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MANIFESTASI KULIT PADA INFEKSI VIRUS NEW EMERGING DAN RE-EMERGING DI INDONESIA Mufqi Handaru Priyanto; Triana Agustin; Eliza Miranda; Sandra Widaty; Sri Linuwih Menaldi
Media Dermato-Venereologica Indonesiana Vol 50 No 3 (2023): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v50i3.247

Abstract

Virus merupakan patogen infeksius yang dapat menyebabkan berbagai penyakit life-threatening, dan memiliki kemampuan untuk berevolusi seiring dengan evolusi manusia sebagai pejamu. Virus new-emerging, memiliki patogenitas yang lebih tinggi karena belum terbentuk imunitas alamiah pada pejamu. Selain itu, berbagai virus re-emergingjuga menjadi ancaman tersendiri karena kemampuannya yang tinggi untuk berevolusi, sehingga keberadaan virus emergingini menyebabkan outbreak, epidemi, dan pandemik global. Indonesia dengan letak geografis yang strategis dan habitat fauna yang beragam, berpotensi besar bagi transmisi zoonosis dan tempat berkembang yang ideal bagi vektor pada penyakit virus. Beberapa infeksi virus new emergingcontohnya virus swine fludan SARS-CoV-2, serta virus re-emergingmisalnya virus chikungunya dan measles yang dilaporkan di Indonesia, tidak hanya memberikan gejala klinis yang biasa, namun dapat disertai dengan manifestasi pada kulit. Beberapa manifestasi pada kulit tersebut juga dapat menjadi penanda khas terhadap jenis inveksi virus yang berperan sebagai patogen. Identifikasi terhadap lesi kulit pada penyakit-penyakit akibat infeksi virus penting untuk dilakukan, dan memiliki peran untuk mengarahkan pada kemungkinan diagnosis dan tata laksana yang tepat.
KOMORBIDITAS PADA AKNE Andira Hardjodipuro Hardjodipuro; Rinadewi Astriningrum; Irma Bernadette; Lili Legiawati; Sandra Widaty
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.334

Abstract

Akne vulgaris (AV) merupakan salah satu penyakit kulit yang paling sering ditemui, terutama pada remaja dan dewasa muda. Patogenesis terjadinya AV setidaknya diperankan oleh empat faktor penting, yaitu hiperproliferasi lapisan epidermis pada folikel, peningkatan produksi sebum, proses peradangan, dan kolonisasi Cutibacterium acnes. Proses tersebut juga dipengaruhi oleh berbagai faktor, antara lain faktor genetik, hormonal, psikologis, gaya hidup, dan lingkungan. Lesi AV bersifat polimorfik dan memiliki derajat keparahan yang beragam. Lesi tersebut diketahui memberikan dampak terhadap kualitas hidup penderitanya. Berbagai studi terkini melaporkan bahwa terdapat berbagai komorbiditas yang dapat memberikan beban tambahan atau memperburuk kondisi AV. Komorbiditas didefinisikan sebagai penyakit yang terjadi secara simultan. Berbeda dengan sindrom yang memiliki arti sekumpulan gejala yang terjadi serentak atau sekumpulan tanda yang menandakan suatu penyakit tertentu. Komorbiditas akne yang telah banyak diinvestigasi antara lain resistensi insulin, hipovitaminosis D, 1 hipervitaminosis B12, gangguan gastrointestinal, gangguan psikologis, disfungsi kelenjar tiroid, dislipidemia, defisiensi seng, dan hipovitaminosis A dan E.
KASUS SERIAL: EFEKTIVITAS TERAPI DERMATITIS SEBOROIK BERDASARKAN PANDUAN PENGOBATAN 2017 Rhida Sarly Amalia; Dini Daniaty; Sandra Widaty
Media Dermato-Venereologica Indonesiana Vol 49 No 3 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i3.430

