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Gambaran Histopatologi Nekrobiosis Lipoidika Sari, Maylita; Setyaningrum, Trisniartami; Sandhika, Willy
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 1 (2014): BIKKK APRIL 2014
Publisher : Faculty Of Medicine Airlangga University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1210.161 KB) | DOI: 10.20473/bikkk.V26.1.2014.1-8

Abstract

Latar belakang: Nekrobiosis Lipoidika (NL) merupakan keadaan dermatologis idiopatik yang menjadi masalah secara kosmetik dan berhubungan erat dengan penyakit diabetes mellitus. Pemahaman tentang patogenesis dan diagnosis NL sangat penting karena adanya komplikasi yang bisa terjadi seperti ulserasi dan karsinoma sel skuamosa, disamping kesulitan penegakan diagnosis NL melalui histopatologi. Tujuan: Memahami patofisiologi, gambaran klinis, dan histopatologi NL serta diagnosis banding granuloma non infeksi. Telaah kepustakaan: Perubahan vaskular dan degenerasi kolagen serta faktor lain adanya Antibody Mediated Vasculitis diduga terjadi pada patogenesis NL. Prinsipnya didapatkan kerusakan mikrosirkulasi pada individu non diabetik dengan NL. Pemeriksaan histopatologi menunjukkan terdapat granuloma interstitial dan palisade yang melibatkan jaringan subkutan dan dermis. Granuloma tersusun berlapis-lapis (tierlike, layered) dan bercampur dengan area degenerasi kolagen, terdiri dari histiosit, beberapa diantaranya limfosit berinti banyak, sel plasma, dan eosinofil. Penebalan dinding pembuluh darah dan pembengkakan sel endotel pada dermis bagian tengah sampai dalam. Imunofluoresens direk didapatkan immunoglobulin M, Ig A, C3, dan fibrinogen pada pembuluh darah. Manifestasi klinis ditandai dengan plak berbatas jelas dengan area atrofi kekuningan pada tengahnya dan tepi menonjol berwarna merah sampai ungu, yang bisa mengalami ulserasi, bilateral, dan multipel. kesimpulan: NL merupakan suatu penyakit degeneratif kronis pada jaringan konektif dermis, dengan etiologi yang tidak diketahui dan terjadi hampir seluruhnya pada penderita diabetes mellitus. Diagnosis ditegakkan secara klinis dan histopatologi. Gambaran histologi NL hampir sama dengan granuloma annulare, namun manifestasi klinis berbeda.Kata kunci: nekrobiosis lipoidika, diabetes melitus, histopatologi, granuloma.
Secondary Syphilis During Pregnancy: The Importance of Screening and Clinical Management Purnamasari, Indah; Barakbah, Jusuf; Martodiharjo, Sunarko; Murtiastutik, Dwi; Astindari, Astindari; Septiana, Septiana; Sari, Maylita; Hidayati, Afif Nurul
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 2 (2021): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.2.2021.145-149

