Satiti Retno Pudjiati Satiti Retno Pudjiati
Department Of Dermatology And Venereology, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada Yogyakarta

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Association between HLA-B alleles and nevirapine-induced allergies among Indonesian HIV patients Angela Satiti Retno Pudjiati; Dyah Ayu Mira Oktarina; Hardyanto Soebono; Saihas Sauda; Dewi Kartikawati Paramita; Iwan Dwiprahasto; Zubairi Djoerban
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.093 KB) | DOI: 10.19106/JMedSci004804201604

Abstract

This study aimed to investigate the association between human leukocyte antigen-B(HLA-B) alleles and nevirapine allergy in HIV patients in Indonesia. A case control studywas conducted involving 147 HIV patients comprising of 50 patients with and 97patients without nevirapine allergy as control. The HLA-B allele typing was conducted byusing polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP),followed by sequencing. Bivariate analysis using Chi-square (X2) test and multivariatelogistic regression with significance level at p<0.05 were applied to analysis the data.Among 147 subjects, 34 with HLA-B alleles were identified. Bivariable analysis showedthat HLA-B*58 allele was the most significant risk factor for the nevirapine allergy (OR= 3.67; 95% CI: 1.79 to 7.54), while HLA-B*35 allele was a protective factor (OR =0.18; 95% CI: 0.08 to 0.42). Multivariate logistic regression analysis showed that youngmen and HLA-B*58 allele were the significant risk factors of nevirapine allergy (OR: 4.63;95% CI: 2.02 to 10.61), while older women with the HLA-B*35 was able to reducethe risk of nevirapine allergy approximately 81% (OR: 0.19; 95% CI: 0.08 to 0.49). Inconclusion, young male with the HLA-B*58 allele are the high risk factor for nevirapineallergy in Indonesian HIV patients.
Correlation between CD4 cell counts with mucocutaneous manifestations: study of HIV patients in Dr. Sardjito General Hospital, Yogyakarta Satiti Retno Pudjiati; Nadia Akita Dewi; Sekar Sari Arum Palupi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.513 KB) | DOI: 10.19106/JMedSci005001201805

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Mucocutaneous disorders often seen in HIV patients with varying morbidity. The HIVprogression is characterized by the declining of CD4 cell counts and emergence ofmucocutaneous manifestations. The aim of the study was to evaluate the relationshipbetween CD4 cell counts with mucocutaneous manifestations in HIV patients. This wasa cross-sectional study based on medical records at Dr. Sardjito General Hospital duringthe period January 2011-December 2015. Data of patient’s age, sex, risk factors oftransmission, most mucocutaneous manifestations and CD4 cell count were gathered. Thecorrelation between CD4 cell counts with muscocutaneous manifestations were analyzedusing chi-square test. A total 928 patients were involved in the study. More than half ofthe patients were male (65.4%) and mostly, the patients aged 20-29 years (38.69%).The main risk factors for HIV transmission were unsafe sex (75%). The highest CD4 cellcounts was 1094 cells/mm3 and the lowest was 1 cell/mm3. We found 306 cases ofmucocutaneous manifestations. The most mucocutaneous manifestations was a fungalinfection (40.4%) with the highest infection type was oral candidiasis(33.8%); then noninfection(28%) with the highest type was drug eruption(35.9%); and tumors(0.5%) thatwas only Kaposi sarcoma cases. We also found sexually transmitted infections (STIs)(18.85%) with the highest cases was condyloma acuminata (49.3%). Statistical analysisshowed a significantly relationship between CD4 cell counts with a fungal infection(p <0.0001; OR= 3.8; 95% CI: 2.29 - 6.30), viral infection (p =0.0031; OR= 0.4;95% CI: 0.24-0.74) and parasitic infection (p=0.043; OR= 0.2; 95% CI: 0.06-0.61).In conclusion, alteration in CD4 cell counts affects opportunistic infections occurencein HIV patients. Lower CD4 cell counts (<200 cells/mm3) increases the risk of fungalinfection as much as 3.8 times. Higher CD4 cell counts (>200 cells/mm3) increases therisk of viral infection by about 2.5 times and parasitic infections as much as 5 times.
The role of Malassezia sp, sebum level and Trans Epidermal Water Loss (TEWL) toward the dandruff severity between hijab and non hijab wearing subjects Kristiana Etnawati; Agnes Sri Siswati; Satiti Retno Pudjiati; Devi Artami Susetiati; Dwi Retno Adiwinarni; Affendi Purbananto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.968 KB) | DOI: 10.19106/JMedScie/0050032018011

