Agnes Sri Siswati
Department Of Dermatology And Venereology, Faculty Of Medicine, Public Health, And Nursing Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia

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Pure Neural Leprosy Verdy Verdy; Arief Budiyanto; Agnes Sri Siswati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 1 (2015): BIKKK APRIL 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.927 KB) | DOI: 10.20473/bikk.V27.1.2015.70-76

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Background: Pure neural leprosy (PNL) is an infection by Mycobacterium leprae with clinical manifestation as nerve thickening, sensory nerve impairment, with or without motoric nerve involvement, and without skin lesion. Pure neural leprosy causes progressive degeneration of nerve function. Diagnosis establishement of PNL is difficult. Purpose: To discuss about PNL especifically in aspects of the diagnosis and therapy. Reviews: Gold standard in diagnosis of PNL is histopathological examination from nerve biopsy but this procedure is still difficult for various reasons. Some investigations can be done for PNL such as cytological fine needle aspiration, Mitsuda test, serology test for antibody anti-PGL1, electroneuromyography (ENMG), and polymerase chain reaction (PCR). Pure neural leprosy classification is based on findings of abnormality in neurological, immunological, and histopathological. Pure neural leprosy therapy is based on the classification of paucibacillary or multibacillary. Conclusions: The clinical and epidemiological findings plus with the electroneuromyography alteration were finally accepted as sufficient criteria to diagnose PNL. Pure neural leprosy therapy follows WHO regiment in accordance with the paucibacillary or multibacillary classification.Key words: pure neural leprosy, Mycobacterium leprae, nerve biopsy, anti-PGL-1, electroneuromyography.
Successful Treatment of Actinomycetoma with Combination of Cotrimoxazole and Tetracycline Verdy Verdy; Vina Ajeng Puspa Dewi; Arief Budiyanto; Agnes Sri Siswati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 1 (2015): BIKKK APRIL 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1047.729 KB) | DOI: 10.20473/bikk.V27.1.2015.77-83

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Background: Actinomycetoma is an infection of chronic granulomatous disease on the skin, subcutaneous tissue, fascia, and bone, occured after trauma because of bacteria innoculation. Clinical features seem painless nodules, abscess, fistula, and sinus  with granulated discharge.Gold standard treatment for actinomycetoma is cotrimoxazole. Combination therapy with other antibiotic is needed to prevent resistance and improve therapeutic efficacy. Purpose: To discuss successful treatment of actinomycetoma with combination of cotrimoxazole and tetracycline Case: A 19-years-old woman had complained of  chronic post-traumatic wounds since two years ago. Dermatological examination showed multiple painless nodules, sinus, and discharge on right dorsum pedis. Histopathological examination demonstrated sinus in dermis, suppurative granulomas, and SplendoreHoeppli phenomenon in dermis layer. Case Management: Combination therapy consist of cotrimoxazole 2x960 mg, that was given for 6 months and tetracycline 4x500 mg, that was given in the first 1 month.  No side effects and drug allergy during and/or post treatment was found. After clinical evaluation for 6 months, successful of treatment  was obtained and no recurrence was found. Conclusion: The combination therapy of cotrimoxazole for 6 months and tetracycline for 1 month was proven to be effective and no recurrence was found.Key words: actinomycetoma, cotrimoxazole, tetracycline.
The efficacy of captopril and 5-fluorouracil combination in the proliferation and collagen deposition of keloid fibroblast Jesslyn Amelia; Yohanes Widodo Wirohadidjojo; Agnes Sri Siswati
Indonesian Journal of Biotechnology Vol 27, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijbiotech.69505

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Keloid is a benign fibroproliferative tissue growth that exceeds the initial wound margins. Captopril has been tested in vitro to reduce fibroblast proliferation and collagen deposition; thus, it has potential for use in the treatment of keloids. Meanwhile, 5‐fluorouracil (5‐FU) has already been used in keloid management. This study aimed to determine the efficacy of the combination of captopril and 5‐FU in keloid fibroblast cultures. Keloid tissues were cultured up to passages 4–7. The study consisted of a control group, captopril in various concentrations (10‐2, 10‐3, 10‐4, and 10‐5 mol/L), 5‐FU 1 mg/mL and a combination of captopril at various concentrations with 5‐FU 1 mg/mL. After 144 hours of treatment, fibroblast proliferation and collagen deposition were measured. The study showed a significant decrease in the mean index of fibroblast proliferation and collagen deposition in the group receiving captopril in various concentrations (10‐2, 10‐3, 10‐4, and 10‐5 mol/L) and the 5‐FU group against the control group (p<0.05). In the combined‐dose group, captopril at a concentration of 10‐2 mol/L and 5‐FU showed a significant reduction in fibroblast proliferation and collagen deposition compared to the 5‐FU group and the captopril at the same dose (p<0.05). In conclusion, the combination of captopril 10‐2 mol/L and 5‐FU 1 mg/mL is better at reducing fibroblast proliferation and collagen deposition in keloid fibroblast cultures than captopril or 5‐FU as a single therapeutic agent.
Therapy selection for tinea corporis and cruris with commorbidity: 3 case series Yefta, Yefta; Winarni, Dwi Retno Adi; Siswati, Agnes Sri
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 1
Publisher : UI Scholars Hub

