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Retrospective Study: Type 1 Leprosy Reaction Pratamasari, Meita Ardini; Listiawan, M. Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 2 (2015): BIKKK AGUSTUS 2015
Publisher : Faculty Of Medicine Airlangga University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.205 KB) | DOI: 10.20473/bikkk.V27.2.2015.137-143

Abstract

Background: Type 1 reaction (T1R) of leprosy occurs due toaltered balance between cell mediated immunity and M. leprae bacilli in the skin and nerves, with upgrading/reversal or downgrading as final result. Leprosy subpolar types have unstable immunity, this cause them often experience recurrence T1R, especially BB type.Clinical findings of T1R are inflammation in the skin or nerves, and can lead to disability if not treated properly. Aim: To evaluate the distribution, diagnosis, trigger factors, and therapy of T1R. Methods: Retrospective study using medical record of leprosy new patients in Dermatology and Venereology Outpatient Clinic, Dr Soetomo General Hospital, Surabaya, during 2010 – 2013. Database, anamnesis, examination, and T1R therapy were recorded. Results: The total of new leprosy patients with T1R within 2010-2013 were 117 patients (19,7% of all new leprosy  patients). Most of them were men (70,1%), aged between 15–34 years (42,8%), with BB as the most frequent type (70,9%). Skin symptom of T1R could be thickening of old lesion (52,1%). T1R most occurred when patients still consume MDT (71,8%). NSAID (37,6%) andcorticosteroid (38,5%)were prescribed as T1R therapy. Conclusions: T1R diagnosis should established accurately by history taking and physical examination.For recurrent T1R,trigger factors should be considered.Key words: type 1 reaction, CMI, reversal, downgrading.
NORWEGIAN SCABIES IN AIDS PATIENT: A CASE REPORT Pratamasari, Meita Ardini; Agusni, Indropo; Prakoeswa, Cita Rosita Sigit; Astari, Linda; Sandhika, Willy
Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 2 (2016)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (924.82 KB) | DOI: 10.20473/ijtid.v6i2.3163

Abstract

Scabies is a skin infection caused by Sarcoptes scabiei var. hominis. This disease may present severe clinical manifestations in immune-compromised patient, well-known as Norwegian scabies or crusted scabies.A 36-year old man with AIDS had chief complaint thick crust almost all over his body in this case. History of household member infected by scabies before was present. Clinical findings show hyperpigmented macules unsharply marginated, covered with thick scales and accompanied by papules, fissures, and erotion. T cell CD4 level was 12 cell/μL. Scraping examination showed scabies infection and so did the histopathology examination. This patient was treated by topical Permethrin 5% combined with 2-4 ointment application in between permethrin usage. Before topical scabicide was given, thick crust was previously treated by topical urea 10% and wet dressing by normal saline. On day 14 after the patient first came there was lesion improvement.