Abstract

Dermatitis seboroik (DS) merupakan penyakit kulit inflamasi di area seboroik dengan berbagai faktor yang mempengaruhinya, antara lain interaksi flora normal dan kerentanan individu. Perjalanan penyakit DS kronis dan rekuren, sehingga penting mengetahui efektivitas terapi yang diberikan. Laporan kasus ini bertujuan mengetahui efektivitas terapi DS dengan modalitas baru berdasarkan Konsensus Asia 2016 dan Pedoman Nasional Pelayanan Kedokteran (PNPK) DS 2017, dengan pilihan pengobatan lini pertama yaitu obat topikal anti jamur golongan azol, diikuti kortikosteroid topikal. Dilaporkan lima kasus pasien DS dewasa dengan lesi di area skalp yang berobat di poliklinik Dermatologi dan Venereologi RSUPN dr. Cipto Mangunkusumo (RSCM) periode tahun 2017-2020 yang terdokumentasi pada rekam medis. Keparahan DS dinilai dengan skor Seborrheic Dermatitis Area Severity Index (SDASI) dan pilihan terapi diberikan sesuai dengan skor SDASI. Didapatkan hasil bahwa seluruh pasien telah ditatalaksana sesuai dengan Konsensus Asia 2016 dan PNPK 2017. Disimpulkan bahwa Konsensus Asia 2016 dan PNPK 2017 dapat digunakan sebagai algoritama terapi DS, dengan hasil sembuh atau perbaikan. Pengobatan DS ringan dengan menggunakan Obat Anti Jamur (OAJ) topikal dan DS sedang dengan kortikosteroid topikal menunjukkan hasil yang baik. Beberapa pasien mengalami rekurensi, hal ini dapat dikarenakan adanya faktor pencetus serta komorbid pada pasien yang belum teratasi.
Microbioma in Aging Skin Nugraheni Pasaribu, Uly Aanda Maria; Rihatmadja, Rahadi; Yusharyahya, Shannaz Nadia; Widaty, Sandra; Legiawati, Lili; Pandjaitan-Sirait, Sondang MHA
Journal La Medihealtico Vol. 5 No. 3 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i3.1315

Abstract

Microbiota is inseparable to the skin. Just as in the gastrointestinal tract, the skin microbiome reflects the health of the organ where it resides. It contributes to skin barrier function and ensures its homeostasis. However relatively stable over time, microbiome composition and number may be influenced by various aging -related changes − dryness, blemish, wrinkles and alteration of sebaceous gland activity impacting the skin ecological conditions − and vice versa. Several generations have been reported to promote the process while others may play a more protective role in this regard.
PENYUSUNAN DAN UJI COBA PROGRAM INTERPROFESSIONAL EDUCATION (IPE) DARING PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS X: SEBUAH STUDI DENGAN METODE CAMPURAN Suryanti, Suryanti; Diantha, Soemantri; Sandra, Widaty; Hamzah, Hamzah
Jurnal Inovasi dan Teknologi Pendidikan Vol. 1 No. 3 (2023): Jurnal Inovasi dan Teknologi Pendidikan
Publisher : LPPM Universitas Bina Bangsa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46306/jurinotep.v1i3.29