Abstract

Background: Syphilis is one of the most serious sexually transmitted diseases worldwide, and has tremendous consequences for the mother and her developing fetus if left untreated. The burden of morbidity and mortality due to congenital syphilis is high. Purpose: Screening and prompt to know the importance of treatment of syphilis during pregnancy. Case: A 32-year-old multigravida in 5 months of pregnancy presented with multiple raised lesions over her labia. It was accompanied by fluor and smelly fishy odor. There was no history of genital ulcers in either spouse and no history of sexual promiscuity. History of antenatal care in public health showed non-reactive status of HIV, syphilis and hepatitis B. Clinical examination revealed multiple flat, moist warts over her labia mayora and minora, and multiple roseola syphilitica on the plantar pedis sinistra. Darkfield microscopic examination presence spirochete, venereal disease research laboratory (VDRL) titer was 1:16 and T. pallidum particle agglutination assay (TPHA) titer was 1:2560. Obstetric ultrasonography examination was suggestive no mayor congenital abnormalities. Both of serology VDRL and TPHA were non-reactive in her husband. Significant of lesion improvement and decrease a fourfold titer serologic in VDRL (1:4) and TPHA (1:320) as follow-up 3 months after being treated with single intra-muscular injections of benzathine penicillin 2.4 million units. Discussion: Coordinated prenatal care and treatment are vital. It's implemented before the fourth month of pregnancy to reduce vertical transmission and all associated side effects of congenital syphilis. Penicillin is highly efficacious in maternal syphilis and prevention of congenital syphilis. Conclusion: Universal screening and adequate pregnancy care must be a priority.
Cutaneous Adverse Drug Reactions in Hospitalized HIV/AIDS Patients Wibisono, Yusuf; Agusni, Indropo; Hidayati, Afif Nurul; Rahmadewi, Rahmadewi; Astindari, Astindari; Septiana, Septiana; Sari, Maylita; Murtiastutik, Dwi
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 2 (2021): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.2.2021.96-102

Abstract

Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in humanimmunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more commonin untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriatetreatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immunedeficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR whowere hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: Therewere more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the mostcommonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most commondiagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscureerythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatmentwas dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation wasmorbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form oftopical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.
Efficacy and Side Effects of Fractional Carbon Dioxide Laser for Acne Scars, Keloids, and Striae Albae in the Dermatovenereology Clinic of Tertiary Hospital: A Retrospective Study Pramitha, Riezky Januar; Zulkarnain, Iskandar; Ervianti, Evy; Rahmadewi, Rahmadewi; Hidayati, Afif Nurul; Budiono, Budiono; Indramaya, Diah Mira; Setyaningrum, Trisniartami; Citrashanty, Irmadita; Sari, Maylita; Umborowati, Menul Ayu; Kusumaputra, Bagus Haryo; Listiawan, Muhammad Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.19-27

Abstract

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.
A Retrospective Study: Epidemiology, Onset, and Duration of Erythema Nodosum Leprosum in Surabaya, Indonesia Fransisca, Cindy; Zulkarnain, Iskandar; Ervianti, Evy; Damayanti, Damayanti; Sari, Maylita; Budiono, Budiono; Alinda, Medhi Denisa; Kusumaputra, Bagus Haryo; Prakoeswa, Cita Rosita Sigit; Listiawan, Muhammad Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.8-12

Abstract

Background: Erythema nodosum leprosum (ENL) has a chronic and recurrent nature which could reduce patient's quality of life in addition to the onset of ENL that occurs before, during, or after multidrug treatment, further emphasizing the importance of regular control and education.Purpose:This study aimed to evaluate the epidemiology, onset, duration, and recurrence of ENL. Methods:Data from medical records were obtained for a 3-year retrospective study of multibacillary leprosy patients at the Leprosy Division of the Dermatology and Venereology Outpatient Department, Dr. Soetomo General Hospital Surabaya, with a minimum of 2–5 years follow-up period.Result:The prevalence of  ENL continued to increase almost every year especially in 2017 (32% in 2015; 32% in 2016; and 36% in 2017). ENL most often occurs during the first year of multi-drug therapy (MDT) administration followed by after the release from treatment (RFT) with the latest onset occurring 4 years after RFT. The majority of patients experienced chronic and recurrent reactions with the longest reactions lasting up to 4.5 years (55 months). Conclusion:Knowledge about the onset, duration, and recurrences of ENL are essential, and strict supervision for routine control shall be encouraged to increase the patients' compliance so as to increase their quality of life.
A Rare Self-Limiting Adamantiades Behcet Diseasen in A Woman: A Case Report Fajrin, Farah Meriana; Damayanti; Hidayati, Afif Nurul; Murtiastutik, Dwi Murtiastutik; Astindari, Astindari; Widyantari, Septiana; Sari, Maylita
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.75-80

