Made Wardhana
Dermatology And Venereology Departement, Faculty Of Medicine, Udayana University, Sanglah General Hospital Denpasar, Bali-Indonesia

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Peran sirkumsisi sebagai pencegahan infeksi herpes genetalis: suatu studi kohort retrospektif Made Wardhana; Martina Windari; Marrietta Sugiarti Sadeli; Anak Agung Gde Putra Wiraguna; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Pande Agung Mahariski
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.07 KB) | DOI: 10.15562/ism.v12i2.1069

Abstract

Background: Recurrent genital herpes (RGH) is a sexually transmitted infection that is a serious public health problem and is quite prominent in most countries worldwide. Management for this infection is antiviral and circumcision. Male circumcision significantly reduces human immunodeficiency virus (HIV) infection and other sexually transmitted infections. This research aims to evaluate circumcision efficacy as the prevention for herpes simplex virus type 2 (HSV-2) infection compared with oral acyclovir.Methods: This research is an experimental study with a retrospective cohort approach. We included 45 males, 24 subjects circumcised and 21 subjects without circumcision and took oral acyclovir as standard treatment. RGH was diagnosed based on typical clinical manifestation. Follow up treatment every two weeks and continued to 2 months after circumcised and given with oral acyclovir. Successful treatment was stated without recurrent genital herpes.Results: Of 24 circumcised subjects, 19 were cured, and five non-circumcised subjects suffered recurrent genital herpes (not cured). Among 21 subjects without circumcision was cured, and 12 subjects were not cured. Based on these results, the value of NNT= 2.7.Conclusion: Circumcision can be considered effective in reducing the incidence of HGR and prevent recurrence of HGR with the NNT value of 2.7.  Latar Belakang: Herpes genetalis rekuren (HGR) merupakan infeksi menular seksual menjadi masalah kesehatan masyarakat yang serius dan cukup menonjol pada sebagian besar negara di dunia. Penanganannya adalah oral dengan antivirus dan tindakan sirkumsisi. Sirkumsisi pada pria secara signifikan mengurangi insiden infeksi human immunodeficiency virus (HIV) dan penyakit infeksi menular lainnya. Penelitian ini mengevaluasi efikasi sirkumsisi sebagai pencegahan infeksi virus herpes simpleks tipe 2 (HSV-2) dibandingkan dengan pemberian obat asiklovir.Metode: Studi ekperimental dengan pendekatan retrospektif kohort dengan mengikutsertakan 45 subjek pria dewasa, 24 subjek disirkumsisi dan 21 tanpa sirkumsisi dan hanya diberikan asiklovir sebagai obat standar. Diagnosis HGR dilakukan secara klinis dengan yang manifestasi klinis yang khas da pemeriksaan Tzanck. Setelah pemberian terapi dilakukan kontrol setiap 2 minggu sampai 2 bulan. Terapi dinyatakan berhasil bila tidak ada kekambuhan.Hasil: Dari 24 subjek disirkumsisi, 19 subjek dinyatakan sembuh dan 5 subjek mengalami kekambuhan (tidak sembuh). Dari 21 subjek tanpa sirkumsisi, 9 subjek dinyatakan sembuh dan 12 subjek dinyatakan tidak sembuh. Berdasarkan hasil ini didapatkan nilai NNT=2,7.Simpulan: Sirkumsisi dapat dinilai cukup efektif mengurangi angka kejadian HGR dan dapat mencegah kekambuhan HGR dengan nilai NNT 2.7.
CLINICAL AND DERMOSCOPIC FEATURES OF SKIN CANCER AT SANGLAH GENERAL HOSPITAL, DENPASAR: A CASE SERIES STUDY Made Wardhana; Nila Puspasari; Prima Sanjiwani; Darmaputra Darmaputra
Journal of Global Pharma Technology Volume 09 Issue 04
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Dermoscopy or epiluminescence microscopy (ELM) is a non-invasive clinical examination technique of pigmented skin lesions and early stage skin cancers.Methods: This was a retrospective study of patients with skin cancer at dermatology outpatient clinic of Sanglah Hospital from January 2013 to December 2014. These patients were firstly assessed with unaided eye before underwent a dermoscopic examination. All diagnoses were confirmed with a histopathology examination.Results: There were 22 patients with skin cancer who enrolled in this study. The study participants were redominantly women (59.1%), age over 50 years (72.7%), working outdoor (90.9%), with the predominantly predominant site being on the face (96%). There were 7 patients (31.8%)  with malignant melanoma and the predominant dermoscopic features were: atypical pigment network (71.4%), blue whitish veil (57.1%) and irregular streaks (57.1%). There were 10 patients (45.5%) with basal cell carcinoma, with the predominant dermoscopic feature being the arborizing vessel (60%) and ulceration (70%). There were 5 squamous cell carcinoma patients (22.7%) and the predominant dermoscopic features observed were keratin (80%) and hairpin vessels (100%). The histopathological examination results were in accordance with the description of dermoscopy featuresConclusions: Dermoscopy is a non-invasive tool for diagnosis of early skin cancer prior to performing a biopsy for histopathologic examination.
Patterns of Mucocutaneous Disorders in HIV-seropositive Patients and Relations with CD4 Counts at Sanglah General Hospital, Denpasar, Bali Made Wardhana; Nila Wardani; Ivana Sugiarto; Made Puspawati; Elis Indira; Wiraguna, Swastika Adiguna
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

