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All Journal International Journal of Integrated Health Sciences Berkala Ilmu Kesehatan Kulit dan Kelamin Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan Journal of General Procedural Dermatology and Venereology Indonesia
Eva Krishna Sutedja
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Tinjauan Pustaka: Manifestasi Klinis dan Gambaran Dermoskopi pada Karsinoma Sel Basal Fakhrosa, Irma; Sutedja, Eva Krishna; Agusni, Jono Hadi; Feriza, Vina; Saraswati, Nia Ayu
Syifa'Medika Vol 8, No 2 (2018): Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v8i2.1346

Abstract

Karsinoma sel basal (KSB) adalah suatu tumor ganas yang berasal dari sel basal  epidermis, ditandai dengan pertumbuhan tumor yang lambat, tetapi dapat menyebabkan destruksi jaringan sekitarnya. Berdasarkan manifestasi klinis, KSB dibagi menjadi subtipe nodular, pigmentasi, superfisial, morfeaformis, dan fibroepitelioma of pinkus. Suatu lesi dapat dicurigai keganasan jika lesi tersebut mudah rapuh, mudah berdarah, sulit sembuh, dan sering berulang. Dalam membantu menegakkan diagnosis KSB selain dari manifestasi klinis, diperlukan pemeriksaan penunjang seperti dermoskopi. Dermoskopi merupakan salah satu pemeriksaan penunjang yang tidak invasif, mudah dilakukan, murah dan cepat dalam membantu menegakkan diagnosis KSB dengan sensitivitas mencapai 95-97% dan spesifitas mencapai 87-96%. Berdasarkan gambaran dermoskopi, diagnosis KSB harus memenuhi dua syarat yaitu tidak ditemukan gambaran pigment network dan terdapat minimal satu karakteristik gambaran dermoskopi KSB.  Karakteristik gambaran dermoskopi yang dapat ditemukan pada KSB berupa arborizing vessel, superfisial fine telangiectasis, ulserasi, multiple small erosions, blue-gray ovoid nest, multiple blue-gray dots/globules, maple leaf-like areas, dan spoke-wheel areas. Berdasarkan hal tersebut, dermoskopi dapat dijadikan suatu pemerikaan rutin pada setiap lesi yang dicurigai keganasan. 
Psoriasis Pustulosa Generalisata dengan Kejadian Berulang pada Kehamilan Hingga Masa Nifas yang Diterapi dengan Siklosporin Saraswati, Nia Ayu; Sutedja, Eva Krishna
Syifa'Medika Vol 7, No 2 (2017): Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v7i2.1362

Abstract

Psoriasis pustulosa generalisata (PPG) adalah salah satu varian psoriasis pustulosa akut. PPG dapat dipicu berbagai faktor, salah satunya adalah kehamilan. Penyakit ini pada kehamilan dapat menyebabkan komplikasi maternal dan mengancam keselamatan janin. Penanganan kasus PPG pada kehamilan memerlukan pemilihan terapi efektif yang juga aman bagi janin dan bayi saat fase menyusui, salah satunya adalah siklosporin. Dilaporkan sebuah kasus PPG yang diinduksi kehamilan pada kehamilan kedua seorang wanita berusia 21 tahun yang telah mengkonsumsi kortikosteroid jangka panjang dan mengalami hipokortisol. Manifestasi klinis timbul sejak usia kehamilan memasuki trimester kedua dan berlanjut setelah melahirkan hingga masa nifas berakhir. Pasien memiliki riwayat PPG berulang sejak enam tahun yang lalu. Siklosporin diberikan pada masa postpartum dengan dosis awal 0,8 mg/kgBB/hari setelah mengalami rekalsitran terhadap pengobatan kortikosteroid sistemik dosis tinggi saat kehamilan. Perbaikan klinis terjadi setelah pemberian siklosporin dengan dosis 2,5 mg/kgBB/hari selama satu minggu. Pemberian kortikosteroid tetap diberikan dengan penurunan dosis secara bertahap dan dihentikan pada pengamatan hari ke-101. Perubahan hormonal dan imunitas selama kehamilan berperan penting dalam mencetuskan PPG. Selama kehamilan terjadi perubahan rasio estrogen dan progesteron yang akan mempengaruhi keadaan sistem imunitas selama kehamilan. Kortikosteroid sistemik menjadi pilihan terapi utama pada kasus PPG berat dalam kehamilan, namun siklosporin dapat digunakan pada kasus refrakter terhadap kortikosteroid dosis tinggi. Pada pasien ini PPG mengalami perbaikan setelah pemberian siklosporin 2,5 mg/kgBB/hari dan kortikosteroid sistemik tetap diberikan karena adanya kondisi hipokortisol. Penggunaan kortikosteroid jangka panjang dapar memberikan efek samping berupa moon face, hipertrikosis, atrofi kulit, dan osteoporosis. Selain itu gangguan maternal dapat terjadi, bayi pada kasus ini lahir dengan berat badan lahir rendah karena penggunaan kortikosteroid selama kehamilan.
Tinjauan Dasar Berbagai Prosedur Bedah Kuku Saraswati, Nia Ayu; Sutedja, Eva Krishna; Agusni, Jono Hadi
Syifa'Medika Vol 8, No 1 (2017): Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v8i1.1355

