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Marked Clinical Improvement of Psoriasis Vulgaris with Methotrexate: A Case Report with 75% PASI Reduction Manurung, Widya Gabriella; Nababan, Kristo Alberto
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.v7i5.6859

Abstract

Psoriasis is an immune-mediated chronic, recurrent, systemic inflammatory disease induced by the combination of hereditary and environmental factors. The etiology of this disease involves many factors, including genetics, immunology, and the environment. Clinically, psoriasis vulgaris is characterized by the presence of reddish plaques with thick, symmetrically distributed squama mainly in the predilection areas. In moderate to severe cases, systemic therapy such as phototherapy, systemic anti-inflammatory agents, or biologic treatments is required, with topical therapy serving as an adjunct. Methotrexate is one of the effective systemic treatment options for severe psoriasis, either as monotherapy or in combination regimens. This case report aims to demonstrate the clinical efficacy of methotrexate in the management of moderate-to-severe psoriasis vulgaris. We report a case of a 37-year-old male presenting with scaly reddish skin thickening accompanied by itching all over the body. Clinical and histopathological examination confirmed the diagnosis of Psoriasis Vulgaris and treated with methotrexate. After a period of regular weekly methotrexate administration and monitoring, the patient achieved a 75% reduction in the Psoriasis Area and Severity Index (PASI), indicating significant therapeutic response. This case highlights the efficacy of methotrexate as a cost-effective and accessible treatment option for achieving substantial disease control in psoriasis vulgaris.
Unveiling harlequin ichthyosis beyond the neonatal period: A case from North Sumatra, Indonesia Manurung, Widya Gabriella; Paramita, Deryne Anggia; Nababan, Kristo Alberto
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 17, No 1, (2026)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol17.Iss1.art11

Abstract

Harlequin ichthyosis (HI) is a rare and life-threatening form of autosomal recessive congenital ichthyosis, typically diagnosed in the neonatal period due to its distinctive clinical features. We report a 7-year-old boy from North Sumatra, Indonesia, who survived well beyond infancy despite limited resources. He was born preterm at 35 weeks to consanguineous parents, with a history of a sibling who died in early infancy from a similar condition. The patient presented with ectropion, eclabium, underdeveloped ears, severe contractures, and generalized hyperkeratotic plaques with deep fissures. Clinical management focused on supportive dermatologic care, including twice-daily bathing, emollient application, topical antibiotics for erosions, and multidisciplinary referrals. Notably, the patient did not receive systemic retinoids or neonatal intensive care, yet the survival was achieved with minimal but consistent supportive measures. This case underscores the importance of early recognition of HI, the role of family history and consanguinity in clinical suspicion, and the potential for survival in resource-limited settings. It also highlights the profound psychosocial burden on affected families and emphasizes the need for genetic counselling to reduce recurrence in high-risk populations.