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

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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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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.
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
Publisher : UI Scholars Hub

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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.
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. 
Co-Authors Alviariza, Annisa Esti, Prima Kartika Ferina, Siti Aisha Nabila Komarasari, Eka Peranginangin, Lenti Br. Stefanus, Benedictus