Abstract

Dandruff is a common symptom in adolescence, which possibly due to increasing ofMalassezia sp. colonization, sebum level as well as skin hydration. Wearing hijab ispredicted to increase the humidity and sebum level lead to increase the number ofMalassezia sp. and dandruff severity. A case-control study was conducted on 19 femalewith dandruff who wear hijab and 19 female with dandruff who do not wear hijab, agebetween 18 and 27 years old. The dandruff severity was defined clinically using ascoring system (0-100), only subjects with minimum score of 28 will be included in thisstudy. The sebum and trans epidermal water loss (TEWL) levels were measured withSebumeter and Tewameter from Courage Khazaka. The Malassezia sp. was examinedusing microscopic examination of the squama and culture in the Saboraud medium.There were no significant differences found between hijab and non-hijab groups fordandruff severity. No difference found between two groups for sebum level, Malasseziasp. number microscopically, and Malassezia sp. colonization. Only TEWL level in hijabgroup that was found to be higher than non-hijab group. Wearing hijab does not increasethe dandruff severity, sebum level and colonization number of Malassezia sp. Wearinghijab is found to increase the TEWL level.
Secondary Syphilis, Anal Condylomata Acuminata, and HIV in Bisexual Male Patient: Another Point of View, Time Evaluation Based on CD4 and Management Vina Ajeng Puspa Dewi; Satiti Retno Pudjiati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 2 (2015): BIKKK AGUSTUS 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (623.775 KB) | DOI: 10.20473/bikk.V27.2.2015.156-162

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Background: A meta analysis study in China states that male bisexual has higher incidence rate for HIV and syphilis than male-sex-male. Syphilis eases the transmission of HIV, vice versa HIV breaches the integrity of mucosal epithelial barrier, allowing translocation virus and bacterial. Syphilis has higher incidence rates in HIV-infected compare with HIV-uninfected patients. Syphilis influences CD4 of patient. We try discussing a case of secondary syphilis in male bisexual HIV in another point of view, to find which one earlier based on CD4 count. Purpose: to understand another point of view, time evaluation based on CD4 and management in secondary syphilis, anal condyloma accuminata, and HIV in bisexual male patient Case: A 19 years old male bisexual patient complained erythematous rash all over his body, no itch or pain; TPHA 1/2560, VDRL 1/128, positive HIV 3antibody, and CD4 425cell/mm. Case management: HIV onset, considering decrease of CD4 in syphilis or not, are 2-5,8years and 3,08-7,7years, respectively. Therapy was given as single dose benzatin penisilin 2,4billion IU intramuscular. Conclusion:HIV infection occurred before syphilis. No differences in management with HIV-uninfected syphilis patient, more often evaluation interval needed.Key words: syphilis, HIV, bisexual, CD4, onset, management.
INFEKSI MENULAR SEKSUAL MULTIPEL PADA PEREMPUAN HAMIL TRIMESTER KEDUA (LAPORAN KASUS) Arum Krismi; Herwinda Brahmanti; Satiti Retno Pudjiati
Berkala Ilmiah Kedokteran Duta Wacana Vol 1, No 1 (2015): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21460/bikdw.v1i1.5

