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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, Sebelas Maret University

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.
Systematic review of the advantages of trichloroacetic acid and electrocautery therapy in verruca vulgaris Kamilah, Lian; Adjie, Sugih Primas; Dharmawan, Nugrohoaji
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 3, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss3.art8

Abstract

Verruca vulgaris (VV), a cutaneous disorder associated with human papillomavirus (HPV), presents as a benign proliferation of keratinocytes. Verruca vulgaris therapy with destructive methods such as trichloroacetic acid (TCA) and electrocautery is the most commonly used therapeutic modality. The study aims to assess the therapeutic efficacy and clinical benefit of trichloroacetic acid (TCA) and electrosurgery in managing VV by synthesising evidence from clinical studies or case series. Systematic review adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To ensure the collection of accurate and relevant information, literature searches were conducted across PubMed, Google Scholar and Cochrane Library covering publications from 2014 to 2023. Twelve studies were included, comprising eight articles on TCA and four articles on electrosurgery. Trichloroacetic acid achieved a maximum cure rate of 93.3% while electrosurgery reached 100%. During six-month follow-up period, TCA showed no recurrence (0%), whereas electrosurgery had a recurrence rate of 21,9%. Electrocautery has more advantages than TCA with a higher cure rate. Even though it has a higher cure rate, electrocautery has a higher recurrence rate with more severe side effects than TCA.
Tatalaksana Platelet Rich Plasma Pada Pasien Chronic Venous Leg Ulcer Adjie, Sugih Primas; Kariosentono, Harijono; Mulianto, Nurrachmat; Dharmawan, Nugrohoaji; Primisawitri, Pratiwi Prasetya
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 12 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i12.4872

Abstract

Latar belakang: Ulkus kronis pada ekstremitas bawah salah satunya yaitu ulkus venosum. Ulkus venosum didefinisikan sebagai lesi terbuka antara sendi lutut dan pergelangan kaki yang terjadi karena penyakit vena. Tantangan dalam mengobati VLU adalah kekambuhan yang sering terjadi maka terapi luka tingkat lanjut harus dipertimbangkan. Platelet rich plasma (PRP) sebagai terapi adjuvan pengobatan ulkus venosum dan menunjukkan hasil yang menjanjikan. Kasus: Seorang laki-laki berusia 55 tahun dengan keluhan luka yang sulit sembuh sejak dua tahun yang lalu. Pemeriksaan status dermatovenereologi pada regio ekstremitas inferior desktra nampak ulkus multipel dengan ukuran terbesar 9 cm x 5 cm x 0.5 cm, dengan dasar eritem dan serum tanpa disertai pus, nekrosis, nekrotik dan darah. Pasien memiliki riwayat hipertensi dan obesitas derajat II dengan Indeks Masa Tubuh (IMT) 44,29. Pasien diberikan terapi Platelet Rich Plasma (PRP) setiap tujuh hari, Kompres luka dengan cairan NaCl 0,9% selama 10 menit dilanjutkan dengan mupirosin 2% salep dan ditutup dengan menggunakan plester hidrokoloid yang dilakukan per 24 jam. Evaluasi pada minggu ke-6 terapi PRP, pasien menunjukkan adanya perbaikan klinis pada luka. Diskusi: Kandungan PRP terdiri dari banyak faktor pertumbuhan untuk mempercepat penyembuhan luka dan angiogenesis. Trombosit mengandung faktor pertumbuhan yang memicu efek biologis yang merupakan kunci dalam proses perbaikan dan regenerasi jaringan.