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Bullous Pemphigoid Treated with Corticosteroid: A Case Report Dwi M. Trisnowati; Hyacintha P. Budi; Shienty Gaspersz; Meilany Durry
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.41403

Abstract

Abstract: Bullous pemphigoid (BP) is an autoimmune disease clinically characterized by pruritic, large, tense subepidermal bullae over normal skin, erythematous or urticarial plaques. The pathogenesis related to the immune system towards BP antigen 180 and 230. Mild lesions may be treated with topical corticosteroid but the more extensive lesions are treated with oral corticosteroids. We reported a case of 58-year-old man came with clear fluid-filled blisters on the body since a week ago. Dermatological examination revealed multiple vesicle-bullae, filled with clear fluid, tense walls. Nikolsky sign and Asboe-Hansen sign were negative. Histopathological examination supported the diagnosis of BP. Diagnosis was established based on anamnesis, and physical and histopathological examinations. The patient was treated with systemic corticosteroid due to the consideration of the extensive lesions. Methylprednisolon was given intravenously at a dose of 43.75 mg per day which was then replaced orally for tapering off. The dose reduction of 4 mg per week was carried out according to the clinical improvement. In conclusion, this case improved after being treated with systemic corticosteroid for approximately 2-3 months.Keywords: bullous pemphigoid; corticosteroid Abstrak: Pemfigoid bulosa (PB) merupakan penyakit bula autoimun ditandai dengan pruritus dan bula subepidermal besar berdinding tegang di atas kulit yang normal, eritematosa atau plak urtikaria. Patogenesisnya berhubungan dengan sistem kekebalan tubuh yaitu respons imun terhadap antigen BP 180 dan 230. Penatalaksanaan untuk lesi ringan diberikan kortikosteroid topikal, sedangkan untuk lesi luas dengan kortikosteroid sistemik. Kami melaporkan seorang laki-laki berusia 58 tahun dengan keluhan lepuh-lepuh berisi cairan jernih pada hampir seluruh tubuh sejak satu minggu lalu. Pada pemeriksaan fisik ditemukan vesikel-bula, multipel, berisi cairan jernih, dinding tegang. Pemeriksaan tanda Nikolsky dan Asboe-Hansen negatif. Pemeriksaan histopatologik mendukung diagnosis PB. Tatalaksana yang diberikan berupa kortikosteroid sistemik karena pertimbangan lesinya yang luas. Metilprednisolon diberikan secara intravena dengan dosis 43,75 mg per hari yang kemudian diganti pemberian per oral saat tapering off. Penurunan dosis 4 mg metilprednisolon per minggu dilakukan sesuai dengan perbaikan kondisi klinis. Simpulan kasus ini ialah pemfigoid bulosa yang mengalami perbaikan setelah diterapi dengan kortikosteroid sistemik selama kurang lebih 2-3 bulan.Kata kunci: pemfigoid bulosa; kortikosteroid
Mycetoma of the Breast: A Case Report Meilany Durry; Lily L. Loho
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.44625

Abstract

Abstract: Mycetoma is a chronic suppurative infection affecting skin, subcutaneous tissue, and bones which is common in tropical and subtropical regions. The manifestations of mycetoma are painless subcutaneous mass, multiple sinuses and purulent or seropurulent discharge that may contain grains. We reported a case of a 39-year-old female with a complaint of skin mass with discharge in her left breast for about a year. The clinical diagnosis was a breast tumour with suspicion of malignancy. A histopathological examination of the breast biopsy was performed which showed foci of granulomas consisting of chronic inflammatory cells, foamy macrophages, and many multinucleated cells. In several granulomas, there were eosinophilic masses with hypha in the peripheral and arranged radially. In conclusion, based on clinical and histopahological examinations the diagnosis of this case was a mycetoma of the breast. Keywords: mycetoma; breast; deep mycosis; mammary infection; pathological diagnosis
Trikoepitelioma Multipel Familial: Laporan Kasus Meilany Durry; Anggreiny Iwisara; Fera Mawu; Sthefanie Gaghana
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44627

Abstract

Abstract: Trichoepithelioma is a benign tumor of folliculosebaceous-apocrine germ cell origin. There are three clinical variants of trichoepithelioma, as follows: solitary, multiple, and desmoplastic. The clinical features of trichoepithelioma are skin-colored papules up to 0.5 cm in size. with predilection areas on the nose, upper lip, and cheeks. The specific variant of familial multiple trichoepithelioma is inherited in an autosomal-dominant type and usually occurs in childhood and puberty. We reported a 36-year-old woman with complaints of skin-colored papules on the face and neck. There were family members with the same complaint. Histopathological examination showed skin tissue with dermal tumor consisting of basaloid cells arranged in palisade form in the periphery, and several horn-cysts among the cells that indicated a trichoepithelioma. The patient was planned to be treated with topical imiquimod and electric surgery. In conclusion, based on anamnesis, physical examination, and histopathological result, the diagnosis of this case was familial multiple trichoepithelioma. Keywords: trichoepitelioma; cylindromatosis; skin appendageal tumor; histopathological examination   Abstrak: Trikoepitelioma merupakan suatu tumor asal sel germinal folliculosebaceous-apocrine. Terdapat tiga varian klinis trikoepitelioma yaitu soliter, multipel, dan desmoplastik. Gambaran klinis trikoepitelioma ialah papula sewarna dengan kulit ukuran sampai 0,5 cm dan lokasi predileksi yaitu hidung, bibir atas, dan pipi. Terdapat satu varian spesifik yaitu trikoepitelioma multipel familial yang diwariskan secara dominan autosomal dan biasanya timbul pada masa kanak-kanak dan pubertas. Kami melaporkan seorang perempuan berusia 36 tahun dengan keluhan bintil-bintil sewarna kulit, multipel pada area wajah dan leher. Di dalam keluarga pasien terdapat anggota keluarga dengan keluhan yang sama. Hasil pemeriksaan histopatologik mendapatkan jaringan kulit dengan tumor pada dermis yang terdiri dari sel-sel basaloid, bagian tepi tersusun palisade, dan di antaranya tampak beberapa horn-cyst yang menunjukkan suatu trikoepitelioma. Pasien ini direncanakan diberikan terapi dengan imiquimod topical dan bedah listrik. Simpulan kasus ini ialah suatu trikoepitelioma multipel familial yang ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan histopatologik. Kata kunci: trikoepitelioma; cylindromatosis; skin appendageal tumor; pemeriksaan histopatologik