Abstract

Background: Adamantiades–Behçet is a genetically determined disorder with a probable environmental triggering factor and is an inflammatory disease representing vasculitis. Chronic relapsing progressive course, Dapson prevents problems in other organs. Case Report: A 31-year-old woman with chief complaints of a progressive painful ulcer on her genitalia in the last month, covered by pus and with a bad odor, and also recurrent tongue sores that healed spontaneously. Multiple partner sexual intercourse, joint pain, and an eye complaint were denied. Her husband has no history of previous sexually transmitted diseases. The labia majora region showed a solitary ulcer, sharply marginated, and covered with pus. The Haemophilus ducreyi, pathergy, VDRL, TPHA, and rapid test HIV all came back negative. Enterococcus faecalis, found in bacterial culture, is sensitive to Penicillin and glycopeptide. Histopathologically recited vasculitis with thrombus in the blood vessel marks Behcet disease. The patient was given Mefenamic Acid (3x500mg), doxycicline (2x100 mg), and a wet dressing. The ulcer decreased in size after 3 weeks of treatment. Discussion: Adamantiades-Behçett disease is characterized by chronic, recurrent oral aphthous ulcers, genital ulcers, skin lesions, ocular lesions, and arthritis or arthropathy. Viral and bacterial infections have been implicated in initiating immunopathologic pathways. The pathergy test is pathognomonic, but it is not specific and often gives a negative result. Histopathological examination is still the best option to establish the diagnosis. 
Profile of Mild Acne Vulgaris Patients at Tertiary Hospital at Surabaya, Indonesia Arifin Saiboo, Alvian; Muhammad Yulianto Listiawan; Sari, Maylita; Indramaya, Diah Mira; Murtiastutik, Dwi; Damayanti; Anggaraeni, Sylvia
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.26-30

Abstract

Background: One of the most prevalent skin conditions worldwide is acne vulgaris (AV). Even mild forms of AV could have an adverse impact on psychological wellbeing. Purpose: To explore the profile of mild AV patients in a tertiary care facility in Surabaya, Indonesia. Method: This was a descriptive study conducted for eight weeks. Data regarding the patient's identity, history, skin type, and complaints related to AV or other complaints that arose were noted on the sample's medical record and collected for analysis. The Lehmann classification was used to assess the AV degree. Result: A total of 34 patients were included. Gender equality was similar in our study, and late adolescence (17-25 years) is the most dominant age group (73.5%). Genetics plays the biggest precipitating factor (73.5%), followed by stress (70.6%). Most patients had an oily skin type (91.2%) with Fitzpatrick's phototype 4 (85.3%). Comedone is the most prevalent lesion in our study (median = 10, range = 4-20). Conclusion: Most patients with mild AV had an oily skin type, and late adolescent is most dominant age group.
Concordance Test Between Dermoscopic and Histopathological Parameteres in Basal Cell Carcinoma Hartanto, Felix; Kusumaputra, Bagus Haryo; Sari, Maylita; Citrashanty, Irmadita; Mappamasing, Hasnikmah; Astari, Linda; Sandhika, Willy; Hidayati, Afif Nurul; Prakoeswa, Cita Rosita Sigit; Listiawan, Muhammad Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.6-11