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Infeksi Menular Seksual (IMS) dapat menimbulkan dampak yang serius pada kehamilan berupa kehamilan ektopik, aborsi spontan, kematian janin dalam rahim, prematuritas, infeksi kongenital dan perinatal serta infeksi puerperal pada ibu. Seorang perempuan hamil berusia 21 tahun mengeluhkan adanya kutil di sekitar kelamin dan dekat anus, serta keputihan berwarna putih keruh dari kemaluan sejak ± 2 bulan yang lalu. Pada perut bagian bawah dan kedua pangkal paha terdapat makula dan papul hiperpigmentasi, teraba keras, multipel, tersebar; pada vulva, perineum dan perianal terdapat papul verukosa multipel dengan luas area (perianal) ± 6 x 5 cm2. Pemeriksaan inspekulo pada cervix didapatkan bintik-bintik kemerahan (strawberry cervix), cervix dan fornix tertutup discharge putih keabuan berbuih dan vagina tertutup discharge putih homogen menggumpal. Diagnosis kerja adalah siflis sekunder, trichomoniasis, dan kandidiasis vulvovaginalis (KVV) pada kehamilan. Penegakan diagnosis dilakukan berdasarkan anamnesis, status dermato-venereologis, pemeriksaan fsik (inspekulo), laboratorium, histopatologis, dan serologis. Infeksi Menular Seksual dapat diderita oleh seorang pasien jika terdapat sumber penularan. Perubahan-perubahan yang terjadi selama kehamilan, baik perubahan dalam respon imun, hormonal maupun anatomis, menyebabkan perempuan hamil lebih rentan untuk menderita IMS multipel. Kata kunci: infeksi menular seksual, perempuan hamil, siflis sekunder, tricho¬moniasis, kandidiasis vulvovaginalis
Allergen profile of facial ACD to cosmetics among patients at Tertiary Referral Hospital in Yogyakarta Alfieri, Alessandro; Indrastuti, Niken; Febriana, Sri Awalia; Pudjiati, Satiti Retno; Waskito, Fajar
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Background: Cosmetics are a part of life for most of the population and may cause allergic contact dermatitis (ACD), especially on the face, as the primary exposure of cosmetics is on the face area.Methods: This research was conducted retrospectively using secondary data. The research subjects and demographic data were taken from the registered list of patients at Dermatology and Venereology Outpatient Clinic Dr. Sardjito General Hospital with a clinical picture of facial ACD due to cosmetics. Patch tests were carried out from January 2017 to December 2020.Results: From three years period, 26 patients were diagnosed with suspected facial ACD due to cosmetics and underwent patch tests. Of the total 26 patients, 3 patients did not show any reaction to the patch test. On the 23 patients who had reactions on the patch test, there were 66 points on the skin that showed a reaction to allergens. Of the 66 points, 37 points gave a positive reaction picture, with the most common allergen causing the reaction being cobalt(II) chloride hexahydrate (n=4, 10.8%). Then, from 29 points that gave doubtful reactions, the allergen that caused the most reactions was potassium dichromate 0.5% (n=4, 13,8%).Conclusion: The allergens that most often give a positive or doubtful reaction on the patch test of this study are metal compounds (cobalt and potassium dichromate). This study only looks at the patch test that gives a reaction without looking at the clinical relevance related to cosmetics use.
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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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.
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.
Expressions of Interleukin-4 and Interleukin-5 in Nodular Prurigo and Pruritic Papular Lesions Ayu Wikan Sayekti; Ann Kautsaria Putri; Dwi Retno Adi Winarni; Satiti Retno Pudjiati
Folia Medica Indonesiana Vol. 60 No. 1 (2024): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i1.55017

