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Cutaneous Manifestations of Breast Cancer Patients in Combination with Capecitabine and Lapatinib Chemotherapy Nita Damayanti Sulistianingrum; Niken Indrastuti; Yohanes Widodo Wirohadidjojo
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 23, No 1 (2023): January
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v23i1.12276

The combination of chemotherapy with lapatinib and capecitabine in human epidermal growth factor receptor 2 (HER2) positive breast cancer is quite effective. The combination of these two agents increases the risk of dermatological toxicities. A woman, 38 years old, HER2 positive breast cancer with a combination of chemotherapy agents between lapatinib and capecitabine gives an overview of skin toxicities such as acneiform eruptions, palmar-plantar erythrodysesthesia (PPE), and paronychia. Therapy, in this case, aims at clinical improvement. The combination of lapatinib and capecitabine has a side effect profile like each drug. Combined use of the two agents increases the incidence of skin side effects, including acneiform eruptions, PPE, and paronychia, compared to monotherapy. Early awareness of the side effects of chemotherapeutic agents is needed for early treatment to prevent the worsening of the condition and discontinuation of chemotherapeutic agents due to drug side effects.

Manajemen Psoriasis Pustulosa Yefta; Dwi Retno Adi Winarni; Yohanes Widodo Wirohadidjojo
Cermin Dunia Kedokteran Vol 50 No 3 (2023): Kardiologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i3.658

Psoriasis merupakan penyakit radang kulit kronis dengan dasar genetik yang kuat. Berdasarkan tipenya, psoriasis dibagi menjadi psoriasis plak (psoriasis vulgaris), psoriasis gutata, psoriasis pustulosa generalisata/lokalisata, psoriasis inversa, dan eritroderma psoriatika. Manajemen psoriasis pustulosa mempertimbangkan tingkat keparahan penyakit. Acitretin, cyclosporine, methotrexate, dan infliximab merupakan terapi lini pertama untuk psoriasis pustular generalisata. Adalimumab, etanercept, dan psoralen plus ultraviolet A (PUVA) adalah modalitas lini kedua. Berbagai modalitas terapi lain yang sedang dikembangkan adalah agen biologis dan terapi berdasar sel punca. Manajemen psoriasis pustulosa dapat menggunakan berbagai modalitas dengan memperhatikan kondisi pasien dan keterjangkauan terapi Psoriasis is a chronic skin inflammation with a strong genetic basis. Based on its type, psoriasis is divided into plaque psoriasis (psoriasis vulgaris), guttate psoriasis, generalized/localized pustular psoriasis, inverse psoriasis, and psoriatic erythroderma. The management of pustular psoriasis depends on the disease severity. Acitretin, cyclosporine, methotrexate, and infliximab are first-line therapies for generalized pustular psoriasis. Adalimumab, etanercept, and psoralen plus ultraviolet A (PUVA) are second-line modalities. Other therapeutic modalities being developed are biologic agents and stem cell-based therapies. Management of pustular psoriasis can use various modalities, depending on the patient’s condition and its affordability

Papuloerythroderma of Ofuji: A first case report from Indonesia Regina, Graciella; Paramita, Listya; Radiono, Sunard; Wirohadidjojo, Yohanes Widodo; Faber, William R
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Papuloerythroderma (PE) is a rare skin disease which was first described by Ofuji et al. in 1984, with a typical sign that the lesions spare the large cutaneous folds, known as the deck chair sign. Due to its recent identification, this disease is still underrecognized and may lead to misdiagnosis. We reported the first case report of PE of Ofuji from Indonesia in which the diagnosis was delayed for two years. Besides the deck chair sign in the large cutaneous fold, we also found that the area between and above his eyebrows that was relatively spared in contrast to the sparing of the cutaneous folds, and it may be considered as pseudo-deck chair sign. The patient showed good response with combination therapy of phototherapy with Narrow-Band Ultraviolet B (NBUVB), oral methotrexate, and corticosteroids. The deck chair sign disappeared after six months therapy, but the patient’s skin was still xerotic.

