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Chronic cutaneous chromoblastomycosis: A rare case Earlia, Nanda; Maulida, Mimi; Handriani, Risna; Kamarlis, Reno Keumalazia; Pradistha, Aldilla
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Chromoblastomycosis (CBM) is a rare, chronic granulomatous and suppurative skin infection classified as a subcutaneous mycosis. CBM has a poor prognosis with a low cure rate and a high recurrence rate. The lack of scientific data regarding the diagnosis and treatment of CBM also presents a challenge for clinicians in treating this disease. Appropriate therapy can increase the cure rate and prevent disease recurrence. Case Illustration: A 66-year-old woman presented with swelling in her left arm since the last 18 years due to wood-related injuries. There were multiple well-defined hyperkeratotic verrucous plaques, papules, and nodules, measuring 6-10 cm in diameter on the left antebrachial and hand regions. Some lesions were covered with erosion and crusts. The patient also had bone malformation. Histopathological examination showed typical characteristics of CBM. The patient was treated with 100 mg Itraconazole b.i.d. for 8 months. Discussion: Clinical manifestations and histopathological examination showed typical characteristics of CBM. Bone malformation occurred due to complications in chronic cases. Facility limitations led to the inability to perform direct microscopic examination using potassium hydroxide (KOH) and fungal culture on Sabouraud's dextrose agar. After 8 weeks of treatment, the patient's lesions were improved. The patient will be evaluated every month until treatment is complete to monitor the side effects of therapy. Conclusion: CBM lesions were improved after 8 weeks of treatment. Bone malformation could occur in chronic cases. It is important to diagnose CBM correctly and provide adequate therapy for a good outcome.
The Profiles of Infantile Hemangiomas Patients hidayati, Arie; earlia, Nanda; Sari, Ninda; Vella; Maulida, Mimi; asrizal, Cynthia wahyu
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 35 No. 2 (2023): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V35.2.2023.130-135

Abstract

Background: Infantile hemangiomas (IH) are the most prevalent benign tumors in children, predominantly in girls. Most IH cases do not require treatment due to spontaneous involution, but 10% of cases do require early treatment due to size, location, and complications. Purpose: This study tried to define the profile, clinical aspects, and therapy of IH in Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods: A descriptive approach using a retrospective analysis employing secondary data from the outpatient clinic's patient registration book. This study included all new cases of infantile hemangioma at the outpatient clinic general hospital between 2013 and 2021. Result: A total of 105 patients were involved in this study. The majority of IH patients (59%) were under the age of one year, with 64 female patients (61%) making the most visits to the pediatric clinic in 2017, 2018, and 2019 (77.1%). The most prevalent clinical features of skin lesions were nodules in 69 individuals (65.7%), and the most common site was the facial region (13.3%) in 44 patients. In 20 individuals, a combination of propanolol and oral corticosteroids was used as the most effective treatment strategy (19% ). Conclusion: Infantile hemangiomas is the most frequently reported benign tumor in children. Females are more likely than males to develop IH. The majority of IH is minor and normally resolves on its own without therapy. However, certain rare kinds of IH require clinician attention and systematic treatment.
Generalized Pustular Psoriasis in Childhood: A Rare Case Asnawi, Vella; Maulida, Mimi; Earlia, Nanda; Hidayati, Arie; Ismida, Fitri Dewi; Liana, Mahda Rizki; Maghfirah, Karamina; Bulqiah, Mikyal
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 35 No. 3 (2023): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V35.3.2023.231-236

Abstract

Background: Generalized pustular psoriasis (GPP) rarely occurs under 10 years of age. GPP is typically characterized by an eruption of generalized pustules accompanied by systemic symptoms such as fever for several days, malaise, and anorexia. Pustules are sterile, with a size of 2-3 mm, and spread over the trunk and extremities. This disease can be life-threatening; therefore, optimal therapy is required. Purpose: to report a rare case of GPP in childhood. Case: A 4-year-old girl with complaints of widespread red patches that spread to her neck, back, and hands, with red patches turning into streaks that are partially pus-filled and itchy. In almost all parts of the body, skin abnormalities were seen in the form of generalized erythematous plaques, well-defined borders, multiple pustules on the edges, and some plaques covered by thick scales and crusts. In the calculation of body surface area (BSA), the result is 44%, and in the calculation of generalized pustular psoriasis area and severity index (GPPASI), the result is 21.30. The patient was treated with combination topical therapy of 3% salicylic acid, desoximethasone cream 0.25%, momethasone cream 0.1% vaseline albume as emollients, and coal tar. Significant improvement was seen after 1 month of therapy. Discussion: GPP in children is a rare case. GPP is idiopathic and can be life-threatening. Until now, there has been no standard therapy that is considered the most effective and safe for children. Topical therapy may be an option.
Systemic manifestation of necrotic erythema nodosum leprosum: A case report of a fatal leprosy Maulida, Mimi; Vella, Vella; Budini, Sulamsih S.; Kamarlis, Reno K.; Junaidi, Fachrul; Pradistha, Aldilla; Bulqiah, Mikyal
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.216

