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All Journal Narra J Media Dermato-Venereologica Indonesiana Indonesian Journal of Case Reports
Vella, Vella
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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.
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. 
Co-Authors Alghani, Fajri Budini, Sulamsih S. Doris , Ezigbo E. Dwiyana, Reiva F. Earlia, Nanda Farsa, Bianda Sabrina Gondokaryono, Srie P. Handriani, Risna hidayati, Arie Ikram, Tubagus Pasca Faiz Junaidi, Fachrul Kamarlis, Reno K. Maulida, Mimi Mikyal Bulqiah, Mikyal Pradistha , Aldilla Pradistha, Aldilla Rahmatillah, Muhammad Zahrul Razaq, Abdur Tasrif, Aqil Yuniawan Thahir, Tanziela Wisesa, Wizurai