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All Journal Health and Medical Journal Jurnal Cahaya Mandalika Journal of General Procedural Dermatology and Venereology Indonesia
Fiqnasyani, Siti Efrida
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Humanities Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Public Health

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Lucio phenomenon in pregnancy: A histopathology review Fiqnasyani, Siti Efrida; Oktavriana,, Triasari; Rosmarwati, Ervina; Novriana, Dita Eka; Mudigdo, Ambar
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Lucio phenomenon (LP) is a reaction occurring in lepromatous, non-nodular, diffuse leprosypatients who have not received multidrug therapy (MDT). The diagnosis of LP are based on clinical features and supported by histopathological examination. This report was conducted to establish a diagnosis of LP byhistopathological examination, considering that cases of LP in pregnancy are quite rare so that clinicians can be more precise. Case: A 35-year-old pregnant woman complained of extensive ulcers on her hand and legs. Madarosis, saddle nose, and earlobes were found A slit skin smear examination showed a bacterial index of +4 and a morphological index of 20%. A skin biopsy from a leg ulcer with HE staining revealed thinning of the epidermis,foamy macrophages, inflammatory cell infiltrate in the dermis and subcutaneous layers, necrotizing vasculitis with thickening of blood vessel walls, and perivascular lymphohistiocytic infiltrate. Histopathological examination of auricular infiltrate showed basket weave type hyperkeratosis, grenz zone, lymphohistiocytic inflammatory cell infiltrates, foamy and touton cells. Histopathological examination by FF staining showed a heavy M. leprae invasion. Discussion: Histopathological characteristics of LP in this patient found flattened epidermis, subepidermal grenz zone, aggregates and sheets of foamy macrophages admixed with predominantly huge numbers of acid-fast bacilli, foamy macrophages and touton cells. The main microscopic features also found subcutis necrotizing vasculitis. Histopathological examinations are essential to diagnose LP. Conclusion: Histopatholgy of Lucio Phenomenon found grenz zone, inflammatory cell infiltrate and foamy cells. This histopatholgy will support the diagnosis and best treatment for LP patient.
Nevus Unius Lateris with Hemophilia: A rare case report Murastami, Ammarilis; Fiqnasyani, Siti Efrida; Widyastuti, Zilpa; Dharmawan, Nugrohoaji
Health and Medical Journal Vol 5, No 3 (2023): HEME September 2023
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v5i3.1314

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Latar Belakang: Nevus Unius Lateris (NUL) adalah kelainan bawaan jaringan kulit langka, ditandai distribusi lesi unilateral mengikuti garis Blaschko. Lesi ditemukan pada tahun pertama kehidupan dengan bercak coklat kekuningan, batas yang jelas, dan permukaan verukosa. Pemeriksaan multidisiplin dianjurkan untuk menegakkan diagnosis dan memberikan penatalaksanaan yang tepat. Terapi bertujuan untuk mengangkat dan menghancurkan lesi hiperkeratosis dengan pembedahan/non-pembedahan. Elektrokauter dapat menjadi pilihan untuk membantu mencegah perdarahan setelah operasi dermatologis, terutama hemofilia. Kasus: Tn. A, 24 tahun, pekerjaan wiraswasta, datang dengan keluhan utama beberapa plak yang meninggi di belakang lehernya. Keluhan pertama muncul sebagai bintik pada usia 6 tahun dan naik perlahan, dan menyebar luas. Pasien memiliki riwayat hemofilia A. Pemeriksaan dermatologis, beberapa nodul verukosa hiperpigmentasi bertangkai dengan batas teratur, garis yang jelas tersusun secara linier mengikuti garis Blaschko di daerah coli posterior. Hasil pemeriksaan dermoskopi menunjukkan pola sirkular hiperpigmentasi dengan struktur epidermis eksofitik dan pola serebriform. Pemeriksaan histopatologi menunjukkan hiperkeratosis, akantosis, papilomatosis minimal, dan deposit melanin dengan kepadatan ringan-sedang. Pasien didiagnosis dengan nevus unius lateris dan diterapi bedah listrik. Pasien diberikan antibiotik sistemik oral dan analgesik selama lima hari setelah prosedur dan disarankan untuk kontrol pada hari ketiga, dan pengangkatan jahitan dilakukan pada hari ketujuh. Kesimpulan: Beberapa perawatan medis dan bedah telah dicoba, tetapi tidak ada pengobatan yang ideal atau dapat diterima secara universal. Namun, kekambuhan dapat terjadi berbulan-bulan atau bertahun-tahun setelah pengangkatan lesi dengan metode apa pun. Terapi dengan bedah listrik dapat dipilih untuk membantu mencegah perdarahan yang mungkin terjadi setelah prosedur melalui target hemostasis dan untuk kerusakan jaringan superfisial.
MORBUS HANSEN PAUSIBASILER TIPE BORDERLINE-BORDERLINE DENGAN LESI TUNGGAL PADA SEORANG ANAK LAKI – LAKI: SATU LAPORAN KASUS JARANG Widhiati, Suci; Widyastuti, Zilpa; Fiqnasyani, Siti Efrida
Jurnal Cahaya Mandalika ISSN 2721-4796 (online) Vol. 4 No. 2 (2023)
Publisher : Institut Penelitian Dan Pengambangan Mandalika Indonesia (IP2MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36312/jcm.v4i2.1529

Abstract

Background: Morbus Hansen (MH) is a chronic infectious disease caused by Mycobacterium leprae. Diagnosis of MH was established based on cardinal signs on clinical examination, AFB examination on ear lobe serum and histopathological examinations. Children with single lesion MH (AFB negative) without any neurological complaints are treated with single dose of Rifampicin-Ofloxacin-Minocycline (ROM) combination therapy. This case was reported because of the rarity of children MH and the importance of early diagnosis to avoid disability risks. Case: A 12-year-old boy with single lesion borderline-borderline (BB) paucibacillary MH presented with white-reddish patch on cheeks that getting wider since 2 years ago. Dermatological status obtained in left maxila region showed hypopigmented and hyperpigmented patch with erythematous base, solitary, well defined, 0.5x1.5 cm in size with central clearing forming a punched out lesion. Bacteriological and histopathological examinations with Hematoxylin-Eosin and Fite-Faraco staining showed AFB negative result, but serological examination of anti-PGL-1 antibodies showed high titers (IgM=845 u/ml, IgG=1004 u/ml). The patient was given single dose of Rifampicin 450mg, Ofloxacin 400mg, Minocycline 100mg (ROM) and atopiclair® lotion applied to the lesion twice a day. Evaluation on the third week showed improvement with disappearance of redness and punched out lesion. Discussion: Patient in this case is a rare incident because it occured in children with no contact history and had never lived in MH endemic area. Because of Mycobacterium leprae’s transmission route is still not known, other factors such as genetics, immunity, environmental conditions and non-human vectors need more attention in breaking the chain of MH transmission.
Co-Authors Ambar Mudigdo Dharmawan, Nugrohoaji Dita Eka Novriana Murastami, Ammarilis Oktavriana,, Triasari Rosmarwati, Ervina Widhiati, Suci Widyastuti, Zilpa