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All Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan MEDICINUS Media Dermato-Venereologica Indonesiana

Achmad Satya Negara

Unknown Affiliation

Author-ID : 5983901

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Granulomatosis Wegener dengan Antineutrophil Cytoplasmic Antibodies (ANCA) Negatif pada Laki-laki Usia 38 Tahun Achmad Satya Negara; Harijono Kariosentono; Endra Yustin Elistasari
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Background : Wegener’s granulomatosis or granulomatosis with polyangiitis is a systemic necrotizing vasculitis, which affects small- and medium-sized blood vessels. This disease is often associated with antineutrophil cytoplasmic antibodies (ANCA). Etiology of Wegener’s granulomatosis may originate from infectious, environmental, chemical, toxic or pharmacological triggers in people who are genetically predisposed to this autoimmune disease. The disease can present with nonspecific symptoms such as malaise, myalgia, arthralgia, anorexia, and weight loss. Skin manifestations of Wegener’s granulomatosis includes leukocytoclastic vasculitis, purpura, ulcer and subcutaneus nodul. It also known could affect different organs. Case: A 38-year-old man came with a chief complaint of erythematous patches and stiffness on his face, body, arms and legs. The dermatological status showed a saddle nose and discrete multiple purpura on the superior and inferior extremities. ANCA examination result was negative. Histopathological examination of the epidermal layer showed dense proliferation of lymphocyte cells, perivascular infiltrates and a few neutrophil cells. In the dermis layer, there were granulomas consisting of many epitheloid histiocytes and foamy macrophages also damaged blood vessels with neutrophil infiltration on the walls and erythrocyte extravasation. Discussion: Wegener’s granulomatosis is a rare autoimmune disease of localized granulomatous inflammation of the upper and lower respiratory tract and systemic vasculitis associated with ANCA. Symptoms that arise in Wegener’s granulomatosis are often mild at first, but may progress to a more severe clinical features. A negative ANCA examination cannot immediately rule out the diagnosis. Initial therapy for Wegener’s granulomatosis are cyclophosphamide and glucocorticoids for 3-6 months. Patient showed clinical improvement with the reduction of purpura throughout the body after five weeks treatment.

Familial Erythema Annulare Centrifugum pada Anak Berusia 9 Tahun Achmad Satya Negara; Endra Yustin Elistasari
MEDICINUS Vol. 34 No. 3 (2021): MEDICINUS
Publisher : PT Dexa Medica

Background: Erythema annulare centrifugum (EAC) is a rare cutaneous disease characterized by erythematous papule which slowly migrates and peripherally enlarges into polycyclic lesion with central clearing that usually involves thigh and legs area. The etiology is unclear, but presumabley related with medication history, infection, malignancy, and stress. The diagnosis of EAC is based on clinical manifestations and histopathological examination. Histopathologically, EAC can be divided into superficial and deep type. Pathognomonic signs include coat sleeve and trailing scale. Symptomatic treatment of EAC may involve topical corticosteroid, topical vitamin D analog, and antihistamine. Case: A 9-year-old boy came with a complaint of erythematous patches on his face and body. Histopathological biopsy showed showed a mild appearance of hyperkeratosis and spongiosis at the epidermis, and perivascular lymphocytic infiltrate at the dermis. Based on these findings, patient was diagnosed with erythema annulare centrifugum. We gave antihistamine and topical corticosteroid to treat his condition. Discussion: Erythema annular centrifugum is a rare skin condition, with most cases is idiopathic. Histopathological biopsy can be used to help establish the diagnosis of EAC. Topical & systemic corticosteroid is the first-line therapy of idiopathic EAC, but administration of empirical therapy using antibiotics or antifungals may also be considered.

Kromoblastomikosis Penyakit Jamur yang Terabaikan Danu Yuliarto; Achmad Satya Negara; Harijono Kariosentono; Nugrohoaji Dharmawan; Nurrachmat Mulianto
MEDICINUS Vol. 36 No. 1 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i1.116

Chromoblastomycosis is a deep fungal infection of the skin and subcutaneous tissue caused by pigmented or dematiaceous fungi. This disease is endemic in tropical and subtropical regions such as Asia, Africa, and Latin America. Chromoblastomycosis is more common in adult men who work in agricultural areas, work as gardeners, or as carpenters. The diagnosis of chromoblastomycosis is confirmed by the finding of muriform cells or medlar bodies obtained from skin scrapings, microscopic culture, or tissue histopathological examination. The clinical feature varies, the initial lesion is a papule that spreads slowly over several months or years, and then this lesion will form a plaque with atrophic center. Many patients go undiagnosed at the early stage of the disease because this stage is rarely seen. Treatment of chromoblastomycosis includes surgery for the initial lesion and pharmacological therapy using antifungal agent such as itraconazole, the most commonly used drug for the treatment of chromoblastomycosis. The prognosis for chromoblastomycosis is poor, except on new lesions.

