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From Patches to Plaques: A Diagnostic Challenge in a Case of Erythroderma Secondary to Pityriasis Rubra Pilaris Kamilah, Lian; Rahmat Firdaus Dwi Utama; Shelly Lavenia Sambodo; Muhammad Eko Irawanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1297

Abstract

Background: Erythroderma, a dramatic and potentially life-threatening condition characterized by fiery redness engulfing over 90% of the skin's surface, presents a formidable diagnostic challenge due to its myriad underlying causes. Among these, pityriasis rubra pilaris (PRP), a rare inflammatory skin disorder, stands out with its distinctive features and often perplexing presentation. This case unveils the intricate diagnostic journey of a young man whose erythroderma masked an underlying PRP, further complicated by the subtle interplay of stress. Case presentation: An 18-year-old male presented with a one-month history of alarming erythroderma accompanied by distressing itching, fever, and sleep disturbances. Adding to the complexity, he exhibited characteristic 'nappes claires' – islands of normal skin amidst the erythrodermic sea – a hallmark of PRP. Palmoplantar keratoderma, alopecia areata, and ectropion further painted an intriguing clinical picture. Histopathological examination revealed the telltale 'checkboard' pattern, confirming PRP as the culprit. Notably, the patient's history revealed a compelling link between stress and disease exacerbation, adding a psychosomatic dimension to the case. Systemic corticosteroids and methotrexate, alongside topical emollients, brought about significant clinical improvement, underscoring the importance of early diagnosis and targeted treatment. Conclusion: This case underscores the critical need to consider PRP in the labyrinth of erythroderma diagnoses, particularly when 'nappes claires' and a history of stress are intertwined. By shining a light on the diagnostic subtleties and therapeutic nuances of PRP-associated erythroderma, this report empowers clinicians to navigate the complexities of this rare and challenging condition, ultimately improving patient outcomes and quality of life.
Topical Fermented Lactobacillus acidophilus Lysate Accelerates Second-Degree Burn Healing: An In Vivo Study in Wistar Rats Kamilah, Lian; Kusumawardani, Arie; Widhiati, Suci; Dharmawan, Nugrohoaji; Ellistasari, Endra Yustin
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.725

Abstract

Second-degree burns, affecting the epidermis and dermis, constitute a major category of thermal injuries globally, presenting significant clinical challenges including pain, infection risk, and potential scarring. While standard treatments like silver sulfadiazine (SSD) exist, limitations including potential cytotoxicity and emerging resistance necessitate exploration of novel therapeutic strategies. Recent interest has focused on topical applications derived from probiotics, such as Lactobacillus spp., due to their suggested roles in modulating inflammation, combating oxidative stress, and providing antimicrobial activity to accelerate wound repair. This study investigated a fermented lysate derived from Lactobacillus acidophilus (L. fermented) as a potential topical agent for burn healing. This study aimed to evaluate the therapeutic efficacy of a 5% topical L. fermented ointment on the healing process of experimentally induced second-degree burns in a Wistar rat model, primarily by assessing the rate of wound closure compared to standard SSD treatment and an untreated control. A true experimental in vivo study utilizing a post-test only control group design was performed following ethical approval. Fifteen male Wistar rats were subjected to a standardized second-degree thermal burn injury on their dorsal aspect. The animals were then randomized (n=5 per group) to receive twice-daily topical applications of either 5% L. fermented ointment (Group A), SSD ointment (Group B), or no treatment (Control, Group C). Wound healing was quantitatively assessed by measuring the wound surface area (mm²) on days 1, 3, 7, and 14 post-injury using digital imaging and ImageJ software analysis. Statistical comparisons between groups were conducted using one-way ANOVA followed by LSD post-hoc tests, with statistical significance set at p<0.05. All treatment groups demonstrated a significant reduction in wound size over the 14-day observation period (p=0.001 within each group). Inter-group comparisons revealed significantly accelerated wound closure in Group A starting from day 3 onwards (p<0.005). At day 14, the mean wound area in Group A (17.5 ± 8.06 mm²) was significantly smaller than in Group B (119.22 ± 45.41 mm²) and Group C (305.18 ± 25.21 mm²) (p=0.001). Post-hoc analysis confirmed the superiority of L. fermented treatment over both SSD (mean difference 101.72 mm², p=0.001) and control (mean difference 287.68 mm², p=0.001). SSD treatment also resulted in significantly better healing than the control group (mean difference 185.96 mm², p=0.001). In conclusion, topical application of 5% fermented Lactobacillus acidophilus lysate significantly accelerated the closure of second-degree burn wounds in Wistar rats, demonstrating superior efficacy compared to both silver sulfadiazine treatment and no treatment. These findings highlight the potential of L. fermented lysate as a promising novel therapeutic agent for burn wound management.
From Patches to Plaques: A Diagnostic Challenge in a Case of Erythroderma Secondary to Pityriasis Rubra Pilaris Kamilah, Lian; Rahmat Firdaus Dwi Utama; Shelly Lavenia Sambodo; Muhammad Eko Irawanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1297

Abstract

Background: Erythroderma, a dramatic and potentially life-threatening condition characterized by fiery redness engulfing over 90% of the skin's surface, presents a formidable diagnostic challenge due to its myriad underlying causes. Among these, pityriasis rubra pilaris (PRP), a rare inflammatory skin disorder, stands out with its distinctive features and often perplexing presentation. This case unveils the intricate diagnostic journey of a young man whose erythroderma masked an underlying PRP, further complicated by the subtle interplay of stress. Case presentation: An 18-year-old male presented with a one-month history of alarming erythroderma accompanied by distressing itching, fever, and sleep disturbances. Adding to the complexity, he exhibited characteristic 'nappes claires' – islands of normal skin amidst the erythrodermic sea – a hallmark of PRP. Palmoplantar keratoderma, alopecia areata, and ectropion further painted an intriguing clinical picture. Histopathological examination revealed the telltale 'checkboard' pattern, confirming PRP as the culprit. Notably, the patient's history revealed a compelling link between stress and disease exacerbation, adding a psychosomatic dimension to the case. Systemic corticosteroids and methotrexate, alongside topical emollients, brought about significant clinical improvement, underscoring the importance of early diagnosis and targeted treatment. Conclusion: This case underscores the critical need to consider PRP in the labyrinth of erythroderma diagnoses, particularly when 'nappes claires' and a history of stress are intertwined. By shining a light on the diagnostic subtleties and therapeutic nuances of PRP-associated erythroderma, this report empowers clinicians to navigate the complexities of this rare and challenging condition, ultimately improving patient outcomes and quality of life.
Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1046

Abstract

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.
Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1046

Abstract

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.