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Nevus Melanositik Didapat yang Disertai dengan Dermatitis Kronik: Tantangan Diagnosis dan Risiko Rekurensi Reshinta, Reisa; Krisanti, Inge Ade; Sirait, Sondang P.
Media Dermato-Venereologica Indonesiana Vol 52 No 1 (2025): 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.v52i1.506

Abstract

Pendahuluan: Nevus melanositik didapat merupakan lesi melanositik jinak yang paling sering ditemui. Proses peradangan kronis dapat membuat gambaran klinis dan dermoskopik nevus melanositik didapat menjadi tidak khas. Rekurensi dapat terjadi terutama pascatindakan pengangkatan lesi secara parsial. Kasus: Anak perempuan, 15 tahun, mengeluhkan tahi lalat hitam di punggung tangan kanan yang sudah ada sejak 10 tahun yang lalu. Tahi lalat membesar perlahan seiring usia, namun dalam 1 tahun terakhir terasa lebih tebal, bersisik dan gatal. Pemeriksaan dermoskopi menunjukkan gambaran tidak khas. Diagnosis nevus melanositik intradermal ditegakkan berdasarkan pemeriksaan histopatologi yang diambil dengan cara biopsi tangensial. Nevus rekuren muncul satu bulan pascaeksisi. Gambaran histopatologi menunjukkan adanya sarang-sarang sel nevus berinti bulat, vesikular, sitoplasma eosinofilik, sebagian dengan pigmen kecokelatan intrasitoplasmik, serta tidak ditemukan mitosis. Selain itu, juga terdapat akantosis, hipergranulosis, spongiosis ringan, dan vertical collagen streaks. Diskusi: Gambaran histopatologi berupa dermatitis kronik di bagian superfisial lesi dapat menjelaskan gambaran dermoskopi yang tidak khas pada nevus melanositik didapat. Pengangkatan lesi secara parsial dengan teknik biopsi tangensial meningkatkan risiko rekurensi, walaupun 23% kasus nevus rekuren ditemukan juga pascaeksisi nevus secara komplet. Gambaran klinis nevus rekuren dapat menyerupai melanoma, tetapi dermoskopi dapat membantu membedakan keduanya. Kesimpulan: Diagnosis dermatitis kronik perlu dipertimbangkan pada dermoskopi lesi nevus melanositik didapat yang tidak khas. Kemungkinan rekurensi pascaeksisi nevus melanositik didapat perlu diinformasikan kepada pasien dan/atau keluarga.
Perbaikan Klinis Green Nail Syndrome yang Signifikan pada Lanjut Usia dengan Terapi Kombinasi: Sebuah Serial Kasus Marizki Ramadhani, Reinanda; Nadia Yusharyahya, Shannaz; Legiawati, Lili; Astriningrum, Rinadewi; Gunardi, Keiko Yolanda; Reshinta, Reisa
Jurnal Kedokteran Meditek Vol 31 No 2 (2025): MARCH
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i2.3383

Abstract

Introduction: Green nail syndrome is a common bacterial infection of the nails and is characterized by green discolouration of the nail plate caused by Pseudomonas aeruginosa. It frequently occurs in people who are exposed to constant water and due to mechanical trauma, especially in elderly patients. Case Illustration: We reported 2 cases treated with a combination therapy of oral ciprofloxacin, 1% acetic acid dressing, gentamicin ointment and showed a significant clinical improvement. There are two cases: a 67-year-old man and a 64-year-old woman complained of black-greenish discolouration on his right big toenail, which has been accompanied by changes in the shape of the nail for 3 months. Both patients have a history of frequent and prolonged contact with water—dermoscopy results in greenish-black discolouration in the nail plate.  The culture results of both patients, Pseudomonas aeruginosa was found. Combination treatment showed significant clinical improvement in both patients. Discussion: Dressing of 1% acetic acid was useful as an adjuvant to improve the ointment penetration, inhibiting the formation of Pseudomonas aeruginosa biofilms. Gentamicin and ciprofloxacin are effective against aerobic gram-negative bacterial infections, such as Pseudomonas aeruginosa. Conclusion: The use of ciprofloxacin is recommended, especially in elderly patients. Combination therapy with oral ciprofloxacin, 1% acetic acid dressing, and gentamicin ointment is an effective option for patients with green nail syndrome
Diagnosis dan Tata Laksana Hydroa Vacciniforme Reshinta, Reisa; Rahmayunita, Githa; Rihatmadja, Rahadi; Astriningrum, Rinadewi
Cermin Dunia Kedokteran Vol 51 No 5 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i5.902

Abstract

Hydroa vacciniforme (HV) is a rare photodermatoses with the most frequent onset in childhood. The exact pathogenesis of HV is still not known. This disease is a spectrum with almost similar clinical symptoms, but with a very different prognosis. Classic HV has the best prognosis, but affects the quality of life due to scar formation, while hydroa vacciniforme-like lymphoma (HVLL) is the variant with the worst prognosis. HV needs to be considered as a differential diagnosis, especially in childhood-onset photodermatoses. Classical HV must be distinguishes from hydroa vacciniforme-like lymphoproliferative disorders (HVLPD) because it is related to prognosis. There is still no consensus or guidelines on diagnosis and management for HV.