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Highlights:1. An examination of IL-4 and IL-5 expressions in nodular prurigo and pruritic papular eruption is crucial for enhancing the effectiveness of biological agent therapy, specifically for HIV/AIDS patients.2. The findings offer evidence suggesting the possibility of IL-4 as a treatment target for individuals diagnosed with nodular prurigo, as well as IL-4 and IL-5 for those diagnosed with pruritic papular eruption. AbstractPruritic papular eruption is a dermatosis characterized by pruritic symptoms in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Similarly, nodular prurigo is an itchy dermatosis with lesions and histopathological features that resemble those of pruritic papular eruption. Both conditions share a common etiopathogenesis, which involves the cytokines produced by T helper 2 (Th2) cells. Nodular prurigo and pruritic papular eruption are chronic and frequently recalcitrant, thus posing challenges in treatment. The use of biological agents represents a treatment development for chronic and recalcitrant dermatoses. This study aimed to determine the difference in the mean percentage of interleukin-4 (IL-4) and interleukin-5 (IL-5) expressions between nodular prurigo and pruritic papular eruption lesions, which may establish a basis for further biological agent therapy. A cross-sectional study was conducted using paraffin block preparations of the skin lesions of patients diagnosed with nodular prurigo (n=16) and pruritic papular eruption (n=16). Each paraffin block preparation involved immunohistochemical staining using IL-4 and IL-5 monoclonal antibodies. The expressions of IL-4 and IL-5 were assessed through ImageJ for Windows, version 1.53 (National Institutes of Health and the Laboratory for Optical and Computational Instrumentation, University of Wisconsin, USA) by pathologists. The data were analyzed using an unpaired t-test with a significance level of p<0.05. The analytical results indicated that data on the average age of the two groups, disease duration, and storage sample duration followed a normal distribution (p>0.05). The mean percentage of IL-4 expression was significantly different between the nodular prurigo and pruritic papular eruption groups (p=0.000). However, the mean percentage of IL-5 expression was not significantly different between the two groups (p=0.060). In conclusion, the expression of IL-4 was higher in the nodular prurigo group in comparison to the pruritic papular eruption group. Nonetheless, the expression of IL-5 was comparably high in both the nodular prurigo and pruritic papular eruption groups.
The effectiveness of ceramide moisturizing cream in pruritic papular eruption treatment of HIV/AIDS patients Sayekti, Ayu Wikan; Putri, Ann Kautsarina; Pudjiati, Satiti Retno; Winarni, Dwi Retno Adi
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 7, Issue 1 (January 2024)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/balidervenaesthj.v7i1.96

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Background: Pruritic papular eruption (PPE) is one of the most common skin manifestations in HIV/AIDS patients. Pruritic papular eruptions are due to immune dysregulation, causing dominance of interleukin-4, which causes a decrease in ceramide synthesis (CER) and impaired skin barrier function. This study aimed to investigate the effectiveness of CER over non-CER moisturizing cream in HIV/AIDS patients with PPE. Methods: Double-blind experimental design. The research subjects are PPE patients at Dr. Sardjito General Hospital. CER and non-CER moisturizing cream are applied for three weeks, respectively. Analysis of the trans-epidermal water loss (TEWL), skin hydration, and itching were analyzed using an unpaired T-test or the Mann-Whitney test with a significance of p<0.05. Results: Ceramide synthesis moisturizing cream decreased the TEWL value by 3.56 ± 2.38 g/m2/hour; increased the value of skin hydration by 16.39±7.19 a.u.; decreased skin lesions by 0.79 ± 4.95; reduced itching by 1.54 ± 0.78 and without causing side effects. Non-CER moisturizing cream decreased the TEWL value by 1.57 ± 2.00 g/m2/hour; increased the value of skin hydration by 12.03 ± 6.88 a.u.; decreased skin lesions by 1.42 ± 3.00; reduced itching by 1.17 ± 0.70 and also without causing side effects. Conclusion: Ceramide cream is more effective than non-CER moisturizing cream in reducing TEWL and increasing skin hydration. Ceramide and non-CER moisturizing creams have the same effectiveness in reducing the number of lesions and reducing itching. Ceramide and non-CER moisturizing creams do not cause side effects.