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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Bali Dermatology Venereology and Aesthetic Journal Cermin Dunia Kedokteran
Devina, Wilona
Unknown Affiliation
Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Other

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A case report of an elderly with herpes zoster and atrial fibrillation taking warfarin Putra, Gilang; Devina, Wilona; Priyadarshini, Ida Ayu Uttari
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 7, Issue 2 (July 2024)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/balidervenaesthj.v7i2.101

Abstract

Background: Herpes zoster (HZ) presents with unilateral dermatomal pain and rash resulting from the reactivation and proliferation of latent varicella zoster virus (VZV) that dwells in neurons following varicella. It mostly occurs in the elderly and in immunocompromised . Warfarin consumption can lead to dysregulation of cytokines that cause immune dysregulation, which can be a factor in the reactivation of herpes zoster. There is limited research or study exploring the correlation between herpes zoster reactivation and the use of warfarin in patients with atrial fibrillation This case report aim to investigate potential role of anticoagulant therapy, specifically warfarin, in the reactivation of HZ in elderly patients, and to explore the implications of polypharmacy and immune dysregulation in the management and prevention of HZ. Case Description: A 55-year-old male with a history of atrial fibrillation, currently on warfarin, was admitted with complaints of pain blister lession that developed 7 days post-discharge from the Cardiology department. His initial symptoms included pruritus and pain localized to the chest and right thoracic area. Dermatological examination revealed herpetiform vesicles on an erythematous base, accompanied by crusts and scabs, distributed along thoracic dermatomes T6-T8. Conclusion: Elderly patients often experience polypharmacy due to degenerative diseases. Cardiovascular treatment often includes anticoagulants such as warfarin. Following 1 week after the administration of topical antibiotic and steroid ointments, the patient demonstrated a positive clinical outcome with a few complications after HZ infection.    
Morbus Hansen dengan Reaksi Eritema Nodosum Leprosum pada Kasus Putus Obat: Laporan Kasus Ruslan, Lettisia Amanda; Devina, Wilona; Pemayun, Tjokorda Dalem
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i1.56044

Abstract

Morbus Hansen atau kusta adalah penyakit infeksi granulomatosis yang disebabkan Mycobacterium leprae yang melibatkan kulit dan saraf. Indonesia menduduki peringkat ketiga di dunia dalam kasus kusta, dengan jumlah kasus mencapai lebih dari 13.000 kasus baru pada tahun 2022. Reaksi kusta tipe II atau Eritema Nodosum Leprosum (ENL) terjadi pada pasien kusta dengan jumlah bakteri sangat banyak, yaitu pada tipe LL dan BL. Kami melaporkan seorang laki-laki usia 33 tahun dengan nodul eritema multipel disertai ulkus berbatas tegas dan krusta kehitaman pada seluruh tubuh sejak satu tahun. Lesi bertambah banyak, terasa nyeri, dan disertai demam. Pasien memiliki riwayat putus obat Multidrug Therapy tipe Multibaciler (MDT MB) yang pernah diberikan tujuh tahun lalu. Pada pemeriksaan basil tahan asam (BTA) pada kerokan kulit cuping telinga kanan didapatkan +2 dan cuping telinga kiri +3. Pasien didiagnosis Morbus Hansen tipe LL dengan reaksi ENL pada kasus putus obat. Pasien diberikan terapi MDT MB, metilprednisolon, dan terapi simtomatik. Prognosis ENL bergantung dari derajat keparahan reaksi kusta, diagnosis dini, tatalaksana yang tepat dan respon pasien terhadap pengobatan. Pendekatan multidisiplin sangat diperlukan dalam diagnosis dan tatalaksana dini untuk mencegah kecacatan pada pasien kusta dengan reaksi ENL.
Tata Laksana Vaskulitis Kulit: Tinjauan Pustaka Devina, Wilona; Saraswati, Putu Dyah Ayu
Cermin Dunia Kedokteran Vol 53 No 03 (2026): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i03.1591

Abstract

Cutaneous vasculitis represents a heterogeneous group of inflammatory disorders characterized by inflammation of the cutaneous blood vessel walls and surrounding perivascular tissue, with highly variable clinical manifestations depending on the size and anatomical location of the affected vessels. This condition may present as a disease limited to the skin or as part of a systemic disorder. Epidemiologically, cutaneous vasculitis can occur at all ages but is more frequently observed in adults, whereas in children it is generally self-limiting, with IgA vasculitis being the most common subtype. The etiology of cutaneous vasculitis is predominantly idiopathic; however, infections, medications, autoimmune diseases, and malignancies may also contribute. The pathogenesis involves immune complex deposition and mechanisms mediated by anti-neutrophil cytoplasmic antibodies (ANCA), leading to endothelial injury and vascular inflammation. The main clinical manifestation is palpable purpura, typically distributed symmetrically on the lower extremities, accompanied by various additional skin lesions such as papules, nodules, vesicles, and ulcers. Diagnosis is established through skin biopsy, which remains the gold standard, including histopathological examination and direct immunofluorescence. Most cases are mild and resolve spontaneously; however, systemic therapy is required in severe, chronic, or recurrent conditions. Overall, the prognosis of cutaneous vasculitis is favorable, with a low risk of progression to systemic vasculitis when appropriate diagnosis and management are implemented.
Co-Authors Pemayun, Tjokorda Dalem Priyadarshini, Ida Ayu Uttari Putra, Gilang Ruslan, Lettisia Amanda Saraswati, Putu Dyah Ayu