Abstract

InterProfessional education (IPE) is a strategy used to prepare interprofessional collaboration teams in the future. However, with the various restrictions on social interaction during the COVID-19 pandemic, it encourages innovation in learning methods. Therefore, this study aims to design an online interprofessional learning module at the Faculty of Medicine of X University (FK X) as a strategy to prepare collaboration teams in the future. This study uses a mixed-method approach to obtain the data needed. A qualitative approach is used to obtain an overview of stakeholders' needs for online IPE learning design. The respondents consisted of study program leaders, lecturers and students of several study programs at the Faculty of Medicine, University X (FK X). Data collection was carried out with structured interviews and focus group discussions (FGDs). The data is recorded and made verbatim, then coding is carried out and arranged into themes and sub-themes.  Evaluation of the online IPE teaching design was carried out by measuring students' perceptions of interprofessional education before and after taking the module using the IEPS (Interdisciplinary Education Perception Scale) questionnaire. The first stage of qualitative research (structured interviews and FGDs) on the leadership element, 2 lecturers, and 5 students of each study program resulted in as many as 14 themes and 47 sub-themes which were described into module learning outcomes, study topics, learning activities, and characteristics of online IPE module students. The module evaluation was carried out by testing the differences in perceptions of 252 students towards pre- and post-module interprofessional education. Wilcoxon's bivariate test results showed a significant difference in perception scores for post-module inteprofessional education compared to premodule( p=0.00). There is a positive difference, namely the number of post-module scores that are greater than the pre-module score of 141 people. The increase in perception scores can also be seen from the results of the bivariate analysis of the Medicine, Nursing, Midwifery, and Psychology Study Programs. This research shows that the implementation of the FK X online IPE module has succeeded in increasing students' perceptions of competence and autonomy, the perceived need to cooperate, and perceptions of interprofessional cooperation. This breakthrough is an alternative solution that can be considered for interprofessional learning during a pandemic
Clinical and microbiological characteristics of onychomycosis in a tertiary hospital: a cross-sectional study Widaty, Sandra; Oktarina, Caroline; Marissa, Melani; Adawiyah, Robiatul; Rozaliyani, Anna; Kartika, Emiliana; Tugiran, Mulyati
Medical Journal of Indonesia Vol. 33 No. 1 (2024): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247201

