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Multiple Manifestations of Cutaneous Larva Migrans: A Case Report Rinda Chindra Risanti; Dina Arwina Dalimunthe
Indonesian Journal of Global Health Research Vol 7 No 4 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i4.6291

Cutaneous larva migrans (CLM) is an infectious disease caused by hookworm larvae that live in animals where infected humans are the final hosts. Clinical symptoms are found serpiginous lesions accompanied by pruritus. Multiple manifestations of cutaneous larva migrans on the skin can occur, but such cases are infrequently reported. This article describes a case report that provides a detailed diagnosis, therapeutic approach, and follow-up care of a patient. A 44-year-old man presented with the primary complaint of multiple reddish bumps and raised skin lesions that spread in a winding pattern, accompanied by itching on the abdomen for the past week after he did physical activities by crawling on the ground without wearing clothes. The onset was marked by small reddish bumps on the abdomen, along with constant itching. Then the reddish bumps lengthened, spread to form winding lesions and left blackish spots. The patient was treated with albendazole 400 mg orally once a day for 7 days and cetirizine 10 mg once a day (at night) to relieve itching, and fusidic acid cream 2x1 in the area of the scratch wound. An evaluation was conducted after 7 days of treatment by assessing the clinical signs and the patient's complaints. The itching had decreased, and the rash appeared to be drying and shows good responses. The patient's history and dermatological examination led to the diagnosis of cutaneous larva migrans with multiple manifestations. Administering antihelminthic medication can speed up the progression of the illness and prevent potential complications. Topical or systemic treatment results in a cure rate approaching 100%. Early and appropriate identification and management can help prevent complications and recurrence.

Cutaneous Polyarteritis Nodosa: A Case Report Fitriend Syahputri; Dina Arwina Dalimunthe; Richard Hutapea
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6618

Cutaneous polyarteritis nodosa is a rare type of vasculitis that involves inflammation in small to medium-sized blood vessels, mainly targeting the skin. It affects people of all ages and significantly impacts both the skin and other organ systems. This case report aims to describe the clinical presentation, diagnostic approach, and therapeutic response. A 38-year-old man came with a two-week history of a red, non-itchy rash on both legs. A week before the rash appeared, patient experienced fever, sore throat, and stomach pain. His general condition was stable. Dermatological examination showed multiple palpable purpura on both legs, ranging from miliary to lenticular in size. Diascopy revealed non-blanching purpura, and dermoscopy showed a homogeneous pattern of multiple erythematous spots. Histopathology indicated a proliferation of blood vessels with enlarged endothelial cells, concluding with a diagnosis of polyarteritis nodosa. Patient was diagnosed with cutaneous polyarteritis nodosa and treated with methylprednisolone at 1 mg/kg/day, divided into three doses of 32 mg each, with tapering off every week. Clinical improvement was observed, and the skin lesions progressively resolved. This case highlights the importance of early recognition and corticosteroid therapy in the successful management of mild cutaneous polyarteritis nodosa. Keywords: corticosteroid, cutaneous polyarteritis nodosa, vasculitis

Varicella Presentation in Adult: A Case Report Jesryn Dhillon; Dina Arwina Dalimunthe
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.7114

Varicella is a disease caused by the varicella-zoster virus (VZV), a herpesvirus specific to humans. It is highly contagious but preventable through vaccination. It is usually diagnosed clinically and is often self-limiting. However, complications can include pneumonia, neurological, hematologic, ocular, renal, hepatic conditions, as well as sepsis, and secondary infections that can be fatal. Effective antiviral therapy has reduced associated morbidity and mortality. To report a case of varicella with bronchopneumonia in an adult patient. A 58-year-old male presented with persistent vesicular eruptions on the face, chest, back, and extremities. He was admitted to the emergency room and referred to dermatology. He had no history of prior varicella or vaccination. He was diagnosed with varicella with pneumonia and treated with acyclovir, cetirizine, paracetamol, and fusidic acid cream. Data were obtained through anamnesis, physical examination, and relevant supporting investigations, then qualitatively analyzed by correlating clinical findings and investigation results to confirm the diagnosis, evaluate treatment response, and construct the case narrative. Adult varicella is up to 25 times more severe than in children. The virus is transmitted via the respiratory tract with an incubation period of 10–21 days. Physical stress and disruption of circadian rhythms may impair immune response. Lesions typically start on the face and scalp and spread to the body. A This case highlights a presentation of adult varicella with systemic involvement. Early antiviral treatment can improve prognosis.

