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

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

Abstract

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; Dewi, Vina Ajeng Puspa; Budiyanto, Arief; Siswati, Agnes Sri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

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

Abstract

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.