Abstract

Bedah kuku termasuk tindakan yang tidak rutin dilakukan pada praktik kedokteran. Tindakan ini menjadi tantangan bagi para klinisi karena memerlukan tindakan bedah rapi yang teliti. Bedah kuku dapat dilakukan untuk penegakan diagnosis maupun terapi berbagai kasus tumor jinak atau ganas, kasus-kasus inflamasi, dan trauma pada kuku. Beragam jenis tindakan bedah kuku memiliki prinsip yang berbeda sesuai dengan patologi kelainan kuku dan letak pada unit kuku yang terkena. Pembedahan pada kuku terutama pada matriks kuku sangat berisiko menimbulkan komplikasi seperti distrofi kuku. Tujuan pembedahan seringkali tidak tercapai pada pengambilan jaringan biopsi, karena spesimen tidak memadai untuk dilakukan pemeriksaan histopatologis yang disebabkan tindakan bedah yang tidak tepat. Oleh karena itu, penting bagi para klinisi untuk dapat memahami berbagai teknik bedah kuku.
Triamcinolone Acetonide and 5-Fluorouracil Intralesional Combination Injection in Keloid Treatment Jono Hadi Agusni; Eva Krishna Sutedja; Franky Chandra
International Journal of Integrated Health Sciences Vol 5, No 1 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.137 KB)

Abstract

Objective: To evaluate the effectiveness of steroid and 5-fluorouracil (5-FU) injection combination for keloid management.Methods: A 22-year-old female patient was presented with recurrent skin lesions. The skin lesions first appeared 10 years prior to consultation, had been surgically excised, and were given triamcinolone acetonide injection. However, no improvement was observed. A decision was made to use and evaluate treatment using an intralesional 4 mg (0.1 ml of 40 mg/ml) triamcinolone acetonide and 45 mg (0.9 ml of 50 mg/ml ) 5-FU injection combination for 5 weeks.Results: Clinical improvements were observed in the third week as the lesions softened and pruritic sensation dinimished. At the end of the fifth week, improvements in the form of keloid lesion flattening and size reduction were observed.Conclusions: Intralesional injection using a combination of triamcinolone acetonide and 5-fluorouracil is effective for keloid lesion treatment.Keywords: 5-fluorouracil, intralesional injection, keloid, triamcinolone acetonide DOI: 10.15850/ijihs.v5n1.959
The Correlation between Interleukin-10 Serum with Bacterial Index in Multidrug Therapy-treated Leprosy Patients Eva Krishna Sutedja; Jono Hadi Agusni; Hartati Purbo Dharmadji
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.285 KB) | DOI: 10.20473/bikk.V28.1.2016.16-22