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Abstract

Background: It is well known that more than 90% of HIV-infected patients will develop at least one type of dermatologic disorder during their HIV infection. As a result of the acquired immunodeficiency or the effect of the treatment, with an increased risk infectious skin condition which caused by viral, bacterial, and fungal infections, as well as inflammatory skin disease, have all been reported to increase as CD4+ T cells depleted.Objective: Our purpose was to evaluate the cutaneous manifestation in HIV/AIDS patients in dermatology-venerology polyclinic, Sanglah Hospital Denpasar. Subjects and Methods: Data was collected from medical records of HIV/AIDS patient whose came to the dermato-venerology department, Sanglah Hospital period 2007-2009.Results: During the three years period, noted 260 HIV/AIDS patients with cutaneous manifestation, 183 males, and 77 females. Those patients mostly in the age group 21-30 years old. Five most common cutaneous manifestation was condyloma acuminate for 59 patients (22,7%), dermatitis 27 patients (10,4%), drug eruptions 26 patients (10,0%), prurigo 24 patients (9,2%) and seborrheic dermatitis 23 patients (8,8%). Conclusion: Cutaneous manifestation in HIV/AIDS patients which dominated by males gender and age group 21-30 years old was very varied, in which the most common cutaneous manifestation is condyloma acuminate.Keywords: Cutaneous manifestations, HIV/AIDS.
Association between obesity and history of atopy with atopic dermatitis in children: A cross-sectional study Batan, Putu Nila Wardhani; Ariana, Ariana; Wardhana, Made
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: The prevalence of atopic dermatitis (AD) has rapidly increased in the past 4 decades and has been mostly observed in children. The prevalence of obesity has also significantly increased worldwide, suggesting that the two conditions may be associated. Methods: This retrospective analytic study involved a cross-sectional design and used secondary data taken from the medical record of patients who visited the Pediatric Dermatology Subdivision at Dermatology and Venereology Polyclinic Sanglah General Hospital from January 2015 to December 2015. Thirty-two samples were selected. Results: The prevalence ratio of obesity among subjects with AD was 2.178 (95% CI = 1.034–4.587; p < 0.05), which indicated a significant association between obesity and AD. This study also found a significant association between the history of atopy and AD, and the prevalence ratio was 2.566 (95% CI = 1.099–5.990; p < 0.05). The risk of developing AD among children with obesity was higher than that among children without obesity. Conclusion: Obesity and history of atopy were significantly associated with AD in children.
VALIDASI KRITERIA MINOR PADA DERMATITIS ATOPIK Sadeli, Marrietta Sugiarti; Wardhana, Made
E-Jurnal Medika Udayana Vol 11 No 2 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i02.P01

Abstract

Dermatitis atopik adalah penyakit kulit inflamatif kronis, disebut juga eksema atopik, prurigo besnier, neurodermatitis diseminata. Diagnosis dermatitis atopik berdasarkan keluhan dan gambaran klinis. Hanifin Rajka telah membuat kriteria diagnosis untuk dermatitis atopik yang didasarkan pada kriteria mayor dan minor yang sampai sekarang masih banyak digunakan. Kriteria mayor dan beberapa kriteria minor pada setiap pusat pelayanan berbeda-beda. Tujuan penelitian ini adalah untuk mencari frekuensi, sensitivitas dan spesifisitas kriteria minor dan nilai pH. Ini merupakan sebuah studi case-control untuk mengetahui frekuensi, sensitivitas dan spesifisitas kriteria minor dan nilai pH pada pasien dermatitis atopik di RSUP Sanglah, Denpasar. Terdapat 29 kasus dan 24 kontrol, dihitung sensitivitas, spesifisitas, nilai prediktif positif dan nilai prediktif negatif pada masing-masing kriteria minor. Xerosis memiliki nilai sensitivitas yang paling tinggi, sebesar 89,6 %. Dari 23 kriteria minor, beberapa diantaranya diteliti pada studi ini. Tanda yang paling sering dijumpai adalah xerosis/kulit kering terjadi pada 26 kasus diikuti kecendungan infeksi kulit berulang terjadi pada 25 kasus dan awitan dini pada 24 kasus. Dengan hasil validasi, sensitivitas tertinggi pada Xerosis sebesar 89.6%, spesifisitas dan PPV tertinggi pada Dennie-Morgan infraorbital sebesar masing-masing 91,6% dan 90% dan NPV tertinggi pada tanda Xerosis sebesar 84,2%. Temuan lain berupa hasil pengukuran nilai pH terbanyak pada nilai pH tinggi (>5,5) sebesar 23 kasus dengan sensitivitas sebesar 79,3%. Kata kunci: validasi, kriteria diagnosis, kriteria minor, kriteria mayor, dermatitis atopik, eksema atopik
CHARACTERISTICS OF DERMATOPHYTOSIS PATIENTS AT DERMATOVENEROLOGY CLINIC OF RSUP SANGLAH DENPASAR DURING THE PERIOD OF 2017-2019 Natih, Sintha Aprillia Gita; Wardhana, Made; Puspawati, Ni Made Dwi; Karmila, IGAA Dwi
E-Jurnal Medika Udayana Vol 11 No 2 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i02.P04

