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All Journal eJournal Kedokteran Indonesia Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia
Eliza Miranda
Departemen Dermatologi Dan Venereologi Fakultas Kedokteran Universitas Indonesia RSUPN Dr. Cipto Mangunkusumo Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Dermatomiositis: Diagnosis dan Tata Laksana Anandika Pawitri; Eliza Miranda
eJournal Kedokteran Indonesia Vol 10, No. 1 - April 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.255 KB) | DOI: 10.23886/ejki.10.98.81-9

Abstract

Dermatomiositis adalah kelainan autoimun yang jarang terjadi dengan gejala inflamasi di kulit dan otot, serta berkaitan dengan 10-20% kasus keganasan organ dalam. Diagnosis dermatomiositis sulit ditegakkankarena hanya sekitar 20% pasien mengalami lesi kulit yang khas bahkan tanpa keluhan otot. Gejala khasdermatomiositis adalah heliotrope sign, gottron’s papules, dan gottron’s sign. Patogenesis penyakit ini berhubungan dengan gangguan imunitas, baik sistem imun alami maupun sistem adaptif. Dibuktikan dengan tingginya kadar interferon yang diinduksi oleh gen dan protein dalam darah, otot, dan kulit berkorelasi denganaktivitas penyakit. Faktor lingkungan, misalnya pajanan sinar matahari, infeksi, dan keganasan juga dapatmemicu terjadinya dermatomiositis. Pilihan terapi topikal dermatomiositis adalah dengan kortikosteroid danpenghambat kalsineurin topikal. Selain itu terapi sistemik terdiri atas kortikosteroid, antimalaria, steroid sparingagent, metotreksat, mikofenolat mofetil, azatioprin, dan penghambat kalsineurin. Pengobatan dermatomiositisterkini adalah imunoglobulin, rituksimab, abatasep, dan lenabasum yang sedang dikembangkan dalam faseuji klinis fase III.
The evidence-based topical therapies for management of minor burns in outpatient clinic Dien, Siphora; Miranda, Eliza; Pusponegoro, Erdina Hardiono D; Wardhana, Aditya
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Burns are often seen in clinics or hospitals. Majority of burns are minor burns, which can be managed in outpatient setting with satisfactory result. The healing outcome depends on physician’s knowledge and competencies in burn pathogenesis and basic principles of burn care. Initial treatment of burns consists of emergency evaluation, assessment of depth and severity of burns and considerations for referral. The principles of minor wound therapy include cooling, cleansing, pain management, and topical therapy. Recently, many topical agents are available and indicated for first to second degree burn. Silver sulfadiazine (SSD) is the standard treatment; however, it has some limitations. Scientific evidences showed that topical antibiotics do not reduce the incidence of local infection, invasive infection, and mortality of infection. Burns heal faster with hydrogel dressings and some other dressings compared to SSD. There are insufficient evidences to support the use of aloe vera, honey, and negative pressure wound therapy in burns. Moist exposed burn ointment (MEBO®) has been demonstrated to have equal efficacy to SSD.
Subcutaneous mycosis at the Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013 Yahya, Sammy; Widaty, Sandra; Miranda, Eliza; Bramono, Kusmarinah; Islami, Artini Wijayanti
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usually found in workers of rural tropical and subtropical area. SM occurs due to trauma along with other predisposing factors such as sex, genetic and occupation.Aim: To identify the types of SM, its clinical findings, laboratory work-up and the treatment at the Dermatomycology Division, Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital between the year 1989 and 2013.Method: This retrospective study collected data from medical records and case reports of patients with SM who came at Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital (1989-2013).Results: We found 16 cases of SM, i.e. subcutaneous mucormycosis (5 cases), eumycetoma (4 cases), actinomycetoma (4 cases) and chromoblastomycosis (3 cases). There was a greater number of male than female patients ratio (3:1) and mostly were in the age group of 25-44 years. The direct microscopic examination did not reveal any fungal element, except for black spora in chromoblastomycosis (1 case). The culture revealed Basidiobolus ranarum in subcutaneous mucormycosis (5 cases), Nocardia transvalensis in actinomycetoma (1 case) and Phialophora sp. in 1 case of chromoblastomycosis. On histopathological examination, we found fine granules of actinomycetoma, sulphuric granules of actinomycetoma, coenocytic hyphae of subcutaneous mucormycosis, eosinophilic granule in 1 case of mycetoma and hyphae with black spore in chromoblastomycosis.Conclusion: SM is still a rare disease, comprehensive management of SM needs supporting laboratory work-up, particularly the histopathological examination.
Correlation between clinical and histopathological findings of five puzzling cases of cutaneous tuberculosis Miranda, Eliza; Widaty, Sandra; Sirait, Sondang Pandjaitan; Rizky, Luddwi Achmad; Menaldi, Sri Linuwih; Lim, Henry W