Abstract

BACKGROUND Onychomycosis is a common fungal nail infection with a low cure rate. While dermatophytes are the most common causal agent for onychomycosis, the incidence of Candida and nondermatophyte mold (NDM) onychomycosis is increasing. This study aimed to analyze the clinical and microbiological characteristics of patients with onychomycosis. METHODS Patients who visited the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, and were diagnosed with onychomycosis from 2017 to 2022 were included. Diagnosis was established through clinical examination, supported by the result of direct microscopic examination with potassium hydroxide. RESULTS Of 171 patients, 93.6% had onychodystrophy, 65.5% were females, and 62.0% were aged 19–59 years. Most patients had onychodystrophy in more than three nails, affecting fingernails (31.6%) and toenails (34.5%). Interestingly, 84.8% of patients had no history of nail diseases. The median onset of disease was 24.0 (1–1,040) weeks, while the median onychomycosis severity index was 10.0 (2–40). Most cases were caused by Candida albicans (48.3%). Fusarium was the only NDM documented (2.3%). Some patients were resistant to itraconazole (11.4%) and miconazole (4.5%). Overall, 49.1% of the patients were declared not cured. CONCLUSIONS Candida was the predominant cause of onychomycosis, and onychodystrophy was the dominant feature. Current treatment regimens with systemic or topical antifungal agents did not yield satisfactory results, with more than half of the patients deemed not cured.
Telogen effluvium incidence in women wearing hijab compared to non-hijab: A cross-sectional study Sirait, Sondang Pandjaitan; Widaty, Sandra; Legiawati, Lili; Surachmiati Suseno, Lis; Krisanti, Roro Inge Ade; Budianti, Windy Keumala; Miranda, Eliza; Rihatmadja, Rahadi; Oktarina, Caroline; Pandelaki, Paulus Anung Anindita; Situmeang, Irhen
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Hair loss is a normal experience, but if the amount of hair loss exceeds what is considered normal, it will usually cause anxiety for the patient. In Indonesia, almost every Muslim woman wears a hijab. The hijab is one of many factors believed to cause hair loss. Telogen effluvium (TE) itself is a hair cycle disorder in which the anagen phase terminates prematurely, resulting in diffuse club hair loss without scarring, and TE itself has many risk factors. The purpose of this study was to determine the relationship between the incidence of TE in women who wear hijabs and those who do not. Methods: This cross-sectional study was conducted from August 2019 to April 2021 involving 188 healthy women aged 18 years and over who had not yet reached menopause. In the hijab group, it was determined that they should wear a minimum of 8 hours a day for at least 5 years. The test was carried out on hair that had not been washed using a trichogram, to look for hair characteristics in each group (hijab-wearing and non-hijab-wearing). Analysis of the data obtained was carried out using the Chi-square test and odds ratio. Results: Telogen effluvium was higher in subjects wearing hijab (26.8%) than in subjects who did not wear hijab (18.1%), (p-value 0.040, OR 2.036). Conclusion: There was a significant relationship between TE in women who wear hijab compared to those who do not. Further studies should be conducted in other populations with a larger sample size to confirm these results.
The spectrum of cutaneous manifestations in COVID-19 patients at Dr. Cipto Mangunkusumo Hospital Widaty, Sandra; Menaldi, Sri Linuwih Susetyo Wardhani; Miranda, Eliza; Marissa, Melani; Nilasari, Hanny; Melinda, Thong Felicia; Cornain, Emilina Faradila
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Cutaneous manifestations are identified in 0.2%–20% of COVID-19 cases, both in adult and pediatric patients. They can occur before, simultaneously with, or after the systemic symptoms of COVID-19. This study aims to analyze the association between cutaneous manifestations, severity, and outcomes of patients with COVID-19. Methods: This observational study was conducted from April 2020 to April 2021 in Dr. Cipto Mangunkusumo Hospital, a referral center for COVID-19 in Jakarta, Indonesia. Medical records were used to collect demographic, clinical, and laboratory data. Results: A total of 0.61% (31/5070) of COVID-19 cases showed cutaneous manifestations, consisting of maculopapular (80.6%), vesicular (16.1%), livedoid (6.4%), pseudo-chilblain (3.2%), and urticarial (3.2%) lesions, with three patients showing more than one cutaneous manifestation. In the present study, only 2,001 out of 5,070 patients were appropriately confirmed to suffer from COVID-19 infection. Multisystem inflammatory syndrome in children (MIS-C) was identified in one out of eleven patients under 21 years old. Laboratory examinations showed an increased neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin, D-dimer, and creatinine alongside a decreased albumin level. Conclusion: We reported various cutaneous manifestations and diagnostic test results associated with COVID-19. More than one cutaneous manifestations are present in several COVID-19 patients in our study. Several contradictory findings relative to previous publications indicate the necessity of collecting more data regarding the cutaneous manifestation of COVID-19.
