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All Journal Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia
Chairista, Inadia Putri
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Health Professions Medicine & Pharmacology

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Purpuric lesion in a patient with leprosy: Was it a Lucio’s phenomenon or an epiphenomenon? Menaldi, Sri Linuwih; Marissa, Melani; Chairista, Inadia Putri; Lim, Henry W.; Rihatmadja, Rahadi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Lucio’s phenomenon (LP) is a severe necrotizing cutaneous reaction that occurs in patients with Lucio’s leprosy. The exact pathomechanism is not fully understood, but typically abundant acid-fast bacilli in the walls of blood vessels point to direct perturbation of blood supply to the epidermis. We report a case of LP where epidermal necrosis occurred in the absence of vascular invasion by mycobacteria, raising the question whether this was an epiphenomenon or a true LP. Case Illustration: A 34-year-old male was referred for an episodic swelling of his hands and feet that persisted for two years. There were signs of leprosy (diffuse shiny skin lesions, anesthesia, and anhidrosis of the extremities) with purpuric patches on lower extremities. The slit-skin smear test revealed a high index of acid- fast bacilli. Histopathological examination revealed epidermal necrosis and leukocytoclastic vasculitis without demonstrable bacillus. WHO multidrug regimen for leprosy and corticosteroids successfully cured the patient and prevented ulcer development. Discussion: Despite the presence of classical LP characteristics clinically and histologically, mycobacterium was absent in the vessels’ walls. We hypothesized that, in LP, vascular impairment might also be secondary due to antigen–antibody reaction and hypercoagulable state.Conclusion: Purpuric patches in Lucio’s leprosy might be the first sign of skin necrosis or vascular damage (purpura and ulceration). Besides the antimycobacterial drugs, anti-inflammatory drugs should be administered. Laboratory test for hemostasis might be advised.
Skrining pada Kanker Kulit Chairista, Inadia Putri; Paramitha, Larisa; Sampurna, Adhimukti T; Krisanti, RR Inge Ade; Wahyudi, Danang T; Hoemardani, Aida SD; Sujudi, Yufanti; Legiawati, Lili
Media Dermato-Venereologica Indonesiana Vol 51 No 3 (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.v51i3.423

Abstract

Tingginya insiden, prevalensi, morbiditas, dan mortalitas kanker kulit telah menjadi permasalahan kesehatan masyarakat di seluruh dunia. Skrining kanker kulit dilakukan sebagai salah satu upaya dalam mengurangi beban kanker kulit yang ditimbulkan. Skrining kanker kulit meliputi total body skin examination yang bersifat non-invasif, mudah, cepat, dan hemat biaya bila dibandingkan dengan skrining untuk kanker lainnya. Akan tetapi, efektivitas skrining kanker kulit pada tingkat populasi masih diperdebatkan. Tenaga kesehatan, khususnya dokter spesialis kulit berperan penting dalam pelayanan skrining kanker kulit. Pengetahuan lebih lanjut mengenai skrining kanker kulit, rekomendasi, dan berbagai teknik pendekatan diagnostik sangat diperlukan untuk memajukan program skrining kanker kulit. 
Co-Authors Hoemardani, Aida SD Krisanti, RR Inge Ade Larisa Paramitha Lili Legiawati Lim, Henry W. Marissa, Melani Rahadi Rihatmadja Sampurna, Adhimukti T Sri L. Menaldi Sujudi, Yufanti Wahyudi, Danang T