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Background: Dermatophytosis is a superficial (skin, hair and nails) fungal infection caused by dermatophyte group fungi (Trichophyton, Epidermophyton and Microsporum). Immunocompromised conditions cause fungal infections to become more widespread and require consideration of therapy. Case Illustration: This case series represented three cases of tinea corporis and tinea cruris in patients with comorbidities. The first case was tinea corporis and tinea cruris in a patient with congestive heart failure with oral terbinafine therapy. The second case was tinea corporis and tinea cruris in a patient with bilateral fourth degree hydronephrosis with oral griseofulvin therapy. The third case was tinea corporis in a patient with autoimmune hemolytic anemia with oral itraconazole therapy. A two-week post-systemic antifungal evaluation gave good results in all of the patients. Discussion: Selection of antifungals in dermatophytosis cases considering the patient's condition (contraindications and side effects that can be caused) provides a good outcome in patients with comorbidities. Conclusion: Dermatophytosis (tinea corporis and tinea cruris) is common in immunocompromised patients. This is due to decreased immunity causing dermatophytes to develop easily on the skin. Selection of the right therapy, considering comorbid conditions is important in order to get the best results for the patients.
Zosteriform cutaneous metastases from a carcinoma mammae Widiasri, Kharisma Yuliasis; Sayekti, Ayu Wikan; Febiyanto, Novian; Wahyuanggradewi, Elliana; Giantoro, Jeffrey; Pudjiati, Satiti Retno; Rinonce, Hanggoro Tri; Siswati, Agnes Sri
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Cutaneous metastases were reported in 18.6-26.5% of breast cancer patients. Zosteriform cutaneous metastasis is an unusual and rare morphological variant. Clinicians, especially dermatovenereologists, should consider dermatomal cutaneous metastases in oncology patients aside from herpes zoster, which is common in this population. Case Illustration: A 62-year-old woman presented with clustered papules and vesicles with an erythematous base, sometimes painful, on the right side of the chest in T5-T7 dermatomal distribution of 1-month duration. She had undergone a radical mastectomy for breast carcinoma and had been receiving chemoradiotherapy, which was completed in March 2018. A diagnosis of zosteriform cutaneous metastases was established after discovering malignant cells in the representative lesion via biopsy, similar to those sampled from the previous cancerous right mammary tissue. Discussion: Zosteriform cutaneous metastasis is a rare occurrence, with a variety of clinical backgrounds, morphological, and histological features that can influence the clinical course of the disease. The mechanism for the occurrence of zosteriform cutaneous metastasis remains uncertain; several studies reported possible causes: Koebner-like reactions at the site of previous herpes zoster infections, perineural lymphatic spread, spread through blood vessels associated with the dorsal ganglion, unintentional implantation during surgery, direct invasion of the underlying structure (primary cancer), and spread from the lymphatic system. This case suits the diagnosis of zosteriform cutaneous metastases based on lesion morphology, location, distribution, and histopathological features matching those of the primary tumor. Conclusion: Metastatic disease should be considered in the differential diagnosis of zosteriform rash in oncology patients.
RASIO NEUTROFIL LIMFOSIT DAN RASIO TROMBOSIT LIMFOSIT DENGAN DERAJAT KEPARAHAN PSORIASIS TIPE PLAK Yefta Yefta; Agnes Sri Siswati; Niken Trisnowati; Fajar Waskito; Niken Indriastuti; Sunardi Radiono; Dwi Retno Adi Winarni
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.v50i3.441