Kasus Morfea Tipe Linier (En Coup de Sabre) pada Wanita Berusia 20 Tahun Achmad Satya Negara; Arie Kusumawardhani
MEDICINUS Vol. 36 No. 2 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v36i2.121

Background: Morphea is a chronic inflammatory disease characterized by sclerosis of the skin which belongs to the group of idiopathic sclerotic diseases. Frontoparietal linear morphea is a unilateral atrophy linear plaque on the forehead that can extend to the eyebrows, nose, lips, and scalps, causing alopecia. The aim of this case report is to establish the diagnosis of frontoparietal linear morphea. Case: A 20-year-old woman presented with a dark brown spot on her forehead. Histopathological examination showed a basket-weave hyperkeratosis and flattening of the rete ridges of epidermal layer, and pigmented cells in the basal cells of the dermal-epidermal junction. Based on the results of physical examination and histopathology, patient was diagnosed with linear morphea en coup de sabre. Patient was treated with topical and systemic corticosteroid. Discussion: Morphea is a rare fibrotic disease of the skin and underlying tissue, characterized with diffuse thickening, induration, or atrophy. Histopathological biopsy examination can be used to confirm the diagnosis and rule out differential diagnosis. Histopathological biopsy of early phase morphea can show inflammation, the dermis looks dense with thickened collagen fibers accompanied by inflammatory cells, especially perivascular lymphocytes between collagen fibers, flattening of the epidermal rete ridges, and atrophy. Topical therapy with corticosteroid as anti-inflammatory drug can be used in active lesions of early-stage linear morphea.

Profil Pasien Infeksi Menular Seksual di Poliklinik Kulit dan Kelamin RSUD Dr. Moewardi Surakarta Periode Januari 2016−Desember 2020 Achmad Satya Negara; Ammarilis Murastami
MEDICINUS Vol. 36 No. 3 (2023): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/8bjbj417

Latar belakang: Infeksi menular seksual (IMS) merupakan infeksi yang disebabkan oleh bakteri, virus, maupun parasit yang sebagian besar ditularkan melalui hubungan seksual secara vaginal, anal, atau oral. Prevalensi IMS di seluruh dunia diperkirakan mencapai 333 juta kasus per tahun dan setiap hari terjadi lebih dari 1 juta kasus IMS. Pelaporan data IMS saat ini diestimasikan hanya mewakili 50−80% dari total keseluruhan penyakit IMS di Amerika Serikat, yang mencerminkan keterbatasan screening, kurangnya informasi mengenai transmisi penyakit, serta rendahnya tingkat pelaporan data. Data mengenai IMS penting diketahui sebagai bahan kajian perencanaan dalam upaya pencegahan dan pengendalian penyakit. Tujuan: Mengetahui profil penyakit IMS di Poliklinik Kulit dan Kelamin RSUD Dr. Moewardi periode Januari 2016 sampai Desember 2020. Metode: Penelitian ini merupakan penelitian retrospektif dengan menggunakan data sekunder berupa rekam medis dan buku registrasi di Poliklinik Kulit dan Kelamin RSUD Dr. Moewardi, Surakarta, periode Januari 2016−Desember 2020. Hasil: Didapatkan jumlah kasus baru IMS rawat jalan di Poliklinik Kulit dan Kelamin RSUD Dr. Moewardi sebanyak 275 kasus selama 5 tahun terakhir. Terdapat 192 kasus kondiloma akuminata, 16 kasus ulkus genital, 35 kasus keluarnya cairan dari genitalia laki-laki, dan 20 kasus keluarnya cairan dari genitalia perempuan. Kesimpulan: Penderita IMS yang berobat di RSUD Dr. Moewardi mayoritas berjenis kelamin laki-laki dengan diagnosis terbanyak adalah kondiloma akuminata. Data ini dapat menjadi acuan dalam upaya pengendalian IMS dengan meningkatkan anamnesis, pemeriksaan fisik dan penunjang, serta memberikan edukasi terkait tindakan preventif pada pasien.

Co-Authors Ammarilis Murastami Arie Kusumawardhani Budi Eko Prasetyorini Danu Yuliarto Dharmawan, Nugrohoaji Endra Yustin Elistasari Endra Yustin Ellistasari Fatimah Fitriani Harijono Kariosentono M. Eko Irawanto Nathania Amelinda Nurrachmat Mulianto Putri Oktriana

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