Abstract

Background: Basal cell carcinoma (BCC) is the most common skin cancer and can cause local tissue damage. BCC can occur in all populations, regardless of skin color. Dermoscopy has compatibility with histopathology in determining the benign or malignant nature of a lesion. Dermoscopy can improve the diagnostic accuracy of BCC by >90%, with 7 parameters that can be found: arborizing vessels, blue-gray ovoid nests, blue-gray dots/globules, maple leaf-like areas, spoke-wheel areas, ulceration, and hiny white areas. Purpose: To assess the compatibility of each dermoscopy parameter with its corresponding histopathological parameters. Methods: Observational analytic study with a cross-sectional approach was performed. Dermoscopy parameters were obtained by reassessing all photographs, while histopathological parameters were obtained from pre-existing slide reviews. Cohen's Kappa test was performed to analyze both variables. Result: A Total of 26 samples met the inclusion criteria. Most BCCs were found in female sex (65.4%), age >50 years (80.8%), and facial location (88.5%). Cohen's Kappa test was significant in 2 out of 7 dermoscopy parameters: "blue-gray ovoid nests" (p = 0.0019; r = 0.458) and "spoke wheel areas" (p = 0.037; r = 0.371). The "shiny white areas” parameter could not be analyzed because there was no negative variation in the examination. The possibility of false positives and negatives could not be ruled out.  Conclusion: Significance between the two variables is found in 28.6% of the 7 parameters analyzed...
Description of Hanifin-Rajka Criteria and Skin Hydration in Adult Patients with Mild-Moderate Atopic Dermatitis at Tertiary Hospital Umborowati, Menul Ayu; Jastika, Faradistiani Rakhmawati; Hendaria, Made Putri; Anggraeni, Sylvia; Damayanti; Sari, Maylita; Prakoeswa, Cita Rosita Sigit
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 36 No. 1 (2024): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V36.1.2024.20-25

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that typically manifests in childhood and has a diverse etiology. In the United States, the prevalence of AD among adults was 4.9%, while in Japan it was 2.1%. The majority of people with AD have dry skin. Hanifin-Rajka criteria were the first to be established and are frequently used as diagnostic standards in research. Purpose: The purpose of this study is to determine the Hanifin-Rajka criteria and skin hydration in adult patients with mild-moderate atopic dermatitis at Dr. Soetomo General Academic Hospital, Surabaya March-May 2022.  Methods: This cross-sectional descriptive study included adult patients with mild to moderate AD according to Hanifin-Rajka aged 18-64 years who visited the Dermatology and Venereology Outpatient Dr. Soetomo General Academic Hospital Surabaya between March and May 2022. Skin hydration was measured using a corneometer on the volar side of the left forearm in the skin area.  Result: Based on the major criteria, all participants had pruritus, typical morphology and distribution, and chronic or chronically recurrent dermatitis. As for the minor criteria, more varied results were obtained, one of which was xerosis, which was experienced by all participants. The skin hydration shows that the mean value for skin hydration was 39.8 ± 12.1. The lowest skin hydration was 21.4 and the highest was 87.4, both found in subjects with mild AD. Conclusion: ..
Large acrochordon of labium majora: an unusual location Citrashanty, Irmadita; Luthfidyaningrum, Hamidah; Murtiastutik, Dwi; Hidayati, Afif Nurul; Widyantari, Septiana; Astindari, Astindari; Sari, Maylita
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 6, Issue 1 (June 2023)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/93p62v41

Abstract

Background: Acrochordon is a soft, round or oval, pedunculated papilloma that can be tan or brown in color. Although acrochordons most commonly appear in the neck, axilla, and groin, they can also appear in unusual sites, such as penis, vulva, and perineum. Most of the lesions are small pedunculated papules or nodules approximately 2–6 mm, but rarely, particularly on the lower section of the trunk, large pedunculated acrochordons can be found. Here we present a large acrochordon on the labium majora. Case Description: A 25 years old woman came to an outpatient clinic because there was a mass on her right labium majora ever since she gave birth three years prior. The size of the mass started off relatively small but has grown significantly over time. From dermatological examination in external genitalia region, there was a solitary, pedunculated, skin-colored mass measuring 10 × 3 cm, attached to right labium majora. There was no redness, ulceration, bleeding or discharge. Cautery excision with local anesthetic was performed to removed the mass. The histopathological examination of the specimen revealed polypoidal tissue lined by epidermal layer, there are proliferation and dilation of capillaries containing erythrocytes in the dermis layer, mild infiltration of lymphocytes and histiocytes. No evidence of malignancy. Conclusion: We report an unusual location of acrochordon presenting with large size. Due to its atypical presentation, it may be confused with a malignancy, necessitating a pathological test. Total excision of the mass is recommended.