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All Journal JOURNAL LA MEDIHEALTICO Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal
Sirait, Sondang Panjaitan
KSM Dermatologi Dan Venereologi Fakultas Kedokteran Universitas Indonesia - Rumah Sakit Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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A rare case of late onset reticulate acropigmentation of Kitamura without involvement of the palms and soles Melly, Conny; Sularsito, Sri Adi; Sirait, Sondang Panjaitan; Rihatmadja, Rahadi; Widyasari, Indah; Onmaya, Vini
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Background: Reticulate acropigmentations of Kitamura (RAPK) is an autosomal dominant inherited disorder characterized by pigmented, angulated, irregular freckle-like lesion with atrophy on the surface, arranged in a reticulate pattern on the dorsa of the hands and feet. It was first described by Kitamura and Akamatsu in Japan in 1943. The usual age of onset is the first and second decades of life. Palms and soles reveal pits and breaks in the epidermal ridge pattern. The histopathological examination show epidermal atrophy, digitate and filiform elongated rete ridges with clumps of heavy melanin pigmentation at their tips. Case: A 59-year-old male presented with asymptomatic and progressive brownish-black discoloration in a reticulate pattern on the dorsal aspect of his hands and feet. The lesions initially appeared when the patient was 45 years old. It was not preceded by any erythema or inflammation. There was no similar case in the family. Laboratory findings were within normal limits. Discussion: Skin biopsy taken from the dorsal of the hand and foot revealed hyperkeratosis, thinning of epithelium, filiform elongation of the rete ridges, increased melanocyte numbers in the basal layer, and lymphocyte infiltration in the dermis. Based on the clinical and histological findings he was diagnosed as RAPK. From some reports, sporadic cases without the involvement of other family members may occur, like our patient. Palms and soles involvement in RAPK is still debated, some considered it as a characteristic sign of this disorder while others refuted it.
Acquired vulvar lymphangioma: Report of two cases Widyasari, Indah; Fathan, Hafiza; Wibawa, Larisa Paramitha; Cipto, Herman; Sampurna, Adhimukti T; Sirait, Sondang Pandjaitan
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
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Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired disorder manifests as dilatation of superficial lymph vessel due to obstruction. It is caused by urogenital infection and most often occurs following surgery and radiotherapy of cervical cancer. The diagnosis is established based on clinical and histopathological features. Treatment aimed to eliminate the cause of obstruction. This article reports two cases of vulvar lymphangioma found in our Hospital. First case was a 43-year-old female with a history of surgery and radiation for cervical cancer 10 years ago presented with vesicular skin lesion in genital area, oozing copious clear fluid since 4 years ago. There are multiple lenticular vesicles containing clear fluid in vulvar area accompanied with bilateral lymphedema of lower extremities. Histopathological features demonstrated dilated superficial lymph vessels. Second case was a 44-year-old female with enlargement of lower abdomen with vesicular lesion containing clear fluid in genital area since 3 years ago. Abdominal USG showed enlarged inguinal lymph node. Histopathological features demonstrated dilated superficial lymph vessels. The treatment for both cases were gradual electrosurgery. In both cases,vulvar dermis’ superficial lymph node dilatation caused the skin lesions. Obstruction of lymph vessel due to radiation and surgery for cervical cancer in the first case and of inguinal lymph node in the second case lead to increased lymphatic pressure in the dermis and later on the dilatations. The treatment in both cases using electrical excision produced good responses; however, we should be attentive on recurrent case.
Atypical mycobacterial infection resembles sporotrichosis in elderly patient Fauziah, Siti Nurani; Legiawati, Lili; Sularsito, Sri Adi; Yusharyahya, Shannaz Nadia; Rihatmadja, Rahadi; Sirait, Sondang P.; Huda, Fifi Mifta; Widyasari, Indah
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
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Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis. An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no fungal element nor acid-fast bacilli (AFB). Culture and polymerase chain reaction (PCR)of M. tuberculosis were negative. The working diagnosis was atypical mycobacterial infection and treatment with 450 mg rifampicin and 100 mg minocycline daily were administered accordingly. In two months observation following the treatment, the pain was no longer exist, the ulcers were completely healed, and some nodules were in the process of healing Among other Mycobacterium spp, M.marinum is the most common cause of AM infrections. Clinical manifestation of M. marinum infection may present as solitary or multiple nodules on the hands, feet, elbows and knees with sporotrichoid spreading patern. The diagnosis of AM was established based on clinical and laboratory examination. The diagnosis was also confirmed by good clinical response to minocycline and rifampicin.