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Cutaneous tuberculosis refers to the clinical manifestation of extrapulmonary tuberculosis affecting the skin. Determining the type of cutaneous tuberculosis from a patient afflicted with is challenging because clinical and histopathological similarities exist between types. Moreover, confirming a diagnosis of cutaneous tuberculosis is difficult because of its similarity with other diseases. For instance, typical and atypical cutaneous tuberculosis may have similar manifestations, but each disease is managed by completely different approaches. Microbiological examination with polymerase chain reaction and bacterial culture are the gold standard methods used to confirm a diagnosis of cutaneous tuberculosis. However, results often demonstrate negative findings. Case Illustration: Five cases of cutaneous tuberculosis, which include two cases of tuberculosis verrucosa cutis, two cases of scrofuloderma, and one case of lupus vulgaris were presented in this article. Four of the five cases demonstrated significant improvement after initiation of an antituberculosis drug regimen. Discussion: Diagnosis of cutaneous tuberculosis in these cases was confirmed through clinical findings and histopathological and microbiological examination. Conclusion: A negative result following microbiological examination does not completely exclude the diagnosis of cutaneous tuberculosis. Investigating the pathognomonic findings of cutaneous tuberculosis through histopathological examination is important to differentiate among its types correctly. Therefore, correlations between clinical and histopathological results are essential to establish a diagnosis of cutaneous tuberculosis.
The management of seborrheic dermatitis 2020 Widaty, Sandra; Bramono, Kusmarinah; Listiawan, Muhammad Yulianto; Yosi, Ariyati; Miranda, Eliza; Rahmayunita, Githa; Brahmanti, Herwinda; Lim, Henry W
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Seborrheic dermatitis (SD) is a chronic relapsing dermatitis manifesting in the seborrheic area, affecting infants or adults. In Indonesia, the prevalence of SD is 0.99–5.8% of all dermatology cases from 2013 to 2015. SD has been known to be a prominent manifestation among HIV patients, but there is an increasing trend in the general population. Therefore, in 2017, the Indonesian Society for Dermatology and Venereology proposed a consensus for the management of SD in Indonesia based on the discussion from 12 dermatological centers. Concurrent with the development of new drugs, this study aims to evaluate and develop a guideline for the treatment of seborrheic dermatitis in Indonesia to update the previous guidelines in 2017. Methods: Systematic review was based on evidence-based methods, and scientific evidences were acquired through systematic search. Evidence analysis was in accordance with the level of evidence. The available evidences were evaluated, and conclusion was based on the grade of recommendation. Critical appraisal was conducted by experts in dermatology and venereology. Results: Severity of SD can be determined by using the Seborrheic Dermatitis Area Severity Index. The principle of scalp SD management is controlling the scalp condition in a cost-effective manner to make patients comfortable. The recommendations for treatment of adult SD are topical agents, such as antifungals, nonsteroidal anti-inflammatory agents with antifungal properties, corticosteroids, and calcineurin inhibitors. Conclusion: We have updated and added newer agents for the treatment of SD. The approach is divided into scalp or nonscalp and also adult or infantile SD.
The effects of vitamin D on chronic wounds Priyanto, Mufqi Handaru; Miranda, Eliza; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Novianto, Endi; Bramono, Kusmarinah; Krisanti, Roro Inge Ade
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Wounds that fail to proceed through the normal healing process are referred to as chronic wounds, also known as ulcers. Chronic wounds have immeasurable biological, psychological, social, and economic effects, bringing tremendous challenges for patients, doctors, healthcare providers, and healthcare systems. Discussion: This condition is associated with a variety of comorbidities and complex etiologies. The global incidence of chronic wounds is expected to increase with longer life expectancy. Thus, a holistic approach is necessary, such as proper wound management, proper control of comorbidities, and provision of adequate nutrition, including vitamin D supplementation. Vitamin D is an essential pro-hormone for cell differentiation, proliferation, and growth. It affects the skin’s immune response, and is therefore thought to promote wound healing and tissue repair. Many studies have been published on the association between low vitamin D levels and chronic wounds. However, whether or not vitamin D supplementation directly contributes to wound healing still needs to be elucidated. Conclusion: Despite the many reports on vitamin D as an adjuvant treatment for chronic wounds, further large-scale clinical studies are needed to cement the role of vitamin D as an effective standard therapy for chronic wound healing.
MANIFESTASI KULIT PADA INFEKSI VIRUS NEW EMERGING DAN RE-EMERGING DI INDONESIA Mufqi Handaru Priyanto; Triana Agustin; Eliza Miranda; Sandra Widaty; Sri Linuwih Menaldi
Media Dermato-Venereologica Indonesiana Vol 50 No 3 (2023): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v50i3.247

