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All Journal Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia
Sirait, Sondang P.
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Health Professions Medicine & Pharmacology

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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
Publisher : UI Scholars Hub

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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
Publisher : UI Scholars Hub

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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
Publisher : UI Scholars Hub

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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.
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 Fauziah, Siti Nurani Hanny Nilasari Hartanto, David Dwiadiputra Huda, Fifi Mifta Irawan, Yudo Krisanti, Inge Ade Lili Legiawati Marissa, Melani Melviana, Gisca Ohara, Kuniaki Prayogo, Rizky Lendl Rahadi Rihatmadja Reshinta, Reisa Rheza, Agung Mohamad Riesye Arisanty Santoso, Irene Dorthy Shannaz Nadia Yusharyahya Sri Adi Sularsito Widyasari, Indah Wresti Indriatmi B. Makes