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Comparison of Intralesional Triamcinolone Acetonide Alone with Intralesional Triamcinolone Acetonide-5-Fluorouracil Combination Injection in Keloid: A Case Report Mawu, Ferra Olivia; Marlyn Grace Kapantow; Oktavia Reymond L. Sondakh; Elrovita Donata; Paulus Mario Christopher
Archives of The Medicine and Case Reports Vol. 5 No. 3 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i3.565

Keloids are abnormal cutaneous wound healing responses extending beyond the borders of the initial wound, usually appearing pink-purplish to hyperpigmented nodules or plaques with a hard consistency, irregular shape, uneven border, and smooth shiny surface. Most often occur on the chest, shoulder, upper arms, earlobes, and cheeks. This case report aims to compare a case of keloid treated with intralesional triamcinolone acetonide (TAC) alone with intralesional triamcinolone acetonide-5-fluorouracil (TAC + 5-FU) combination injection. A 21-year-old Minahasa male complains of growing pruritic scars in the back area and right and left upper arms since five years ago. Physical examination of the right and left upper arms revealed multiple hyperpigmented nodules and plaques, irregularly shaped, smooth, and shiny surfaces with defined borders and varying sizes. A clinical diagnosis of keloid was made. Treatment was initiated with weekly intralesional TAC alone on the left upper arm vs. intralesional TAC + 5-FU combination injection on the right upper arm. The evaluation was made based on the clinical and modified Vancouver scar scale. One of the most commonly used therapeutic options for keloid is TAC. However, the combination of TAC + 5-FU may be opted for due to its mechanism through the corticosteroid mechanism of action in conjunction with the antimetabolite activity of 5-FU. The combination may yield a more effective and faster outcome with fewer side effects. Intralesional combination TAC + 5-FU injection may be a therapeutic option for keloid with minimal side effects.

A Distinctive Clinical Phenotype of Discoid Lupus Erythematosus in Papuanese Women: A 5-Year Analysis of Dyspigmentation, Scarring, and Malar Predilection Inneke Viviane Sumolang; Astrina Rosaria Indah; Timothy Verellino Reba; Aryani Adji; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1358

Background: Discoid lupus erythematosus (DLE), the most common form of chronic cutaneous lupus, exhibits significant clinical variability influenced by ethnicity. While disparities in presentation are recognized, data from unique indigenous populations such as the Papuanese in East Indonesia remain scarce. This study aimed to characterize the clinical and sociodemographic features of DLE in this specific cohort to identify its potentially distinctive phenotype. Methods: A five-year retrospective analysis of clinical databases was conducted at the Department of Dermatology and Venereology at a tertiary referral hospital in Jayapura, Papua, Indonesia. All patients clinically diagnosed with DLE by board-certified dermatovenereologists between January 2019 and December 2023 were included. Sociodemographic and clinical data, including lesion morphology, location, and management, were systematically collected and analyzed using descriptive statistics. Results: A total of 22 patients meeting the criteria were identified. The cohort demonstrated remarkable homogeneity; all patients were of Papuanese ethnicity and female (100.0%). The majority were in the 26-35 age group (40.9%), with a mean age of 29.4 years, and half were farmers (50.0%). Clinically, lesions were universally present on the nose and/or malar area (100.0%). The most common morphological triad was dyspigmentation, scarring, and telangiectasia, observed in 81.8% of patients. All patients reported photosensitivity and were managed with photoprotection and topical steroids. Conclusion: DLE I n Papuanese women presents as a distinctive, highly uniform clinical phenotype characterized by an exclusive female predilection, a strong association with sun exposure, and a universal malar distribution with a high propensity for disfiguring dyspigmentation and scarring. These findings underscore the necessity of culturally competent, early, and aggressive management strategies to mitigate long-term sequelae in this vulnerable population.

A Distinctive Clinical Phenotype of Discoid Lupus Erythematosus in Papuanese Women: A 5-Year Analysis of Dyspigmentation, Scarring, and Malar Predilection Inneke Viviane Sumolang; Astrina Rosaria Indah; Timothy Verellino Reba; Aryani Adji; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1358

Background: Discoid lupus erythematosus (DLE), the most common form of chronic cutaneous lupus, exhibits significant clinical variability influenced by ethnicity. While disparities in presentation are recognized, data from unique indigenous populations such as the Papuanese in East Indonesia remain scarce. This study aimed to characterize the clinical and sociodemographic features of DLE in this specific cohort to identify its potentially distinctive phenotype. Methods: A five-year retrospective analysis of clinical databases was conducted at the Department of Dermatology and Venereology at a tertiary referral hospital in Jayapura, Papua, Indonesia. All patients clinically diagnosed with DLE by board-certified dermatovenereologists between January 2019 and December 2023 were included. Sociodemographic and clinical data, including lesion morphology, location, and management, were systematically collected and analyzed using descriptive statistics. Results: A total of 22 patients meeting the criteria were identified. The cohort demonstrated remarkable homogeneity; all patients were of Papuanese ethnicity and female (100.0%). The majority were in the 26-35 age group (40.9%), with a mean age of 29.4 years, and half were farmers (50.0%). Clinically, lesions were universally present on the nose and/or malar area (100.0%). The most common morphological triad was dyspigmentation, scarring, and telangiectasia, observed in 81.8% of patients. All patients reported photosensitivity and were managed with photoprotection and topical steroids. Conclusion: DLE I n Papuanese women presents as a distinctive, highly uniform clinical phenotype characterized by an exclusive female predilection, a strong association with sun exposure, and a universal malar distribution with a high propensity for disfiguring dyspigmentation and scarring. These findings underscore the necessity of culturally competent, early, and aggressive management strategies to mitigate long-term sequelae in this vulnerable population.

