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Natasha Caroline Gigir
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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What Are The Most Effective Management Strategies For Psoriasis During Pregnancy That Minimize Risks To Maternal And Fetal Health? : A Systematic Review Ni Putu Devi Gema Partamayani; Anak Agung Istri Indah Paramita; Natasha Caroline Gigir
The International Journal of Medical Science and Health Research Vol. 12 No. 6 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/r294yr02

Abstract

Introduction: Psoriasis, a chronic inflammatory skin disease, affects 2–3% of the global population, including women of childbearing age. Managing psoriasis during pregnancy presents a challenge, balancing maternal disease control with fetal safety, as physiological changes can influence disease severity. Individualized treatment plans are necessary, prioritizing medications with established safety profiles to minimize risks to both mother and fetus while ensuring effective disease control. Methods: This systematic review adhered to the PRISMA 2020 guidelines to ensure methodological rigor and accuracy. Data extraction was performed using a large language model, focusing on study design, population characteristics, management strategies, maternal and fetal health outcomes, and risk of bias. The search strategy employed Boolean MeSH keywords across databases like PubMed, Semantic Scholar, Sagepub, and Google Scholar. Results: Forty studies were included in the systematic review. Biologic therapies, such as TNF inhibitors and ustekinumab, showed acceptable safety profiles with miscarriage rates (8.9–15.3%) and congenital malformation rates (3–4%) comparable to the general population. Certolizumab pegol notably exhibited minimal placental transfer. Methotrexate is contraindicated due to teratogenic effects. Sulfasalazine demonstrated modest efficacy with few serious adverse events. Topical treatments generally lacked robust pregnancy-specific safety data. Discussion: Biologic therapies are effective and generally safe for psoriasis management during pregnancy, with certolizumab pegol being a preferred choice due to minimal placental transfer. Discontinuation of biologics may lead to disease flares, necessitating individualized risk-benefit assessments. Preconception counseling, close monitoring, and shared decision-making are crucial for optimizing outcomes. Conclusion: Effective management of psoriasis during pregnancy balances maternal disease control with fetal health. Biologics offer acceptable safety profiles, with certolizumab pegol being particularly favorable. Methotrexate is contraindicated, and topical treatments require more research for definitive safety recommendations. A multidisciplinary and patient-centered approach, including preconception counseling and close monitoring, is essential to optimize care.
What Are The Most Effective First-Line Pharmacological Treatments For Managing Bullous Pemphigoid In Elderly Patients Over 65 Years Old? : A Systematic Review Anak Agung Istri Indah Paramita; I Dewa Ayu Supriyantini; Ni Putu Devi Gema Partamayani; Natasha Caroline Gigir
The International Journal of Medical Science and Health Research Vol. 13 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/dk1c9f42

Abstract

Introduction: Bullous pemphigoid is an autoimmune blistering disease primarily affecting older adults. Managing this condition in patients over 65 is challenging, requiring a balance between controlling severe symptoms and minimizing treatment-related risks. This review synthesizes evidence on the most effective and safe first-line pharmacological treatments for this vulnerable population. Methods: A systematic review was conducted following PRISMA guidelines. We searched PubMed, Semantic Scholar, Springer, and Google Scholar for randomized controlled trials, systematic reviews, and prospective cohort studies investigating first-line pharmacological treatments for bullous pemphigoid in patients over 65. Results: Systemic corticosteroids like prednisolone offer rapid disease control (91% achieving ≤3 blisters at 6 weeks) but are associated with a high rate of severe adverse events (36% at 1 year). Doxycycline was found to be non-inferior for short-term control (74% achieving ≤3 blisters at 6 weeks) with a significantly better safety profile, halving the rate of severe adverse events to 18%. High-potency topical corticosteroids were effective and well-tolerated for moderate disease. Discussion: The evidence supports a risk-stratified approach. While effective, the high toxicity of systemic corticosteroids makes them less ideal as a universal first-line choice. Doxycycline and high-potency topical corticosteroids represent a safer initial strategy, balancing good efficacy with significantly lower risk. Novel biologics, particularly dupilumab, are poised to become a new standard of care, offering high efficacy without the severe risks of broad immunosuppression, pending results from ongoing randomized controlled trials. Conclusion: For elderly patients with bullous pemphigoid, doxycycline and high-potency topical corticosteroids are the preferred first-line treatments due to their favorable balance of efficacy and safety. Systemic corticosteroids should be reserved for specific cases where rapid control is essential and risks are manageable. Novel therapies like dupilumab show great promise and may soon redefine the standard of care, pending final evidence from ongoing trials.
Cement-Induced Irritant Contact Dermatitis: A Case Report Natasha Caroline Gigir; Anak Agung Istri Indah Paramita; Ni Putu Devi Gema Partamayani
The International Journal of Medical Science and Health Research Vol. 14 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ty5v1n10