Erythroderma Suspected Caused by Sambiloto (Andrographis paniculata): A Case Report Revinanda Venincia Pangaribuan; Dina Arwina Dalimunthe; Ade Arhamni
Indonesian Journal of Global Health Research Vol. 7 No. 6 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i6.172

Erythroderma, or Exfoliative Dermatitis (ED), is a serious dermatological emergency marked by erythema and scaling over more than 90% of the body surface area. Although etiologies are diverse, drug reactions remain a major cause. Beyond conventional pharmaceuticals such as antibiotics, antivirals, anti-inflammatory agents, cardiac drugs, and chemotherapeutics, herbal remedies have also been linked to hypersensitivity reactions. Sambiloto (Andrographis paniculata), a traditional antidiabetic widely used in Southeast Asia, has been reported to trigger severe cutaneous adverse reactions, including erythroderma. We present the case of a 53-year-old woman with diabetes mellitus who developed generalized erythematous macules, scaling, severe pruritus, fever, chills, and fatigue four days after consuming a Sambiloto decoction. She denied the use of other medications. Clinical findings supported by histopathological analysis confirmed erythroderma. Management involved discontinuation of the suspected herbal, systemic corticosteroids, antihistamines, moisturizers, antibiotics, and glucose control, leading to marked improvement within eight days. This case highlights that drug-induced erythroderma often has an acute onset and rapid course. Despite their reputation for safety, herbal medicines may provoke severe hypersensitivity reactions with potentially life-threatening outcomes. Comprehensive drug history-taking, including traditional remedies, is therefore essential in evaluating patients with exfoliative dermatitis. The objective of this report and journal is to raise awareness of herbal-induced erythroderma and to contribute to the growing body of evidence regarding the risks of traditional therapies. Early recognition and prompt withdrawal of the causative agent remain critical for preventing recurrence and improving patient outcomes.

Effectiveness of Ivermectin as A Treatment Modality for Cutaneous Larva Migrans: A Case Series Dina Arwina Dalimunthe; Elza Wahyuni; Adina Miltania Tasmil; Regina Maharani Tambunan
Indonesian Journal of Global Health Research Vol. 8 No. 3 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i3.1213

Cutaneous larva migrans (CLM) is a parasitic skin infection caused by the penetration of nematode larvae into the epidermis, typically following direct contact with contaminated soil or sand. The disease presents with characteristic serpiginous erythematous papules accompanied by intense pruritus and is commonly found in tropical regions with warm and humid climates. Although hookworm infection affects an estimated 740 million people globally, and Indonesia has a reported prevalence of 30–50%, ivermectin had not been used as a therapeutic option for CLM in Indonesia prior to the COVID-19 pandemic due to limited availability. The purpose of this report is to describe the clinical response of CLM patients treated with oral ivermectin as an alternative therapy that has only recently become accessible in Indonesia. This study was conducted as a descriptive case series. The respondents were three patients attending the dermatology outpatient clinic who were clinically diagnosed with cutaneous larva migrans. Data were obtained through patient interviews, dermatological examinations, dermoscopic evaluation, eosinophil counts, and clinical documentation before and after treatment. All patients received a single oral dose of 12 mg ivermectin. Three patients—two aged 67 years (one male and one female) and one 40-year-old female—presented with serpiginous erythematous papules accompanied by pruritus for 3 to 4 weeks. Two of them had previously shown no improvement with mebendazole and topical betamethasone. All patients demonstrated complete resolution of lesions after receiving a single 12 mg dose of ivermectin without any adverse effects. The results showed a 100% clinical cure rate across all cases, with no reported side effects following treatment. This case series highlights the effectiveness and safety of single-dose oral ivermectin for CLM and suggests that ivermectin may be considered a viable therapeutic option for the management of CLM in Indonesia.

A Rare Case of Cutaneous Ulcer Caused by Pseudomonas Putida Dina Arwina Dalimunthe; Michael Andrianus
Indonesian Journal of Global Health Research Vol. 8 No. 4 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i4.1711

Cutaneous ulcers are commonly caused by bacterial infections, most frequently Staphylococcus aureus. However, infection caused by Pseudomonas putida is extremely rare in humans. Pseudomonas putida is a gram-negative, obligate aerobic bacterium widely found in soil, water, and moist environments and is generally considered non-pathogenic. Nevertheless, under certain conditions, it may act as an opportunistic pathogen and cause infection, particularly in the presence of open wounds or environmental exposure. This report describes a rare case of a cutaneous ulcer caused by Pseudomonas putida in a 26-year-old male laborer. The patient presented with multiple painful ulcers with erythematous edges and purulent discharge on the anterior and lateral regions of the left foot. The lesions initially developed after minor trauma caused by a plant prick while working in a rice field. Laboratory investigations including pus culture revealed growth of Pseudomonas putida without fungal infection. Antibiotic susceptibility testing showed sensitivity to amikacin, gentamicin, and meropenem. The patient was treated with oral ciprofloxacin, topical gentamicin, analgesics, and saline compresses, resulting in gradual clinical improvement with resolution of the ulcers and residual hyperpigmented macules.

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