The Rhomboid Flap for Facial Reconstruction Following Basal Cell Carcinoma Excision: A Case Report on Achieving Optimal Aesthetic and Functional Outcomes Tilesky Caprizio Phoanda; Ferra Olivia Mawu; Oktavia Reymond Leomer Sondakh; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1401

Background: Reconstruction of the lower eyelid following oncologic surgery presents a formidable challenge due to the region's unique anatomy and functional importance. The primary goal is to restore the lamellar structure while avoiding ectropion, a complication with significant functional and aesthetic consequences. This report details the successful application of a rhomboid flap, a classic transposition flap, for a moderate-sized defect in this high-risk anatomical subunit. Case presentation: A 75-year-old male farmer presented with a 2x1 cm nodular basal cell carcinoma on his left lower eyelid. After surgical excision with 4 mm margins, a superolaterally based rhomboid flap was designed to close the defect. The procedure was performed under local anesthesia. The postoperative course was uncomplicated. Objective functional assessment at 12 weeks confirmed a normal lower lid position with margin-to-reflex distance 2 (MRD2) symmetrical to the contralateral eye and no evidence of ectropion or lagophthalmos. The cosmetic outcome was assessed as favorable using the Patient and Observer Scar Assessment Scale (POSAS), and the patient reported high satisfaction (5/5 on a Likert scale). Conclusion: This case report illustrates the successful use of a rhomboid flap for a moderate-sized lower eyelid defect, resulting in a favorable functional and aesthetic outcome without complications in the short-term follow-up period. The technique successfully restored tissue volume and preserved normal eyelid function, critically preventing ectropion. It supports the rhomboid flap as a robust and reliable option in the reconstructive surgeon's toolkit for this challenging anatomical area.

The Rhomboid Flap for Facial Reconstruction Following Basal Cell Carcinoma Excision: A Case Report on Achieving Optimal Aesthetic and Functional Outcomes Tilesky Caprizio Phoanda; Ferra Olivia Mawu; Oktavia Reymond Leomer Sondakh; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1401

Background: Reconstruction of the lower eyelid following oncologic surgery presents a formidable challenge due to the region's unique anatomy and functional importance. The primary goal is to restore the lamellar structure while avoiding ectropion, a complication with significant functional and aesthetic consequences. This report details the successful application of a rhomboid flap, a classic transposition flap, for a moderate-sized defect in this high-risk anatomical subunit. Case presentation: A 75-year-old male farmer presented with a 2x1 cm nodular basal cell carcinoma on his left lower eyelid. After surgical excision with 4 mm margins, a superolaterally based rhomboid flap was designed to close the defect. The procedure was performed under local anesthesia. The postoperative course was uncomplicated. Objective functional assessment at 12 weeks confirmed a normal lower lid position with margin-to-reflex distance 2 (MRD2) symmetrical to the contralateral eye and no evidence of ectropion or lagophthalmos. The cosmetic outcome was assessed as favorable using the Patient and Observer Scar Assessment Scale (POSAS), and the patient reported high satisfaction (5/5 on a Likert scale). Conclusion: This case report illustrates the successful use of a rhomboid flap for a moderate-sized lower eyelid defect, resulting in a favorable functional and aesthetic outcome without complications in the short-term follow-up period. The technique successfully restored tissue volume and preserved normal eyelid function, critically preventing ectropion. It supports the rhomboid flap as a robust and reliable option in the reconstructive surgeon's toolkit for this challenging anatomical area.

Update on scrofuloderma Marianto; Hartono Kosim; Pande Agung Mahariski; Paulus Mario Christopher
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vygwv246

Tuberculosis is one of the most significant diseases which causes death worldwide. TB infection is assumed to infect the lungs only from a general perspective. In fact, TB infection also causes lesions on the skin. Scrofuloderma, as one of the most common types of cutaneous tuberculosis, often misdiagnosed and managed improperly due to its similarity with abscess. In addition, there were still no national and international guidelines for scrofuloderma. This review to give insights and review about an update in the basic principle of scrofuloderma and management.

Buschke Lowenstein tumor (BLT)/giant condyloma acuminatum (GCA): An immunopathogenesis insight Paulus Mario Christopher; Hartono Kosim; Ratna Sari Wijaya; Silvi Suhardi; Linda Julianti
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 3 No. 1 (June 2020)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/kajdxg43

Buschke Lowenstein tumor (BLT)/giant condyloma acuminatum is a rare variant of sexually transmitted infection caused by human papillomavirus (HPV) type 6 and 11. HPV has its viral factors that exist to avoid immune surveillance and control through 1) infecting only the basal layer of the epithelium, 2) downregulation of host immunity, 3) suppression of proinflammatory proteins essential for viral clearance. The incidence of BLT/GCA is estimated to be 0.1% in the general population, with males having 2.7 times increased risk than females. The definitive diagnosis of BLT/GCA is typical morphology along with histopathological examination, and/or viral serotyping. Treatment of BLT/GCA requires a multidisciplinary approach, determined based on age, the extent of the lesion, organ involvement, and organ location.

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