Abstract

Background: Irritant Contact Dermatitis (ICD) is a non-immunologic inflammatory skin reaction resulting from direct epidermal damage by exogenous agents, which subsequently activates the innate immune system. Its development is influenced by both endogenous and exogenous factors. As one of the most frequently reported occupational health problems, ICD poses a significant risk to construction workers who are routinely exposed to irritants like cement. Case Presentation: We present the case of a 35-year-old male construction worker who presented with a two-week history of intense pruritus and progressive skin thickening on his hands and feet. Dermatological examination revealed erosions, significant crusting, and marked lichenification on the dorsal aspects of both hands and feet. Management and Outcome: The patient was diagnosed with Chronic Irritant Contact Dermatitis based on his clinical history and physical findings. He was managed with a combination of systemic corticosteroids and antihistamines, complemented by topical corticosteroid therapy and comprehensive patient education. Follow-up revealed significant clinical improvement. Conclusion: The diagnosis of ICD was established through a thorough anamnesis and physical examination, highlighting the patient's occupational exposure to cement as the primary risk factor. This case underscores that effective management hinges on the strict avoidance of the causative irritant, robust patient education on personal protective equipment, and appropriate pharmacotherapy to control inflammation and symptoms.
Effectiveness of Rosmarinus officinalis for Androgenetic Alopecia: A Literature Review Cintantya Prakasita; Desak Nyoman Trisepti Utami; Natasha Caroline Gigir; Ni Ketut Putri Ratih Sindunata
The International Journal of Medical Science and Health Research Vol. 21 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/khjhbh24

Abstract

Androgenetic alopecia (AGA), also known as androgenic alopecia or male pattern baldness, is the most common type of progressive hair loss.. Androgenetic alopecia is hereditary and is transmitted through an autosomal dominant genetic pattern. This genetic predisposition is directly associated with androgen hormones, in which androgens induce miniaturization of hair follicles on the scalp and a progressive shortening of the anagen phase in the hair cycle. There are evidence-based therapeutic interventions for androgenetic alopecia, including both pharmacological and non-pharmacological approaches. The 5α-reductase inhibitors, finasteride and dutasteride, effectively suppress dihydrotestosterone (DHT) synthesis but are associated with sexual dysfunction including erectile dysfunction, reduced libido, and ejaculatory disorder as well as gynecomastia. Androgen receptor antagonists such as spironolactone may induce postural hypotension and hyperkalemia, cyproterone acetate carries risks of mood disturbances and hepatotoxicity, and flutamide is linked to dose-dependent severe hepatic injury. This literature review explores the therapeutic potential of herbal remedies Rosmarinus Officinalis known for their anti inflammatory agent, anti androgenic agent, anti fungal agent, photoprotective agent, and a vasodilator. This review emphasizes the potential and effectiveness of Rosmarinus Officinalis  in advancing dermatological care and providing effective, plant-based solutions for Androgenetic Alopecia with minimal side effects.
Co-Authors Anak Agung Istri Indah Paramita Cintantya Prakasita Desak Nyoman Trisepti Utami I Dewa Ayu Supriyantini Ni Ketut Putri Ratih Sindunata Ni Putu Devi Gema Partamayani