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All Journal Journal of General Procedural Dermatology and Venereology Indonesia
Ferina, Siti Aisha Nabila
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Medicine & Pharmacology

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Lichen amyloidosis treated with topical combination therapy and narrowband ultraviolet B phototherapy Hasibah, Ulfah Hasna; Ferina, Siti Aisha Nabila; Komarasari, Eka; Esti, Prima Kartika; Angin, Lenti Perangin
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 2
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Background: Lichen amyloidosis (LA) is characterized by linear rows of firm, pigmented, grouped, hyperkeratotic papules that can form a plaque, usually occurring on the shins and forearms, with intense itch as the prominent symptom. Case Illustration: A 57-year-old female complained of brown spots on her shins and arms that gradually thickened six years ago. The lesions were brown, multiple, discrete, slightly scaly papules forming hyperpigmented plaques. The result of the histopathology examination showed an acanthotic epidermis with hyperkeratotic foci and eosinophilic amorphous mass deposits in the papillary dermis with brown pigments. The working diagnosis was lichen amyloidosis. Topical treatments were ointment consisting of 6% salicylic acid mixed with clobetasol propionate ointment 0.05% used once daily and emollient used twice daily. Narrowband ultraviolet B (NB-UVB) was administered at a dose of 300 mJ/cm2 once a week and increased by 10-20% on the next episodes. After six weeks of treatment, there were no new brown spots, the lesions became thinner and less erythematous, and the itch decreased significantly. Discussion: The factors that induce and worsen LA are pruritus and scratching. Topical combination therapy of salicylic acid and corticosteroid can increase the effectiveness of treatment on thick, scaly plaque lesions. NB-UVB was found to reduce pruritus. Conclusion: Topical combination therapy of keratolytic agents and potent corticosteroids can be used as a non-invasive therapy to improve skin lesions by thinning these lesions in LA patients. NB-UVB phototherapy has also been significantly shown to relieve a patient’s severe itch.
Histoid leprosy mimicking lichen planus Kimberly, Kesya; Alviariza, Annisa; Ferina, Siti Aisha Nabila; Esti, Prima Kartika; Peranginangin, Lenti Br.; Komarasari, Eka
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Background: Histoid leprosy is a rare variant of lepromatous leprosy (LL), characterized by unique clinical, histopathological, and microbiological features. This type of leprosy is caused by multidrug therapy (MDT) drug resistance, train mutation of Mycobacterium leprae, or genetic factors. Case Illustration: A 21-year-old Indonesian woman with a family history of histoid leprosy complained of multiple hypo-esthetic erythematous partly flat-topped papules around the lesion on the face and bilateral superior and inferior extremities for the last two years. A Slit-skin smear examination revealed acid-fast bacilli with a bacterial index (BI) of 4.17+ and morphological index (MI) of 1%. Histopathological examination on hematoxylin & eosin (H&E) stained revealed epidermal atrophy, Grenz zone, and bundles of thin spindle-like histiocytes with Virchow cells. Ziehl-Nielsen stain showed copious acid-fast bacilli. Therefore, the diagnosis of histoid leprosy was established. Discussion: Lichen planus (LP) was considered because LP typically presents as pruritic, polygonal, violaceous flat-topped papules with symmetric distribution on the flexural surfaces of the forearms, wrists, and ankles, as well as the dorsal surface of the hands and shins. However, the face is rarely affected in LP. The patient’s slit-skin smear and histopathological examinations presented strong evidence for histoid leprosy. Treatment with an MDT regimen resulted in clinical improvements as the erythematous lesions transformed into hyperpigmentation after weeks of treatment. Conclusion: Histoid leprosy mimicking LP lesions in this patient developed without any prior administration of agents. Additionally, the patient had a high bacillary load, indicating a potential reservoir of the infection as the patient had a family history of leprosy.
Immunomodulators in leprosy: A narrative review Kimberly, Kesya; Ferina, Siti Aisha Nabila; Esti, Prima Kartika
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
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Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Current therapeutic regimen, like the multidrug therapy (MDT), are effective in treating most cases, but new cases continue to emerge in Indonesia every year. While multidrug therapy alone is adequate for treating leprosy, there is a need for adjuvant treatment options to boost the host’s immune system to prevent the worsening of leprosy and reduce the activation of M. leprae, such as immunomodulators. Discussion: Immunomodulators are drugs that can stimulate the body’s natural and adaptive defense mechanisms, acting as either immunosuppressants or immunostimulants. To understand how immunomodulatory drugs (IMiDs) work, it is important to understand the role of immunity. This article reviews the role of immunity in leprosy and discusses various immunomodulators that have been developed or investigated to enhance the host’s immune system. Substances like levamisole, thalidomide, zinc, selenium, as well as vitamins A, D, E, and C have been clinically tried in various combinations and durations, showing promise as immunomodulating agents. Conclusion: Studies have suggested that immunomodulating agents may be considered as adjuncts to MDT to enhance the elimination and clearance of bacteria, making them potential recommendations for leprosy treatment.
Co-Authors Alviariza, Annisa Angin, Lenti Perangin Esti, Prima Kartika Hasibah, Ulfah Hasna Kimberly, Kesya Komarasari, Eka Peranginangin, Lenti Br.