Abstract

Dermatophytosis is a desases that caused by dermatofita from the family of arthrodermatacecae. There are six types of dermatofitosis based on the lesi location ; which are tinea korporis, tinea kruris, tinea pedis, tinea kaptisis, tinea unguium, tinea barbae and tinea kapitis. tinea korporis and tinea kruris are the most common happens in the dermatifita deases. This research conduct with a descriptive retrospektif method using secondary data from the patient book registration at dermatovenerology clinic of RSUP Sanglah Denpasar during the period of 2017-2019. the data collection base on the criteria of age, sex, old or new patient, type of dermatophytosis and the type of theraphy. during the researc, 123 data were meet the criteria of age, sex,old or new patient, type of dermatophytosis and the type of therapy. Thus, the data analyzed deskriptifly. the highest percentage obtained are tines corporis (33,6%) age group range 1-14 years old (25,4%) 15-24 years old (25,4%), male (55,0%), old patient (51,6%), combination theraphy (54,1%) Keywords : Dermatophytosis, Tinea, Descriptive
The positive correlation between psoriasis vulgaris severity degree with HbA1C level Made Swastika Adiguna; Made Wardhana; Fresa Nathania Rahardjo
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 2 (December 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/w3yp6214

Abstract

Introduction: Psoriasis is a skin abnormality based on chronic inflammation immune-mediated. Insulin resistance and psoriasis seem to have a connection, but it has not been explained clearly. HbA1c describe the glucose concentration and demonstrate the insulin resistance condition indirectly. Objective: This study aims to understand the correlation between psoriasis vulgaris severity degree with HbA1c. Material and methods: This study was using a cross sectional method. Psoriasis vulgaris diagnosed clinically and assessed with the PASI score. The HbA1c level examination done by drawing venous blood then analyzed with chromatography method. Samples were selected by using inclusion and exclusion criteria and a consecutive sampling method. Results: Total 51 subjects (33 subjects with psoriasis vulgaris and 18 subjects without psoriasis vulgaris) were included in this study. Mostly (57.6%) of the subject was mild, 24.2% moderate, and 18.2% severe psoriasis. HbA1c level of psoriasis vulgaris subjects is significantly higher than non-psoriasis vulgaris subjects (p=0.019, PR=6.545). Correlation between severity degree and HbA1c level found in positive course significantly with moderate strength of correlation (r = 0.580, p<0.001). Conclusion: HbA1c level on psoriasis vulgaris subjects are higher than non-psoriasis vulgaris. Psoriasis vulgaris severity degree positively correlated with HbA1c.
High plasma dopamine level as a risk factor for atopic dermatitis Made Swastika Adiguna; Made Wardhana; Ermon Naftali Limbara
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pnkrda77

Abstract

Background: Dopamine is responsible for inflammatory response and plays a role in the skin immune system by modulating T-cells, dendritic cells, and keratinocytes which increases skin inflammatory response in atopic dermatitis (AD). Elevation of dopamine level will affect IL-6, IL-8, IL-23, Th-17, and TNF-α, which promotes keratinocyte proliferation and differentiation, infiltration of inflammatory cells, angiogenesis, vasodilation, and skin barrier disruption on AD. Objective: This study aimed to establish whether the increase of plasma dopamine level contributes to a risk factor for AD occurrence. Methods: This is a matched-pair case-control observational analytical study which involves patients with AD and without AD as control. Samples were taken using a consecutive sampling method which fulfilled inclusion and exclusion criteria, matched for gender and age. Plasma dopamine level was measured from venous blood and processed using enzyme-linked immunosorbent assay (ELISA) method. The collected data were then analysed using SPSS version 20.0 with Pearson chi-square test for the odds ratio. Results: A total of 30 samples with AD (case group) and 30 samples without AD (control group) involved in this study. This study proves that plasma dopamine levels in the case group were significantly higher than the control group (p<0.05). Odds ratio for plasma dopamine was 42.2 (95%CI: 9.5-187.2, p < 0.001). Conclusion: This study concludes that high plasma dopamine level is a risk factor for AD.
High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris Anak Agung Gde Putra Wiraguna; Made Wardhana; Made Kusuma Dewi Maharani
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vacekd89

