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All Journal Indonesian Journal of Medicine Indonesian Basic and Experimental Health Sciences
Tansil, Ivana
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Health Professions Medicine & Pharmacology Nursing Public Health

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Successful Combination Therapy with Phototherapy and Topical Corticosteroid in a Rare Case : 57 Years Old Male Patient with Lichen Amyloidosis Sambodo, Shelly Lavenia; Mawardi, Prasetyadi; Tansil, Ivana; Dewi, Ayu Kusuma; Utama, Rahmat Firdaus Dwi; Octarica, Stella Gracia; Adjie, Sugih Primas
Indonesian Journal of Medicine Vol. 9 No. 4 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.4.745

Abstract

Background: : Lichen Amyloidosis (LA) is one of the most common forms of primary localized cutaneous amyloidosis, with clinical manifestations of itchy blackish brown hyperkeratotic papules. The most predilection site is the upper extensor of the legs. This case report aims to improve the clinician’s knowledge regarding clinical features and supporting examinations to the provision of appropriate therapy in LA. Case Report: A 57 years old farmer presented to dermatology and venereology outpatient clinic of Dr. Moewardi general hospital with itchy black spots on nearly all over his body since 2 years ago. Dermatology examination obtained generalized papules and scaly hyperpigmented patches. Dermoscopy revealed a scar-like center with a whitish color in the center. Histopathological examination showed an amorphous eosinophilic (amyloid) in the dermis. Congo red examination demonstrated a reddish-orange amyloid. We treated the patient with oral cetirizine 10 mg/day, desoximetasone 0.25% cream applied twice a day in the morning and in the evening, Carmed® cream 20% cream applied twice a day in the afternoon and night, phototherapy 350 MJ/cm2 twice a week. We observed for 14 weeks. The lesion and itching started improving in week 8. Result: Lichen amyloidosis is resulted from amyloid deposits in the papillary dermis which are derived from degradation of basal keratinocytes. The diagnosis is based on history taking, clinical examination, dermoscopy and skin biopsy. The combination of phototherapy and topical corticosteroid can be an option for LA therapy, especially for the symptom of pruritus. Conclusion: Lichen Amyloidosis is the most common type of primary localized cutaneous amyloidosis, presents as blackish brown hyperkeratotic papules. The combined therapy of topical corticosteroids and phototherapy can significantly improve pruritus and skin lesions.
Combined Immunosuppressive Therapy (Corticosteroid-Cyclosporine) on Hospital Stay in Patients with SevereCutaneous Adverse Reactions perspective of health worker: A Qualitative Study Widhiati, Suci; -, Hastika Dwi Oktiningrum; Tansil, Ivana; Arrosyid, Azhar
Indonesian Basic and Experimental Health Sciences Vol. 14 No. 1 (2025): November
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol14iss1pp98-102

Abstract

IntroductionSevere cutaneous adverse reactions (SCARs) such as Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and DRESS are rare but life-threatening conditions requiring intensive inpatient care. Corticosteroids remain the main therapy but may prolong hospitalization and increase complications. Combining corticosteroids with cyclosporine has been considered to improve patient outcomes. This study explored healthcare professionals’ perspectives on the impact of this therapy combination on hospitalization duration for SCAR patients. MethodsA qualitative exploratory study was conducted at Dr. Moewardi General Hospital, Surakarta (August–October 2023). Purposive sampling recruited 12 healthcare professionals (3 consultants, 5 residents, 4 nurses) involved in SCAR management. Semi-structured interviews explored diagnostic confidence, treatment approaches, and hospitalization duration. Data were analyzed using thematic analysis. ResultPhysicians reported high diagnostic confidence, with typical hospital stays ranging from 14–30 days. Most favored corticosteroid–cyclosporine combination therapy, perceiving faster recovery and fewer complications. Barriers included limited drug availability, unfamiliarity with dosing, and safety concerns. Nurses emphasized wound care challenges, infection risks, and psychosocial needs. Both groups underlined the importance of multidisciplinary collaboration and family involvement in optimizing patient outcomes. ConclusionHealthcare professionals perceive corticosteroid–cyclosporine combination therapy as potentially effective in shortening hospitalization and reducing complications among SCAR patients. Institutional support, clinician training, and further clinical research are recommended to strengthen its implementation.
Co-Authors -, Hastika Dwi Oktiningrum Adjie, Sugih Primas Arrosyid, Azhar Ayu Kusuma Dewi Octarica, Stella Gracia Prasetyadi Mawardi Shelly Lavenia Sambodo Utama, Rahmat Firdaus Dwi Widhiati, Suci