Abstract

Background: Immune respons disturbance oftenly found in leprosy patient, mainly in various T cell subset and cytokine immune system arranger. Interleukin-10 produced by Th 2 cell, Th3 cell, monocyte, dendritic cell, eosinophil, mast cell, and keratinocyte. Interleukin 10 (IL-10) works in active macrophage to end the respons to microbe and restore the system to the resting state after the microbes are destroyed. Purpose: To analyze correlation between IL-10 level with Bacterial Index (BI)  in Multidrug Therapy (MDT)-treared leprosy patient. Methods: Cross sectional analytical observational study of 43 subjects, consisting of 38 males (88.4%) and 5 females (11.6%). The IL-10 examination used quantitative sandwich enzyme immunoassay, human IL-10 Quantikine® ELISA methods from R & D systems® Result: There was positive correlation between IL-10 and BI of MDT-treated leprosy patient (r = 0,504; p=0,001). Conclusion: The increasing of IL-0 correlated with high BI. Interleukin-10 level is higher in MB type than PB type of leprosy patients.Key words: Interleukin-10 (IL-10), bacterial index (BI).
Seborrheic Keratosis Profile at Dr. Hasan Sadikin Central General Hospital Bandung 2015-2019 Sutedja, Eva Krishna; Gradia, Resti; Latifah, Tri Aswila
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 6, No. 2
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Seborrheic keratosis (SK) is adults’ most prevalent benign skin tumor. SK originates from the proliferation of keratinocyte cells with varying morphology and degree of pigmentation. The lesions often resemble other types of malignancy. There are still many discrepancies in SK in Indonesia; hence, SK needs further understanding. This study aimed to describe the profile of seborrheic keratosis cases based on age, sex, location of lesions, and therapy at Dr. Hasan Sadikin Central General Hospital, Bandung, for five years Methods: This was a retrospective descriptive study with total sampling. Secondary data were collected from medical records of SK patients in the Tumor and Skin Surgery Polyclinic of Dr. Hasan Sadikin Central General Hospital, Bandung, from Jan 1, 2015, to Dec 31, 2019. A total of 105 medical records fulfilled the inclusion and exclusion criteria. Results: In most cases of SK, 41% occurred in middle-aged (40-59 years) patients. The average age was 49 ± 15 years old. Most patients, 64.8% were women. The location was mainly in the head and or neck (94.3%). SK was most frequently treated with a CO2 laser (56.2%), followed by electrocautery (36.2%). Conclusion: Most SK patients in this study were female, middle-aged (40-59 years), with lesions on the head and or neck, and were treated with CO2 laser.
Comparison of the Effectiveness of Topical 5-Fluorouracil, Topical Calcipotriol, and Liquid Nitrogen Cryosurgery in Seborrhoeic Keratosis Sutedja, Eva Krishna; Suwarsa, Oki; Febrina, Dia; Wibowo , Raka Ghufran; Tasbun, Felix
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 37 No. 3 (2025): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikkk.V37.3.2025.172-178

Abstract

Background: Seborrhoeic keratosis (SK) is a benign tumor composed of epidermal keratinocytes occurs most frequently in the elderly. The action of 5-fluorouracil (FU) cream and calcipotrienes on keratinocyte development and has been shown beneficial for SK. Purpose: To compare the effectiveness of 5-FU and calcipotriol topical with cryosurgery. Methods: Eighteen SK patients with 54 skin lesions were enlisted, which were separated into three groups. The first group received topical 5-FU twice daily, the second group received one 10-second freeze-thaw cycle of liquid nitrogen cryosurgery, and the third group received topical calcipotriol twice daily. The success of therapy was assessed based on the reduction in baseline lesion size, and observations were made every two weeks for three months. Result: This study found that at the 12th week, the mean percentage of decrease in lesion size in group I was 34.6%, group II was 100%, and group III was 6.18%. Statistically, there was a significant difference in the decrease in lesion size in groups treated with cryosurgery (p value<0.001). The most common side effect in group I was discomfort, whereas in group II it was hyperpigmentation. Patients from group III reported no negative effects. Conclusion: Topical 5-FU and topical calcipotriol are less effective than cryosurgery in SK in terms of reducing lesion size. However, topical 5-FU reduced the size of lesions more than topical calcipotriol.
Co-Authors Fakhrosa, Irma Febrina, Dia Feriza, Vina Franky Chandra Gradia, Resti Hartati Purbo Dharmadji Jono Hadi Agusni Jono Hadi Agusni, Jono Hadi Latifah, Tri Aswila Oki Suwarsa Saraswati, Nia Ayu Tasbun, Felix Wibowo , Raka Ghufran