Achatina fulica Mucus Ameliorates UVB-induced Human Dermal Fibroblast Photoaging via the TGF-β/Smad Pathway Christiana Tri Nuryana; Tiara Puspita Agustin; Sofia Mubarika Haryana; Yohanes Widodo Wirohadidjojo; Nur Arfian
The Indonesian Biomedical Journal Vol 15, No 6 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i6.2580

BACKGROUND: Ultraviolet B (UVB) induces skin photoaging by reducing collagen deposition via impairment of the TGF-β/Smad signaling pathway. Achatina fulica mucus (AFM) is a native medicine acting as vehicle of anti-aging ingredients. The present investigation examined the effect of AFM on UVB-induced fibroblast photoaging by assessing TGF-β, Smad3, and Smad7 mRNA expressions.METHODS: AFM was extracted from A. fulica using electrical shock and freeze-dried into a powder. Normal human dermal fibroblast (NHDF) cultures were irradiated with/without 100 mJ/cm2 UVB and treated with/without 10% platelet-rich plasma or different concentrations of AFM: 3.9 μg/mL in AF3 group; 15.625 μg/mL in AF15 group, and 62.5 μg/mL in AF62 group. The mRNA expressions of TGF-β, Smad3, and Smad7 in NHDF were evaluated by quantitative polymerase chain reaction.RESULTS: TGF-β mRNA expressions in the AF3 (0.85±0.01), AF15 (0.94±0.02) and AF62 (1.64±0.03) groups were significantly higher (p<0.05) compared with that in the UVB group (0.55±0.04). Moreover, Smad3 expressions in the AF3 (1.42±0.25), AF15 (1.89±0.13), and AF62 (2.50±0.31) groups were significantly higher (p<0.05) compared with that in the UVB group (0.57±0.08). Furthermore, Smad7 expressions in the AF3 (1.57±0.18), AF15 (0.87±0.03), and AF62 (0.25±0.09) groups were significantly lower (p<0.05) than that in the UVB group (2.57±0.06).CONCLUSION: AFM ameliorates UVB-induced fibroblast photoaging by upregulating the TGF-β/Smad3 expressions and downregulating Smad7 expression.KEYWORDS: Achatina fulica, TGF-β, Smad, collagen, UVB, fibroblast, photoaging

Epigenetic Alterations in Keloid a Possible Method to Find Novel Agents for Keloid Treatment Budiyanto, Arief Budiyanto; Wirohadidjojo, Yohanes Widodo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.60-67

Background: Keloids are dermal fibro-proliferative disorders due to prolonged wound healing processes with excessive collagen depositions, which produce symptoms of itching and pain, cosmetic disfigurement, and limitation of joint motion. Standard treatment for keloid has not been accepted yet. It may be due to the complexities and poorly understood keloid development that are driven by various factors from systemic to local, genetic to epigenetic. Since genetic factors are difficult to manipulate, an approach to epigenetic factors may be hopeful. Purpose: To review various related reports on epigenetic factors such as DNA methylations, histone modifications, and micro-RNAs, which have significant roles in keloid development and can be used as targets for novel agents in keloid treatment. Review: Various genes in keloid fibroblasts (KFs) are repressed by DNA methylation, and one of them can inhibit the regulation of TGF-β1/Smad signaling, whereas another gene may influence anti-fibrotic events. Either inhibitor of methyl-transferase, inhibitor of histone-acetyltransferase, or histone-deacetylase can reduce TGF-β1/Smad signaling in KFs. Abnormal expressions of pro-fibrotic miRNAs have been identified in KFs and transfection KFs with anti-fibrotic miRNAs such as miRNA-205 and miRNA- 31, evidently can inhibit VEGF signaling. Furthermore, transfection of miRNA-637 into KFs can inhibit KFs in proliferation, migration, and collagen synthesis through TGF-β1/Smad signaling. Apoptosis and cellular senescence in KFs can also be stimulated by miRA-34 and miRNA-30. Conclusion: In the future, targets in epigenetic events such as inhibitors of methyl-transferase, histone-acetyltransferases, and histone-deacetylases, together with various miRNA, may be applied as novel agents for the treatment of keloid.