Abstract

Virus merupakan patogen infeksius yang dapat menyebabkan berbagai penyakit life-threatening, dan memiliki kemampuan untuk berevolusi seiring dengan evolusi manusia sebagai pejamu. Virus new-emerging, memiliki patogenitas yang lebih tinggi karena belum terbentuk imunitas alamiah pada pejamu. Selain itu, berbagai virus re-emergingjuga menjadi ancaman tersendiri karena kemampuannya yang tinggi untuk berevolusi, sehingga keberadaan virus emergingini menyebabkan outbreak, epidemi, dan pandemik global. Indonesia dengan letak geografis yang strategis dan habitat fauna yang beragam, berpotensi besar bagi transmisi zoonosis dan tempat berkembang yang ideal bagi vektor pada penyakit virus. Beberapa infeksi virus new emergingcontohnya virus swine fludan SARS-CoV-2, serta virus re-emergingmisalnya virus chikungunya dan measles yang dilaporkan di Indonesia, tidak hanya memberikan gejala klinis yang biasa, namun dapat disertai dengan manifestasi pada kulit. Beberapa manifestasi pada kulit tersebut juga dapat menjadi penanda khas terhadap jenis inveksi virus yang berperan sebagai patogen. Identifikasi terhadap lesi kulit pada penyakit-penyakit akibat infeksi virus penting untuk dilakukan, dan memiliki peran untuk mengarahkan pada kemungkinan diagnosis dan tata laksana yang tepat.
PATOGENESIS DAN TATA LAKSANA DERMATITIS ATOPIK TERKINI Teguh Hopkop Putera Manurung; Eyleny Meisyah Fitri; Windy Keumala Budianti; Sondang P Sirait; Eliza Miranda
Media Dermato-Venereologica Indonesiana Vol 50 No 2 (2023): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i4.295

Abstract

Dermatitis atopik (DA) merupakan salah satu dermatosis kronik yang ditandai dengan eksema berulang yang disertai dengan rasa gatal yang tidak tertahankan dan dapat mengakibatkan gangguan kualitas hidup yang bermakna. Studi terdahulu melaporkan faktor genetik, sawar kulit, disregulasi sistem imun, dan faktor eksternal saling memengaruhi dalam menimbulkan penyakit. Meskipun gambaran klinis DA pada tiap pasien relatif sama, studi terkini menyatakan tiap pasien memiliki perbedaan dalam komponen yang dominan berperan dalam patogenesis penyakit. Terapi standar DA saat ini meliputi kortikosteroid, inhibitor kalsineurin, dan pelembap. Pemahaman mengenai patogenesis DA penting untuk mengembangkan modalitas terapi DA yang baru. Uji klinis obat terhadap sitokin (dupilumab, tralokinumab, dan lebrikizumab), molekul kecil (apremilast, crisaborol, tofacitinib, dan baricitinib), reseptor (tapinarof), dan mikrobiom yang terlibat pada DA telah banyak dilakukan dan diharapkan dapat memberi solusi pada tata laksana DA. Tinjauan pustaka ini bertujuan untuk memaparkan studi terkini mengenai patogenesis dan berbagai modalitas terapi yang telah dikembangkan untuk tata laksana DA.
VASKULITIS LEUKOSITOKLASTIK ATIPIKAL: KASUS DENGAN PRESENTASI ANULAR MENYERUPAI REAKSI ID PADA TINEA KORPORIS Halim, Melissa; Miranda, Eliza; Rihatmadja, Rahadi; Fitri, Eyleny Meisyah; Andrea, Valerie
Media Dermato-Venereologica Indonesiana Vol 52 No 3 (2025): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v52i3.491