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Abstrak Latar Belakang: Psoriasis merupakan gangguan inflamasi sistemik kronis dan rekuren yang mempengaruhi 2-3% populasi. Patogenesis psoriasis melibatkan neutrofil, limfosit, trombosit, sitokin dan kemokin. Penentuan derajat keparahan psoriasis tipe plak yang sering digunakan adalah Psoriasis Area Severity Index (PASI) memiliki kelemahan yaitu subyektivitas antar pemeriksa. Rasio neutrofil limfosit (N/L) dan rasio trombosit limfosit (T/L) adalah penanda sederhana respon inflamasi sistemik yang mudah diukur dan murah sebagai bagian dari pemeriksaan darah rutin dan umum digunakan dalam penyakit inflamasi kronis. Tujuan: mengetahui perbedaan dan hubungan antara rasio N/L dan rasio T/L dengan derajat keparahan psoriasis tipe plak berdasarkan PASI. Metode: Penelitian menggunakan rancangan potong lintang dengan subyek telah memenuhi kriteria inklusi dan eksklusi. Analisis komparatif dan korelatif digunakan untuk menilai perbedaan dan hubungan kedua rasio dengan skor PASI. Hasil: Jumlah subyek penelitian 48 orang dibagi menjadi 3 kelompok psoriasis (derajat ringan, sedang dan berat). Terdapat perbedaan antara rasio N/L dan rasio T/L dengan derajat keparahan psoriasis tipe plak (p<0,05). Terdapat hubungan antara rasio N/L dan rasio T/L dengan derajat keparahan psoriasis tipe plak berdasarkan PASI (p<0,05 dan r: 0,550, r: 0,314). Kesimpulan: terdapat perbedaan dan hubungan antara rasio N/L dan rasio T/L dengan derajat keparahan psoriasis tipe plak berdasarkan PASI. Kata Kunci: rasio neutrofil limfosit, rasio trombosit limfosit, psoriasis tipe plak, psoriasis area severity index (PASI)
Epidemiology of Leprosy in Indonesia: a Retrospective Study Lubis, Ramona Sari; Anum, Qaira; Argentina, Fifa; Menaldi, Sri Linuwih; Gunawan, Hendra; Yuniati, Renni; Mulianto, Nur Rachmat; Siswati, Agnes Sri; Widasmara, Dhelya; Rusyati, Luh Made Mas; Mamuaja, Enricco Hendra; Muchtar, Vitayani; Cita Rosita Sigit Prakoeswa; Agusni, Regitta Indira; Bagus Haryo Kusumaputra; Medhi Denisa Alinda; Listiawan, Muhammad Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 1 (2022): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.1.2022.29-35

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Background: According to WHO data, the number of new cases of leprosy has decreased in 2019. However, Indonesia continues to provide a significant number of cases. According to statistics, India, Brazil, and Indonesia account for 79 percent of all instances. Purpose: This study aims to describe the profile of leprosy patients, and involves all Dermatology and Venereology Academic Hospitals in Indonesia. Methods: This study was a retrospective study of 2461 patients from Dermatology and Venereology Outpatient Clinic at 13 Academic Hospitals in Indonesia between January 2018 and December 2020. Result: Subjects in this study were dominated by males (66.8%) and aged > 14 years (95.3%). The most common type of leprosy was multibacillary (MB) (86.2%), and erythema nodosum leprosum (ENL) was the most leprosy reaction (20.3%). Majority of the subjects experienced disability in the hands (26.6%), in grade 1. Conclusion: Leprosy cases in Indonesia are mostly experienced by adult males. The most common type of leprosy is MB, with ENL being the most common leprosy reaction. Grade 1 disability is the most prevalent, therefore proper education is necessary to keep patients from progressing to grade 2 disability.
The Validity of Point-of-Care Test (POCT) Lateral Flow Immunochromatographic Assay (LFIA) Candida albicans for the Diagnosis of Vulvovaginal Candidiasis Puspitasari, Monika; Retno Pudjiati, Satiti; Sri Siswati, Agnes
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 2 (2024): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.2.2024.136-141

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Background: Vulvovaginal candidiasis is one of the most common causes of complaints of vaginal discharge, which is mostly caused by Candida albicans. The common diagnosis of vulvovaginal candidiasis is microscopic and culture examination. However, the availability of examinations is limited at the private clinic, and for culture examinations, the cost is high and results take several days. The point-of-care test (POCT) lateral flow immunochromatographic assay (LFIA) is a tool that can detect Candida albicans antigens, but this diagnostic test has never been carried out in Indonesia. Purpose: to know the validity of POCT LFIA Candida albicans for the diagnosis of vulvovaginal candidiasis caused by Candida albicans in women with complaints of vaginal discharge. Methods: Cross-sectional observational study with a diagnostic test design, using vaginal discharge samples. Vaginal discharge samples were subjected to POCT LFIA examination with the Medomic Candida albicans/ Trichomonas vaginalis/ Gardnerella vaginalis Antigen Combo Test KitÒ and Candida spp culture. Result: POCT LFIA Candida albicans had a sensitivity of 100%, specificity of 89.9%, accuracy of 90.32 %, LR (+) 9, LR (-) 0, PPV 50%, and NPV 100% against Candida spp. culture. Conclusion: The POCT LFIA Candida albicans can be used to diagnose vulvovaginal candidiasis caused by Candida albicans in women who complain of vaginal discharge.
Penile squamous cell carcinoma related to high risk HPV infection Harsono, Erliana Tantri; Siswati, Agnes Sri; Diovani, Sonia; Andayani, Raden Roro Rini; Dyah Ayu Mira Oktarina
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 2 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i2.17119