Ulcus vulvae acutum - A rare case Santoso, Irene Dorthy; Anggraini, Ika; Indriatmi, Wresti; Irawan, Yudo; Nilasari, Hanny; Marissa, Melani; Sirait, Sondang P.; Rihatmadja, Rahadi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 3, No. 2
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Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy. Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of Behçet’s. The patient was treated with a combination of 2.5% lidocaine and 2.5% prilocaine creams for 1 week, 2% fusidic acid ointment for 1 week, with no significant progression. Later, the therapy was changed to 0.05% clobetasol propionate ointment for 10 days. Complete healing occurred in about 10 weeks with no scarring. Discussion: Diagnosis of ulcus vulvae acutum in this patient was made by excluding other differential diagnoses. Conclusion: Ulcus vulvae acutum is a difficult diagnosis, and clinician should be aware of this entity especially when encountering young woman without previous sexual experience problem with ulcer.
Nail involvement in Langerhans cell histiocytosis: Diagnostic and prognostic Clues Sirait, Sondang P.; Rihatmadja, Rahadi; Prayogo, Rizky Lendl; Arisanty, Riesye; Melviana, Gisca; Ohara, Kuniaki
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 4, No. 2
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Introduction: Despite its rarity, nail involvement in Langerhans cell histiocytosis (LCH) may show various clinical presentations. This study aims to show the roles of nail involvement in LCH patients as the diagnostic and prognostic clues.Case illustrations: We presented four cases of multisystem LCH in children which were already confirmed by skin biopsy with various nail abnormalities. We were able to perform nail biopsy in two patients and confirmed the nail involvement. Histopathological examination showed the infiltration of Langerhans cells characterized by indented/reniform nuclei and CD1a expressions. All patients had high-risk organ involvements. Discussion: Langerhans cells may infiltrate the nail bed, proximal nail fold, and nail matrix. Further infiltration may destruct the nail plate. Hypothetically, we suggest that the nail bed as the initial infiltration site of Langerhans cells. The different sites of involvement lead to different clinical presentation. Nail abnormalities may predict a poorer prognosis, as they mostly occur in patients with multisystem disease. Conclusions: Nails should be routinely inspected in the suspicion of LCH. The presence of nail abnormalities in LCH patients may predict a poorer prognosis.
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
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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.
Challenges in Diagnosing Staphylococcal Scalded Skin Syndrome in Children with Kwashiorkor: A Case Report Hamdali, Christie; Sirait, Sondang; Rusvita, Adria; Bhakti, Bawono
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 1
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Staphylococcal scalded skin syndrome (SSSS) is a type of exfoliating skin disease with high incidence in children. This condition can cause serious morbidity and even mortality with certain comorbid diseases such as malnutrition. Malnutrition could mask the diagnosis of SSSS because of its similarity to numerous differential diagnoses. Accuracy of clinical diagnosis is then essential to determine the proper initial management. This case report presents a 6-month-old male baby with staphylococcal scalded skin syndrome and kwashiorkor. The patient presented with complaints of multiple erythematous plaques and widespread vesicular lesions that subsequently ruptured, resulting in erosions. Physical examination revealed edema, coarse hypopigmented hair, multiple erythematous plaques, erosion, along with scales and crusts. Laboratory examination showed leukocytosis. The patient was administered intravenous ampicillin and chloramphenicol, along with wet dressings. The skin lesions showed improvement, but unfortunately, the patient passed away due to septic shock. Differential diagnoses of the skin lesions are also described, along with clinical signs to help differentiate. Proper diagnosis can help decide the correct early management and improve patient prognosis.
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.
Microbioma in Aging Skin Nugraheni Pasaribu, Uly Aanda Maria; Rihatmadja, Rahadi; Yusharyahya, Shannaz Nadia; Widaty, Sandra; Legiawati, Lili; Pandjaitan-Sirait, Sondang MHA
Journal La Medihealtico Vol. 5 No. 3 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i3.1315

Abstract

Microbiota is inseparable to the skin. Just as in the gastrointestinal tract, the skin microbiome reflects the health of the organ where it resides. It contributes to skin barrier function and ensures its homeostasis. However relatively stable over time, microbiome composition and number may be influenced by various aging -related changes − dryness, blemish, wrinkles and alteration of sebaceous gland activity impacting the skin ecological conditions − and vice versa. Several generations have been reported to promote the process while others may play a more protective role in this regard.