Abstract

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion. Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne. Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS. Results: H2O2 mean level in the case and control group, respectively 0.68 ± 0.03 and 0.42 ± 0.04 µmol/ml. High H2O2 level was determined from cut-off point >0.62 µmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p<0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 ± 0.06 and 0.74 ± 0.07 U/ml. Low catalase level was determined from the cut-off point <0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p<0.001; 95% CI: 5.18-77.21; OR: 20.00). Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.
Positive correlation of psoriasis vulgaris severity and HOMA-IR Made Wardhana; Made Swastika Adiguna; Putu Ayu Diah Nareswari
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/0x8dn445

Abstract

Background: Psoriasis vulgaris is a chronic inflammatory skin disease that its aetiology is still not completely known. A chronic inflammation in psoriasis can cause organ dysfunctions. Elevation of proinflammatory cytokines gives rise to insulin resistance by inhibiting insulin and glucose transport mechanism signals. Insulin resistance is the underlying pathogenesis of metabolic syndrome. Objective: This study aimed to undestand any correlation in the severity of psoriasis vulgaris with HOMA-IR. Methods: A cross sectional research involving 35 subjects with psoriasis vulgaris and 15 subjects without who met the selection criteria. HOMA-IR is a formula used to measure insulin resistance which calculates the fasting insulin value in μU/ml x fasting glucose in mg/DL/405 taken from the blood veins of subjects. PASI score was used to determine psoriasis vulgaris severity. Results: This study shows that the HOMA-IR median value was higher in psoriasis subject than the subjects without psoriasis (p<0.05). The correlaton analysis shows a moderate positive correlation between psoriasis vulgaris severity and HOMA-IR (r= 0.427; p<0.05). The prevalence ratio was 8.57, which means psoriasis vulgaris subjects were 8.57 times more likely to have HOMA-IR compared to those without psoriasis vulgaris (p<0.05; 95%CI: 1.26-58.1). Conclusion: This study concludes that there is a moderate positive correlation between severity of psoriasis vulgaris and HOMA-IR values.
Co-Authors Adeline Santoso Ana Rahmawati Anak Agung Gde Putra Wiraguna Anak Agung Gde Putra Wiraguna Ariana Ariana Ariana Ariana Batan, Putu Nila Wardhani Dewi Gotama Ermon Naftali Limbara Ermon Naftali Limbara Fresa Nathania Rahardjo Fresa Nathania Rahardjo Gde Ngurah Arya Ariwangsa Gde Somayana GK Darmaputra I Dewa Nyoman Wibawa I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman Sunyamurti Wirawan I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Nyoman Darmaputra I Ketut Mariadi I Ketut Suastika I.G.A. Karmila Ida Ayu Intan Pratiwi Ida Ayu Trisna Dewi IGAA Ratna Medikawati, IGAA Ratna IGN Darma Putra Ivana Sugiarto Ketut Suata Limbara, Ermon Naftali Luh Made Mas Rusyati Made Kusuma Dewi Maharani Made Kusuma Dewi Maharani Made Martina Windari Made Puspawati Made Swastika Adiguna Maharani, Made Kusuma Dewi Marrietta Sugiarti Sadeli Marrietta Sugiarti Sadeli Martima W Martina Windari Martina Windari Nareswari, Putu Ayu Diah Natih, Sintha Aprillia Gita Ni Luh Putu Ratih Vibriyanti Karna Ni Luh Putu Sri Widhiastuty Ni Made Dwi Puspawati Ni Putu Tiza Murtia Margha Nila Puspasari Nila Wardani Nila Wardhani Batan Nyoman Suryawati Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Pande Agung Mahariski Prima Sanjiwani Puspawati . Putu Ayu Diah Nareswari Putu Ayu Diah Nareswari Putu Kurniawan Dhana Rahardjo, Fresa Nathania Ratih Vebrianti Ricky Fernando Maharis Rikcy Fernando Maharis Sadeli, Marrietta Sugiarti Sissy Sissy Sunny Wangko Suryawati . Wiraguna, Swastika Adiguna