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Penile cancer is an uncommon form of malignancy, with squamous cell carcinoma (SCC) being the most common subtype. Human papillomavirus (HPV) infection is strongly associated with the development of penile SCC, particularly strains 16 and 18. This report presents two cases of penile SCC related to HPV type 18 infection and discusses the diagnosis and role of HPV in penile cancer. It aims to illustrate the clinical presentation and diagnostic challenges of penile SCC, with emphasis on the role of HPV infection. Case 1 involves a 41 yo man with a verrucous mass on the glans penis, diagnosed as well-differentiated SCC, with HPV type 18 detected. Case 2 is a 54 yo man presenting with multiple ulcerative plaques on the distal glans, also diagnosed as SCC with HPV type 18. Penile SCC can be classified into HPV-associated and non-HPV-associated subtypes. The HPV-associated SCC, more commonly seen in younger patients, is driven by viral oncogenes E6 and E7, which disrupt tumor suppressor proteins. The pathogenesis is similar to that seen in cervical cancer. Diagnosis is confirmed through histopathology and genotyping, while treatment involves surgical excision, with possible radiotherapy and chemotherapy depending on lymph node involvement. Early detection and diagnosis of penile SCC are critical for effective treatment. The HPV infection plays a significant role in the pathogenesis of penile SCC, highlighting the importance of HPV vaccination in prevention. Multidisciplinary management is essential for improving patient outcomes
ONSET KEKAMBUHAN PADA PASIEN PSORIASIS VULGARIS PASKA TERAPI INJEKSI KE-8 SECUKINUMAB DI RSUP DR. SARDJITO YOGYAKARTA PERIODE 2022-2024 Harsono, Erliana Tantri; Waskito, Fajar; Siswati, Agnes Sri; Andayani, Raden Roro Rini; Khalidah, Miya
Media Dermato-Venereologica Indonesiana Vol 52 No 2 (2025): 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.v52i2.528

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   Pendahuluan: Psoriasis merupakan penyakit autoimun kulit inflamasi kronis yang ditandai oleh hiperproliferasi epidermis. Terapi agen biologis seperti secukinumab digunakan untuk psoriasis derajat berat dan sekitar 4,6% pasien psoriasis vulgaris di RSUP Dr. Sardjito mendapat terapi secukinumab. Terkait asuransi kesehatan nasional, pemberian injeksi subkutan Secukinumab diberikan sebanyak 8 kali untuk satu pasien. Setelah penghentian terapi agen biologis seringkali psoriasis mengalami kekambuhan. Mengetahui awitan kekambuhan pasien psoriasis pasca terapi injeksi ke-8 secukinumab 300 mg di RSUP Dr. Sardjito serta faktor yang mempengaruhi kekambuhan sehingga dapat menjadi data pendukung penelitian lebih lanjut. Metode: Rancangan penelitian adalah deskriptif. Data diperoleh dari catatan medik elektronik pasien dengan diagnosis psoriasis vulgaris yang telah selesai terapi secukinumab 300 mg sebanyak 8 kali injeksi di Poliklinik Kulit dan Kelamin RSUP Dr. Sardjito periode 2022-2024. Hasil: Total subyek pada studi ini adalah 12. Awitan kambuh ≤ 6 bulan paska terapi secukinumab didapatkan pada 8 pasien (66,7%). Pasien dengan awitan kambuh ≤ 6 bulan paska terapi secukinumab yang memiliki indeks massa tubuh ≥ 25 sebanyak 8 pasien (66,7%). Pasien dengan awitan kambuh ≤ 6 bulan paska terapi secukinumab dengan awitan terdiagnosis psoriasis dini < 40 tahun sebanyak 7 pasien (58,3%). Kesimpulan: Kekambuhan psoriasis paska terapi secukinumab dengan awitan kambuh ≤ 6 bulan lebih banyak terjadi dengan rerata awitan kekambuhan adalah 18 minggu. Awitan kambuh ≤ 6 bulan lebih banyak terjadi pada pasien dengan awitan dini psoriasis dan obesitas. Diperlukan penelitian lebih lanjut terkait faktor risiko kekambuhan dan mekanisme terjadinya kekambuhan paska terapi secukinumab atau agen biologis.