Abstract

Pendahuluan: Dermatofitosis (tinea) biasanya ditandai lesi anular atau serpiginosa dengan skuama di tepi. Pada sebagian kasus, infeksi ini dapat memicu erupsi inflamasi sekunder di lokasi jauh dari fokus primer, disebut reaksi id. Salah satu manifestasi jarang sebagai respons imun sekunder adalah vaskulitis leukositoklastik, yaitu peradangan pembuluh darah kecil dengan ciri histopatologis deposit fibrin, kerusakan dinding vaskular, dan debris inti. Kasus: Laki-laki 47 tahun datang dengan bercak dan bintik kemerahan di kedua tungkai bawah sejak satu tahun. Pemeriksaan menunjukkan papul-plak eritematosa hingga hiperpigmentasi multipel, sebagian anular dengan tepi meninggi, dan skuama. Pemeriksaan mikroskopik jamur dari lesi representatif di pedis dekstra memperlihatkan hifa dan artrospora yang sesuai dengan tinea korporis, sedangkan hasil dari pedis sinistra negatif. Setelah empat minggu terapi antijamur, infeksi sembuh, tetapi muncul lesi anular baru pada lutut dan kaki bilateral disertai palpable purpura. Biopsi kulit menunjukkan vaskulitis leukositoklastik. Diskusi: Reaksi id awalnya dipertimbangkan karena memenuhi kriteria diagnosis untuk reaksi id, tetapi lesi tidak menghilang walaupun tinea korporis sembuh. Diagnosis vaskulitis leukositoklastik anular ditegakkan berdasarkan pemeriksaan klinis dan histopatologi. Pasien mendapat kortikosteroid sistemik tapering hingga tercapai remisi. Kesimpulan: Kasus ini menyoroti presentasi jarang vaskulitis leukositoklastik anular yang menyerupai reaksi id pada tinea korporis. Studi lebih lanjut diperlukan untuk memperjelas hubungan antara tinea, reaksi id, dan vaskulitis, serta menentukan terapi optimal.
PIODERMA FASIALE: DERMATOSIS AKIBAT INFEKSI ATAU AKIBAT ETIOLOGI LAIN? SUATU KASUS JARANG Priyanto, Mufqi Handaru; Miranda, Eliza; Sirait, Sondang Pandjaitan; Menaldi, Sri Linuwih SW
Media Dermato-Venereologica Indonesiana Vol 51 No 1 (2024): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v51i1.261

Abstract

Pioderma fasiale merupakan kondisi kelainan kulit yang jarang terjadi. Kelainan ini secara klasik ditandai dengan munculnya erupsi inflamatori berupa papul, pustul, nodul, bahkan kista pada wajah, terutama mengenai perempuan usia 15-46 tahun. Kondisi tersebut saat ini disebut sebagai rosasea fulminan, suatu varian rosasea yang berat dengan etiologi yang belum diketahui jelas sampai sekarang. Diduga terdapat hubungan antara pioderma fasiale dengan faktor imunologi, hormonal, dan vaskular. Dilaporkan satu kasus yang sepengetahuan penulis belum pernah dilaporkan di Indonesia. Perempuan usia 15 tahun dalam terapi lupus eritematosus sistemik, datang dengan erupsi pustul multipel di atas plak eritematosa disertai beberapa telangiektasis pada wajah. Kondisi ini awalnya dipikirkan sebagai suatu pioderma yang membaik dengan antibiotik sistemik  amoksisilin/asam klavulanat, namun mengalami rekurensi. Kultur dari pustul tidak didapatkan pertumbuhan isolat bakteri, dan biopsi jaringan menunjukkan sebukan sel polimorfonuklear di sekitar pembuluh darah, jaringan interstitial, dan folikel rambut. Pasien kemudian diterapi dengan kombinasi asam retinoat dan eritromisin topikal yang memberikan respons sangat baik dalam 3 minggu sejak dimulainya terapi.
Co-Authors Aditya Wardhana Anandika Pawitri Andrea, Valerie Cornain, Emilina Faradila Dien, Siphora Edwar, Sarah Qanita Endi Novianto Eyleny Meisyah Fitri Fitri, Eyleny Meisyah Gaol, Evangelina Lumban Githa Rahmayunita Halim, Melissa Hanny Nilasari Hapsari, Yari Castiliani Herwinda Brahmanti Islami, Artini Wijayanti Krisanti, Roro Inge Ade Kusmarinah Bramono Lili Legiawati Lim, Henry W M. Yulianto Listiawan Marissa, Melani Melinda, Thong Felicia Menaldi, Sri Linuwih Susetyo Wardhani Menaldi, Sri Linuwih SW Mufqi Handaru Priyanto Oktarina, Caroline Pandelaki, Paulus Anung Anindita Priyanto, Mufqi Handaru Pusponegoro, Erdina Hardiono D Rahadi Rihatmadja Ratu Siti Khadijah Sarah Rizky, Luddwi Achmad Sandra Widaty Shannaz Nadia Yusharyahya Sirait, Sondang Pandjaitan Situmeang, Irhen Sondang P Sirait Sri L. Menaldi Sri Linuwih Menaldi Surachmiati Suseno, Lis Teguh Hopkop Putera Manurung Triana Agustin Windy Keumala Budianti Windy Keumala Budianti Yahya, Sammy Yosi, Ariyati