.093 KB) | DOI: 10.19106/JMedSci004804201604

Abstract

This study aimed to investigate the association between human leukocyte antigen-B(HLA-B) alleles and nevirapine allergy in HIV patients in Indonesia. A case control studywas conducted involving 147 HIV patients comprising of 50 patients with and 97patients without nevirapine allergy as control. The HLA-B allele typing was conducted byusing polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP),followed by sequencing. Bivariate analysis using Chi-square (X2) test and multivariatelogistic regression with significance level at p<0.05 were applied to analysis the data.Among 147 subjects, 34 with HLA-B alleles were identified. Bivariable analysis showedthat HLA-B*58 allele was the most significant risk factor for the nevirapine allergy (OR= 3.67; 95% CI: 1.79 to 7.54), while HLA-B*35 allele was a protective factor (OR =0.18; 95% CI: 0.08 to 0.42). Multivariate logistic regression analysis showed that youngmen and HLA-B*58 allele were the significant risk factors of nevirapine allergy (OR: 4.63;95% CI: 2.02 to 10.61), while older women with the HLA-B*35 was able to reducethe risk of nevirapine allergy approximately 81% (OR: 0.19; 95% CI: 0.08 to 0.49). Inconclusion, young male with the HLA-B*58 allele are the high risk factor for nevirapineallergy in Indonesian HIV patients.
The role of nickel contact allergy in nummular dermatitis in Indonesia Niken Indrastuti; Moh Hakimi; Marsetyawan HNE Soesatyo; Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 1 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (277.457 KB) | DOI: 10.19106/JMedSci005101201907

Abstract

In the recurrence of nummular dermatitis (ND) as a problem for patients, it is necessary to identify interferon-γ (IFN- γ), interleukin-4 (IL-4), interleukin-17 (IL-17), and stimulation of lymphocytes against nickel. This study aimed to investigate the role of nickel contact allergy in ND. Forty-two patients with ND were studied and 42 healthy subjects who were equal in age, sex and atopy history as control. All subjects underwent nickel skin patch test, detection of IFN-γ, IL-4, IL-17 in blood, and lymphocyte stimulation assays. To determine cut off point of the variables, receiver operator characteristic (ROC) curves were calculated. Bivariate and multivariate analyses were performed to measure the strength of association using odds ratio (ORs) and 95% confidence intervals (95% CI). Statistical analysis was performed using McNemar X2-square test and multiple conditional logistic regression. Nickel contact allergy was shown by nickel patch test (OR= 3.5; 95% CI = 1.09–14.60), stimulation index/SI (OR= 29; 95% CI = 4.81-1184.43), IFN-γ (OR= 4.25; 95% CI = 1.39–17.36). These results were supported after multivariate analysis with conditional logistic regression which showed nickel patch test (OR= 9.63; 95% CI= 1.02–109.38; p= 0.04), SI (OR= 42.19; 95% CI = 2.32–766.03; p= 0.01), IFN-γ (OR= 11.51; 95% CI = 1.08–122.63; p= 0.04). Nickel contact allergy is an important risk factor for ND. Patients with ND are recommended to be tested for nickel contact allergy.
The Role of Connexin in Cutaneous Adverse Drug Reactions (CADRs) in Patients with Increasing Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) Dyah Ayu Mira Oktarina; Gilang Baswara; Hardyanto Soebono
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 2 (2021): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.2.2021.123-128

Abstract

Background: The occurrence of Cutaneous Adverse Drug Reactions (CADRs) is relatively rare but can be fatal when causing organ failure, especially in the liver. The supporting examinations to determine liver injury are aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Connexin-32 (Cx32) and connexin-43 (Cx43) are gap junction proteins that can be found in the liver and allegedly have a role in the mechanism of liver injury. To date, correlations between the level of connexin and aminotransferases enzyme in humans with CADRs cases are still unclear. Purpose: To determine the correlations between Cx32/Cx43 and AST/ALT levels in CADRs cases. Methods: This was a retrospective study, data collected from inpatient and outpatient’s medical records, Department of Dermatology and Venereology of Dr. Sardjito Hospital, from 2011–2015. Result: A total of 25 patients with CADRs and 35 healthy controls were included in this study. The levels between Cx32 and AST, Cx32 and ALT, Cx43 and AST, and Cx43 and ALT were not significantly correlated in CADRs cases (p>0.05). Both Cx32 and Cx43 were not significantly different between patients with and without CADRs (p>0.05). Confounding factors such as gender were not associated with this study (p>0.05). Conclusion: There was no correlation between levels of Cx32/Cx43 and increasing AST/ALT in CADRs cases. Therefore, further study is necessary to conclude the correlation between connexin and aminotransferase enzyme in CADRs patients.
A Five-Year Review of Adverse Cutaneous Drug Reaction in a Tertiary Care Hospital in Yogyakarta, Indonesia Dyah Ayu Mira Oktarina; Maria Sophiati; Erinda Maharani Rambu Moha; Fajar Waskito; Hardyanto Soebono
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 3 (2021): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.3.2021.150-155

Abstract

Background: The prevalence of adverse drug reactions is likely to increase, and it is associated with increased usage of various drugs. Adverse Cutaneous Drug Reaction (ACDR) is the most frequent adverse drug reaction (30–45%). In Indonesia, the study on the prevalence of ACDR is still limited. Purpose: This study investigated the prevalence, clinical features, causative agents, and mortality rate of ACDR with a type-IV hypersensitivity reaction among patients attending the Department of Dermatology and Venereology in Dr. Sardjito Hospital, Yogyakarta. Methods: This retrospective study was conducted examining medical records undertaken for five years (2011–2015). Of 68,375 patients medicated in the Department of Dermatology and Venereology, 397 patients were diagnosed as ACDR with a type-IV hypersensitivity reaction. Detailed history, including age, sex, past history, and family history of drug reaction taken by the patient, were obtained. Patch testing was done wherever feasible. Result: Of 68,375 patients, 397 patients were included in ACDR with type-IV hypersensitivity (0.58%), giving a 5% of mortality rate. The mean age of the patients was 40.42 years (±16.30; range 18 to 89 years). The female to male ratio was 1.1: 1. The Maculopapular rash was the most common ACDR manifestation (50.88%), followed by Stevens-Johnson Syndrome (13.85%), Fixed Drug Eruption (12.85%), and Drug Reaction with Eosinophilia and Systemic Symptoms (10.08%). The most common causative agents were beta-lactam (16.55%), NSAIDs (12.18%), and acetaminophen (8.62%). Conclusion:  Prescription of those drugs should be considered carefully so the incidence of ACDR can be reduced.