Systemic antibiotic selection in skin and soft tissue infections Purnawan, Shafira Anindya; Budianti, Windy Keumala; Widaty, Sandra
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Antibiotics are used in daily practice. To properly select antibiotics, it is important to pay attention to the definitive diagnosis, class of antibiotic, dose, interval, route of administration, and exact duration of use. Discussion: The World Health Organization (WHO) categorizes antibiotics into three groups: Access, Watch, and Reserve—known as the AWaRe classification—to help guide appropriate usage and combat antibiotic resistance. The Gyssens flowchart serves as a valuable tool for clinicians to qualitatively evaluate antibiotic utilization. In skin and soft tissue infections (SSTIs), treatment strategies are tailored according to the characteristics of the infection, including purulence, necrosis, and overall severity. For mild-to-moderate non-purulent SSTIs, beta-lactam antibiotics, such as penicillin and cephalosporin, alongside lincosamides like clindamycin, are recommended as first-line therapies. In cases of moderate-to-severe non-purulent SSTIs, empirical therapy must account for methicillin-resistant Staphylococcus aureus (MRSA). Meanwhile, purulent SSTIs require an initial incision and drainage, with subsequent treatment options including topical antibiotics for mild cases and systemic antibiotics for more complicated or severe infections. Extensive purulent SSTI in adults is empirically considered MRSA. Conclusion: Control of antimicrobial resistance can be achieved by using antibiotics according to the AWaRe classification and evaluating the use of antibiotics qualitatively using the Gyssens flowchart.
Control of Scabies in a Boarding School Using 5% Permethrin Applied on Lesion Only Sungkar, Saleha; Wahdini, Sri; Kekalih, Aria; Rilanda, Risa; Angkasa, Hansen; Widaty, Sandra
ASEAN Journal of Community Engagement Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Scabies is one of the most neglected tropical skin diseases in Indonesia. It is usually found in overcrowded communities with poor hygiene. The gold standard for scabies treatment is the whole-body topical application of 5% permethrin cream. However, the treatment causes inconvenience and stickiness for a prolonged period. The modification of topical treatment by applying only to the lesion yielded results similar with whole-body topical application. We consider using this mode of treatment to control the disease in a boarding school. The study was conducted from June to August 2019. All students were examined by dermatologists, and individuals who were diagnosed with scabies were treated using 5% permethrin for 12 h before wash-off (week 0) applied on the lesion only and reapplied a week after. The evaluation was conducted on weeks 4 and 8 by observing scabies lesions. Local health cadres were also trained, and environmental interventions were also performed. A total of 75 participants were analyzed. Most lesions were found on predilection sites such as finger web spaces of the left (57.3%) and right (58.7%) hands, gluteal region (60%), and penis (40%). The cure rate (CR) was 83%–100% of the lesions in week 4, which increased to 95%–100% in week 8. The CR on week 8 compared with baseline was 94.7% (p < 0.001). A total of 23 cadres were trained, and from post-test, 84% of the cadres showed good knowledge of scabies management. This novel application of 5% permethrin cream on the lesion only is an effective alternative to the conventional whole-body topical application.
Co-Authors Andira Hardjodipuro Hardjodipuro Anna Rozaliyani Aria Kekalih Ariyati Yosi Artini Wijayanti Islami Bianti, Marsha Cornain, Emilina Faradila Darmawan, Irene Dewi Friska Dewi Lestarini Diantha, Soemantri Dini Daniaty Eliza Miranda Eliza Miranda Eliza Miranda Githa Rahmayunita Hamzah Hamzah Hanny Nilasari Hansen Angkasa Hartanto, David Dwiadiputra Henry Wan-Peng Lim Herwinda Brahmanti Huda Marlina Wati Irma Bernadette Islami, Artini Wijayanti Joanne Natasha Joses Saputra Kartika, Emiliana Keiko Gunardi Krisanti, Roro Inge Ade Kusmarinah Bramono Lili Legiawati Lili Legiawati Lili Legiawati Lim, Henry W Lis Surachmiati Luddwi Achmad Rizky M. Yulianto Listiawan Marissa, Melani Marsha Bianti Martinus Martinus Melinda, Thong Felicia Menaldi, Sri Linuwih Susetyo Wardhani Mochamad H Azis Mufqi Handaru Priyanto Mustika, Rita Novita Suprapto Nuary, Teffy Nugraheni Pasaribu, Uly Aanda Maria Oktarina, Caroline Oktavia, Nikken Rima Pandelaki, Paulus Anung Anindita Pandjaitan-Sirait, Sondang MHA Purnawan, Shafira Anindya Rahadi Rihatmadja Rhida Sarly Amalia Rilanda, Risa Rinadewi Astriningrum Rita Mustika Rizky, Luddwi Achmad Robiatul Adawiyah Saleha Sungkar Sammy Yahya Sari, Siti Maulidya Shannaz Nadia Yusharyahya Sirait, Sondang Pandjaitan Situmeang, Irhen Sondang Pandjaitan Sirait Sri L. Menaldi Sri Linuwih Menaldi Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Sri Wahdini Sujudi, Yufanti Surachmiati Suseno, Lis Suryanti Teffy Nuary Triana Agustin Tugiran, Mulyati Wati, Huda Marlina Windy Keumala Budianti Yahya, Sammy Yenny Rachmawati Yosi, Ariyati Yudo Irawan Yudo Irawan