Nevus Melanositik Didapat yang Disertai dengan Dermatitis Kronik: Tantangan Diagnosis dan Risiko Rekurensi Reshinta, Reisa; Krisanti, Inge Ade; Sirait, Sondang P.
Media Dermato-Venereologica Indonesiana Vol 52 No 1 (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.v52i1.506

Abstract

Pendahuluan: Nevus melanositik didapat merupakan lesi melanositik jinak yang paling sering ditemui. Proses peradangan kronis dapat membuat gambaran klinis dan dermoskopik nevus melanositik didapat menjadi tidak khas. Rekurensi dapat terjadi terutama pascatindakan pengangkatan lesi secara parsial. Kasus: Anak perempuan, 15 tahun, mengeluhkan tahi lalat hitam di punggung tangan kanan yang sudah ada sejak 10 tahun yang lalu. Tahi lalat membesar perlahan seiring usia, namun dalam 1 tahun terakhir terasa lebih tebal, bersisik dan gatal. Pemeriksaan dermoskopi menunjukkan gambaran tidak khas. Diagnosis nevus melanositik intradermal ditegakkan berdasarkan pemeriksaan histopatologi yang diambil dengan cara biopsi tangensial. Nevus rekuren muncul satu bulan pascaeksisi. Gambaran histopatologi menunjukkan adanya sarang-sarang sel nevus berinti bulat, vesikular, sitoplasma eosinofilik, sebagian dengan pigmen kecokelatan intrasitoplasmik, serta tidak ditemukan mitosis. Selain itu, juga terdapat akantosis, hipergranulosis, spongiosis ringan, dan vertical collagen streaks. Diskusi: Gambaran histopatologi berupa dermatitis kronik di bagian superfisial lesi dapat menjelaskan gambaran dermoskopi yang tidak khas pada nevus melanositik didapat. Pengangkatan lesi secara parsial dengan teknik biopsi tangensial meningkatkan risiko rekurensi, walaupun 23% kasus nevus rekuren ditemukan juga pascaeksisi nevus secara komplet. Gambaran klinis nevus rekuren dapat menyerupai melanoma, tetapi dermoskopi dapat membantu membedakan keduanya. Kesimpulan: Diagnosis dermatitis kronik perlu dipertimbangkan pada dermoskopi lesi nevus melanositik didapat yang tidak khas. Kemungkinan rekurensi pascaeksisi nevus melanositik didapat perlu diinformasikan kepada pasien dan/atau keluarga.
Co-Authors Anggraini, Ika Astriningrum, Rinadewi Bhakti, Bawono Eliza Miranda Eyleny Meisyah Fitri Fathan, Hafiza Fauziah, Siti Nurani Gaol, Evangelina Lumban Hamdali, Christie Hanny Nilasari Hartanto, David Dwiadiputra Herman Cipto Huda, Fifi Mifta Irawan, Yudo Irianti Rakasiwi Ningrum, Rizki Irma Bernadette Simbolon Sitohang Isni Maulina Sukmara, Isni Maulina Krisanti, Inge Ade Krisanti, Roro Inge Ade Lili Legiawati Lili Legiawati Lim, Henry W Marissa, Melani Melly, Conny Melviana, Gisca Menaldi, Sri Linuwih SW Nugraheni Pasaribu, Uly Aanda Maria Ohara, Kuniaki Oktarina, Caroline Onmaya, Vini Pandelaki, Paulus Anung Anindita Prayogo, Rizky Lendl Priyanto, Mufqi Handaru Rahadi Rihatmadja Randy Satria Nugraha Rusdy Reshinta, Reisa Rheza, Agung Mohamad Riesye Arisanty Rizky, Luddwi Achmad Rusvita, Adria Sampurna, Adhimukti T Sandra Widaty Santoso, Irene Dorthy Shannaz Nadia Yusharyahya Situmeang, Irhen Sri Adi Sularsito Sri L. Menaldi Surachmiati Suseno, Lis Teguh Hopkop Putera Manurung Tiara Aninditha Widyasari, Indah Windy Keumala Budianti Windy Keumala Budianti Wresti Indriatmi B. Makes Zaneta, Nabila