Claim Missing Document
Check
Articles

Found 5 Documents
Search

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
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

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.
Case report of a 28 years old woman with lepromatous leprosy mimicking systemic lupus erythematosus Wijaya, Edward; Komarasari, Eka; Esti, Prima Kartika
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 7, Issue 1 (January 2024)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/balidervenaesthj.v7i1.87

Abstract

Background: Leprosy has been known as the greatest imitator disease that can mimic a disease condition, including autoimmune disease. This case report aims to demonstrate and remind healthcare providers that leprosy infection may manifest with various autoimmune phenomena reminiscent of classic autoimmune disease, including systemic lupus erythematosus (SLE), and to prevent delayed treatment and further complications. Case report: A 28-year-old female patient with ulcers all over her body and amputation of her fingers and toes. Based on the positive antinuclear antibodies (ANA) test results, weak positive ANA profile band, anticardiolipin antibodies immunoglobulin M (ACA IgM), and complement C4 test, the patient has been diagnosed with systemic lupus erythematosus (SLE) since eleven years ago. There was no improvement during SLE therapy as the years passed. The patient developed leprosy symptoms such as madarosis, saddle nose, and facies leonine. Slit skin smear for leprosy acid-fast bacilli (AFB) from forehead and chin showed bacterial index +6, skin biopsy examination concluded lepromatous leprosy with bacterial index +5, and IgM anti-PGL-1 serological test examination 3185 u/ml. She was treated with steroids at the hospital and multidrug therapy for multibacillary leprosy (MDT MB) for one year. She had significant improvement after receiving medication. Conclusion: The diagnosis of leprosy is delayed because of the clinical similarities between the disease and SLE. The clinicians should know leprosy-specific symptoms to avoid inaccurate diagnoses and treatment delays.
Serial Kasus Sindroma Steven Johnson-Nekrolisis Epidermal Toksik akibat Terapi Multiobat Lepra: Tantangan dalam Diagnostik dan Tatalaksana. Stefanus, Benedictus; Kimberly, Kesya; Esti, Prima Kartika; Komarasari, Eka
Media Dermato-Venereologica Indonesiana Vol 52 No 3 (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.v52i3.459

Abstract

Pendahuluan: Efek samping timbulnya reaksi sindrom Stevens-Johnson akibat terapi antilepra multiobat perlu diwaspadai walaupun belum banyak dilaporkan dalam kepustakaan. Kasus: Kami melaporkan serial kasus pada dua pasien laki-laki penderita kusta tipe LL dan tipe BL dengan awitan terapi dua bulan. Manifestasi klinis diawali mual, muntah, lemas, dan demam ringan diikuti dengan timbulnya ekskoriasi, erosi kulit generalisata, dan melibatkan jaringan mukosa. Diskusi: Adapun tujuan dari penyajian serial kasus ini adalah meningkatkan kesadaran pengenalan dini gejala prodromal, pentingnya implementasi penilaian berdasarkan SCORTEN dalam pemantauan harian, dan penilaian berdasarkan skor ALDEN dalam menentukan obat penyebab untuk mencegah komplikasi. Kesimpulan: Pengenalan dini terhadap gejala prodromal, penilaian skor ALDEN, SCORTEN, tata laksana segera dan edukasi kepada pasien penting untuk dilakukan. 
Factors Associated with the Severity of Erythema Nodosum Leprosum Reactions Anggraini, Ita; Esti, Prima Kartika; Komarasari, Eka
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Leprosy is a chronic infection caused by Mycobacterium leprae. Leprosy reactions, including erythema nodosum leprosum (ENL), are induced by immune responses. ENL can cause neurological damage and deformities that result in disabilities. This study aimed to identify factors associated with the severity of ENL to help control the leprosy reactions. Methods: This was an analytical study on 148 patients with ENL reactions, who were divided into two groups based on the severity of their reactions. A retrospective cross–sectional study was conducted in the medical record unit of Sitanala Hospital, Tangerang, Banten, Indonesia, from May 2022 to April 2024. Data evaluated included age, gender, leprosy types, treatment status, duration of illness, clinical manifestations, involvement of other organs, disability, comorbidities, acid-fast bacilli, and laboratory examination. Categorical data was analyzed with chi-square test or Fisher’s exact test, and numerical data was analyzed with the Mann-Whitney test. Significance is determined at p < 0.05. Results: Characteristics including age, neuritis, skin ulcers, and comorbidities differ significantly between mild and severe ENL (p = 0.034; < 0.001; < 0.001; and 0.003, respectively). Severe ENL reactions tend to occur more frequently in older patients, and is associated with higher bacterial index (p = 0.004) and lower sodium and albumin levels (p = 0.014 and < 0.001, respectively). Conclusion: Age, neuritis, skin ulcer, comorbidities, bacterial index, as well as sodium and albumin levels were associated with the severity of ENL reactions. Appropriate management is required to prevent further complications.