Abstract

Necrotic erythema nodosum leprosum (ENL) is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. Necrotic ENL is associated with the involvement of multiple organs, therefore delayed diagnosis and treatment will lead to complications and poor prognosis. The aim of this case report was to report a challenging case of necrotic ENL misdiagnosed with multiple cellulitis since there were no signs of prior leprosy nor had any antimycobacterial treatment. A 45-year-old man was presented to the surgery department of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, with complaints of fever, joint pain, and painful tender skin lesions with ulceration over the trunk, extremities, and ears for one month. The patient was diagnosed clinically with multiple cellulitis and underwent a debridement procedure. Clinical improvement was absent, the patient was then consulted to the dermatology department. Physical examination showed normal vital signs, madarosis, inguinal lymphadenopathy, thickening of nerves, and sensation of numbness in both hands and feet. Laboratory examinations on admission showed leucocytosis, anemia, thrombocytopenia, hypoalbuminemia, hypocalcemia, and elevated creatinine and ureum level. A slit skin smears examination yielded positive acid-fast bacilli (AFB) with a bacteriological index (BI) value of 3+ and morphological index (MI) of 72%. The patient was diagnosed with lepromatous leprosywith necrotic ENL reaction. Intravenous methylprednisolone and cefoperazone-sulbactam were given. Multidrug therapy mulitbacillary (MDT-MB) without dapsone, and ofloxacin 400 mg was initiated. On day 17, the patient had septic shock. The patient became unconscious and experienced death. This case highlights that medical professionals should be aware of the various manifestations of necrotic ENL to correctly diagnose and provide treatment as soon as possible to prevent mortality, especially in leprosy-endemic country, Indonesia.
A fatal case of Harlequin ichthyosis: Experience from low-resource setting Vella, Vella; Maulida, Mimi; Earlia, Nanda; Hidayati, Arie; Handriani, Risna; Gondokaryono, Srie P.; Dwiyana, Reiva F.; Doris , Ezigbo E.; Pradistha , Aldilla; Bulqiah, Mikyal
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.302

Abstract

Harlequin ichthyosis is a severe and fatal presentation of ichthyosis with an autosomal recessive inheritance. Infants with Harlequin ichthyosis have a high mortality rate, and a dismal prognosis; therefore the majority of neonates die shortly after birth from infection, heat loss, dehydration, electrolytic imbalances, or respiratory distress. The aim of this case report was to present a fatal case of Harlequin ichthyosis with no family history of any inherited skin disorder. A 3-day-old baby was presented to the emergency room with congenital abnormalities at birth, fissured hyperkeratotic skin, and thick yellow plates of scales. The parents had no history of consanguineous marriage, no relevant past medical history, and no family history of the same condition. The patient was unwell, pulse 162 times/minute, respiratory rate 48 times/minute, and axillary temperature 36.9oC. APGAR score was 8 in the 1st minute and 9 in the 5th minute. Based on the typical clinical appearance, the patient was diagnosed with Harlequin ichthyosis. Due to a lack of facility, a mutation analysis was not carried out. The patient was then transferred to the neonatal intensive care unit (NICU) and treated in a humidified incubator and medicated with intravenous antibiotics (ampicillin sulbactam 125 mg/12 hour and gentamicin 13 mg/24 hour), topically fusidic acid and mild emollients. A central venous catheter was used for intravenous access. The poor prognosis resulted in the patient dying at the age of 5-day-old. This case highlights that prenatal diagnosis is critical for early detection and disease prevention. Mutation screening for the ABCA12 gene is suggested for consanguinity marriages and with a history of ichthyosis.
Comprehensive Treatment Approaches in a Unique Case of Generalized Pustular Psoriasis Earlia, Nanda; Maulida, Mimi; Badiri, Istanul; Pradistha, Aldilla; Bulqiah, Mikyal; Fajrina, Nur
Indonesian Journal of Case Reports Vol. 1 No. 2 (2023): December 2023
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v1i2.113