Manajemen Psoriasis Pustulosa Yefta; Dwi Retno Adi Winarni; Yohanes Widodo Wirohadidjojo
Cermin Dunia Kedokteran Vol 50 No 3 (2023): Kardiologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i3.658

Psoriasis merupakan penyakit radang kulit kronis dengan dasar genetik yang kuat. Berdasarkan tipenya, psoriasis dibagi menjadi psoriasis plak (psoriasis vulgaris), psoriasis gutata, psoriasis pustulosa generalisata/lokalisata, psoriasis inversa, dan eritroderma psoriatika. Manajemen psoriasis pustulosa mempertimbangkan tingkat keparahan penyakit. Acitretin, cyclosporine, methotrexate, dan infliximab merupakan terapi lini pertama untuk psoriasis pustular generalisata. Adalimumab, etanercept, dan psoralen plus ultraviolet A (PUVA) adalah modalitas lini kedua. Berbagai modalitas terapi lain yang sedang dikembangkan adalah agen biologis dan terapi berdasar sel punca. Manajemen psoriasis pustulosa dapat menggunakan berbagai modalitas dengan memperhatikan kondisi pasien dan keterjangkauan terapi Psoriasis is a chronic skin inflammation with a strong genetic basis. Based on its type, psoriasis is divided into plaque psoriasis (psoriasis vulgaris), guttate psoriasis, generalized/localized pustular psoriasis, inverse psoriasis, and psoriatic erythroderma. The management of pustular psoriasis depends on the disease severity. Acitretin, cyclosporine, methotrexate, and infliximab are first-line therapies for generalized pustular psoriasis. Adalimumab, etanercept, and psoralen plus ultraviolet A (PUVA) are second-line modalities. Other therapeutic modalities being developed are biologic agents and stem cell-based therapies. Management of pustular psoriasis can use various modalities, depending on the patient’s condition and its affordability

A Rare Case of Lower Limb Poroid Hidradenoma Anggreana, Farisa; Shelly, Wan Gifanni Efmadian; Fitriani, Katia; Andayani, Raden Roro Rini; Wirohadidjojo, Yohanes Widodo
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1354

Introduction: Poroid hidradenoma (PH) is a benign tumor of the eccrine gland, which is the rarest variant of poroid tumor. The case reports that have been published since 1990 are around 75 cases. The presentation of PH lesions is nonspecific and varied, which often leads to misdiagnosis and requires histopathological examination to confirm the diagnosis. Case Presentation: A 53-year-old woman came with complaints of a prominent wound on her right lower leg for 4 years. Physical examination showed a partially bluish erythematous nodule accompanied by blackish brown crusted erosion in the central area, 1 cm in diameter, and solitary. Dermoscopic examination shows a central blue-grey pigmented area, a whitish halo, and erosion. The differential diagnosis of this case is keratoacanthoma, eccrine poroma, dermal duct tumor, and PH. Histopathological findings showed solid and cystic components, as well as poroid and cuticular cells in the dermis area. The final diagnosis in this case is PH.Conclusion: This report shows the challenge of PH diagnosis that requires an in-depth understanding of the clinical manifestation, dermoscopic, and histopathologic features.

Erythroderma due to generalized pustular psoriasis in an infant: A case report of a rare condition Anggatama, Marcella; Rinonce, Hanggoro Tri; Wirohadidjojo, Yohanes Widodo; Danarti, Retno
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 3, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss3.art15

Erythroderma is a widespread redness of the skin accompanied by exfoliation that affects over 90% of the body surface. Its presence in infants is clinically important because it can be life-threatening, making it essential for paediatricians and dermatologists to be vigilant. Various skin diseases can cause erythroderma. Timely, accurate identification of the underlying cause results in improved treatment and prognosis. Generalized pustular psoriasis is one of many causes for erythroderma. Nevertheless, this condition is rare in infants, making it challenging to diagnose and treat. The current medical evidence for treatment is primarily derived from case reports rather than clinical trials. Hence, this case report aims to share the authors’ experience in treating infants aged 6 months with erythroderma caused by generalized pustular psoriasis. In our case, the diagnosis was determined by completing the patient's medical history, performing a physical examination, and conducting a histopathological examination. The treatment involved the topical application of moisturizers containing ceramide as well as the systemic administration of steroids and vitamin D. Due to the restricted availability of systemic retinoids, the authors administered steroids in this particular case, resulting in an improved outcome.

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