Abstract

Psoriasis is an immunological inflammatory disease characterized by skin inflammation and epidermal hyperplasia. One type of psoriasis is Generalized Pustular Psoriasis (GPP), which is usually preceded by other diseases. A 56-year-old woman presented to the Department of Dermatology and Venereology with a recent onset of red spots accompanied by pustules distributed across her body. The initial manifestation of these symptoms occurred approximately one month prior, and the condition has progressively worsened over the past three days. Physical examination of dermatological status showed erythematous plaques with smooth, well-defined scales with irregular, round edges, lenticular size, multiple, discrete, and confluent distribution, generalized distribution in the pedis dextra et sinistra, manus dextra et sinistra, and femoral regions. Skin biopsy examination results showed skin tissue with hyperkeratosis, acanthosis, and parakeratosis, with PMN inflammatory cells (Munro's micro abscess). The conclusion of the skin biopsy is pustular psoriasis. The patient was diagnosed with GPP. Patients were given Methotrexate, calcitriol tablets 0.25 mcg twice a day, cetirizine tablets 10 mg twice a day, and topical cream. After one week of treatment, the patient's lesions improved. Treatment continues, and patients are given education to avoid trigger factors such as stress, excessive activity, extreme temperature changes, and focal infections. The management must consider various influencing factors, including genetic factors, skin barriers, predisposing factors, and trigger factors. Prevention is also important. The patient needs to be educated about the details of the disease, how to prevent a recurrence, and treatment when the disease recurs.
Skin Changes in Iatrogenic Cushing’s Syndrome: A Detailed Case Analysis Earlia, Nanda; Maulida, Mimi; Vella, Vella; Pradistha, Aldilla; Wisesa, Wizurai; Razaq, Abdur; Ikram, Tubagus Pasca Faiz; Rahmatillah, Muhammad Zahrul; Farsa, Bianda Sabrina; Alghani, Fajri
Indonesian Journal of Case Reports Vol. 2 No. 2 (2024): December 2024
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v2i2.243

Abstract

Cushing's syndrome can lead to various skin complications. Iatrogenic Cushing's syndrome is a condition caused by excessive exogenous glucocorticoid exposure. This case report presents a patient with a history of Cushing's syndrome and long-term corticosteroid use who developed multiple skin manifestations. A 20-year-old male presented with erythematous purulent lesions on the face, neck, chest, and back. Concurrently, the patient developed purplish-red striae on the chest, abdomen, arms, and legs. Physical examination revealed erythematous nodules and pustules, along with atrophic striae. Laboratory tests showed leukocytosis with a left shift and hypokalemia. Radiological investigations revealed lumbar spondylosis and cardiomegaly. The patient was treated with a combination therapy, including topical and systemic medications, and showed significant improvement in skin lesions. This case highlights the importance of a comprehensive evaluation for patients presenting with unusual skin lesions. A thorough history, physical examination, and laboratory investigations are crucial to identify underlying conditions and initiate appropriate treatment.
Herpes Zoster Sakral Menyerupai Herpes Simpleks Genital pada Pasien Diabetes Melitus: Sebuah Kasus Jarang: Herpes Zoster Sacral Looking Like Genital Herpes Simplex in Patients with Diabetes Mellitus: A Rare Case Tasrif, Aqil Yuniawan; Maulida, Mimi; Vella, Vella; Pradistha, Aldilla; Thahir, Tanziela
Media Dermato-Venereologica Indonesiana Vol 51 No 4 (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.v51i4.442

Abstract

   Herpes zoster (HZ) merupakan keadaan akut infeksi virus pada kulit yang disebabkan oleh adanya reaktivasi dari virus varisela zoster. Tampilan klinis HZ umumnya terbatas pada satu dermatom. Herpes zoster sakral merupakan kasus yang jarang terjadi. Diabetes melitus dapat meningkatkan risiko terjadinya herpes zoster. Dilaporkan satu kasus herpes zoster sakral pada pasien laki-laki berusia 48 tahun. Pada pemeriksaan status dermatologi dijumpai pada regio penis, skrotalis sinistra, dan gluteus maksimus sinistra, tampak vesikel berkelompok, multipel, lentikuler hingga gutata, susunan zosteriformis, dan distribusi sesuai dermatom. Pemeriksaan tes Tzank dijumpai sel datia berinti banyak. Pasien diterapi dengan valasiklovir 500 mg 3 kali 2 tablet per hari. Setelah pengobatan selama 1 minggu, herpes zoster sakral mengalami perbaikan dan keluhan penyerta seperti rasa gatal dan rasa perih mulai berkurang. 
PERAN ANTIOKSIDAN PADA MELASMA Sari, Ninda; Earlia, Nanda; Maulida, Mimi
Media Dermato-Venereologica Indonesiana Vol 52 No 2 (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.v52i2.479

Abstract

   Melasma adalah kelainan hipermelanotik didapat, biasanya terjadi pada perempuan dengan jenis kulit yang lebih gelap. Sejumlah faktor pemicu melasma antara lain genetik, pajanan sinar ultraviolet (UV), dan hormon seks perempuan. Patofisiologi melasma tidak terbatas pada melanosit; penelitian saat ini menunjukkan bahwa keratinosit, sel mast, regulasi gen yang menyimpang, neovaskularisasi, dan gangguan membran basal saling barkaitan. Sinar UV sebagai agen utama diyakini memicu reactive oxygen species (ROS) melalui stimulus melanogenesis dan mengaktifkan oksida nitrat terinduksi. Melasma sulit diobati dan cenderung kambuh setelah pengobatan karena patofisiologinya yang kompleks. Antioksidan telah digunakan dalam pengobatan melasma untuk mengurangi melanogenesis akibat sinar UV, karena fungsinya sebagai penetral dan penghambat pembentukan ROS.