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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Luh Putu Sustiana Kartika Sari
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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A Retrospective Three-Year Analysis of Adult Scabies at a Tertiary Referral Center in Bali, Indonesia I Gusti Ayu Agung Praharsini; Luh Putu Sustiana Kartika Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1388

Abstract

Background: Scabies, a parasitic infestation by Sarcoptes scabiei var. hominis, is a global health challenge with significant morbidity, particularly in tropical climates. While often studied in community settings, the profile of adult patients presenting to tertiary care facilities remains under-documented. This study aimed to delineate the clinical-demographic characteristics of adult scabies patients at a major referral hospital in Bali, Indonesia, to better understand this specific patient study. Methods: A retrospective, descriptive study was conducted utilizing electronic medical records from the Dermatology and Venereology outpatient clinic at Prof. Dr. I.G.N.G. Ngoerah General Hospital from January 2021 to December 2023. Following a total sampling method based on strict inclusion and exclusion criteria, data from 38 adult patients with a clinical diagnosis of scabies were extracted. The analysis focused on descriptive statistics to summarize patient demographics, contact history, and prescribed therapeutic regimens. Results: The study of 38 patients had a mean age of 34.1 ± 2.5 years. A male predominance was noted (n=22, 57.9%). The highest frequency of cases was in the 40-49 year age bracket (n=9, 23.7%). Most patients had completed senior high school (n=17, 44.7%) and were employed in the private sector (n=20, 52.6%). A family history of scabies was prevalent (n=18, 47.4%). While indirect transmission via shared clothing was rare (reported by only 7.9%), direct contact through bed sharing with at least one other person was common (n=24, 63.2%). The standard therapeutic protocol was combination therapy, with topical 5% Permethrin and oral antihistamines being the most frequent regimen (n=24, 63.2%). Conclusion: Adult scabies patients at this tertiary center are typically middle-aged, educated, working males. Transmission is overwhelmingly linked to intimate household contact, highlighting the inefficiency of fomite-based spread compared to direct skin-to-skin contact. The standard use of combination therapy reflects a proactive clinical approach to managing both the parasitic infestation and the complex immunologic cascade of pruritus. These findings provide a crucial clinical baseline for this specific patient population.
A Retrospective Three-Year Analysis of Adult Scabies at a Tertiary Referral Center in Bali, Indonesia I Gusti Ayu Agung Praharsini; Luh Putu Sustiana Kartika Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1388

Abstract

Background: Scabies, a parasitic infestation by Sarcoptes scabiei var. hominis, is a global health challenge with significant morbidity, particularly in tropical climates. While often studied in community settings, the profile of adult patients presenting to tertiary care facilities remains under-documented. This study aimed to delineate the clinical-demographic characteristics of adult scabies patients at a major referral hospital in Bali, Indonesia, to better understand this specific patient study. Methods: A retrospective, descriptive study was conducted utilizing electronic medical records from the Dermatology and Venereology outpatient clinic at Prof. Dr. I.G.N.G. Ngoerah General Hospital from January 2021 to December 2023. Following a total sampling method based on strict inclusion and exclusion criteria, data from 38 adult patients with a clinical diagnosis of scabies were extracted. The analysis focused on descriptive statistics to summarize patient demographics, contact history, and prescribed therapeutic regimens. Results: The study of 38 patients had a mean age of 34.1 ± 2.5 years. A male predominance was noted (n=22, 57.9%). The highest frequency of cases was in the 40-49 year age bracket (n=9, 23.7%). Most patients had completed senior high school (n=17, 44.7%) and were employed in the private sector (n=20, 52.6%). A family history of scabies was prevalent (n=18, 47.4%). While indirect transmission via shared clothing was rare (reported by only 7.9%), direct contact through bed sharing with at least one other person was common (n=24, 63.2%). The standard therapeutic protocol was combination therapy, with topical 5% Permethrin and oral antihistamines being the most frequent regimen (n=24, 63.2%). Conclusion: Adult scabies patients at this tertiary center are typically middle-aged, educated, working males. Transmission is overwhelmingly linked to intimate household contact, highlighting the inefficiency of fomite-based spread compared to direct skin-to-skin contact. The standard use of combination therapy reflects a proactive clinical approach to managing both the parasitic infestation and the complex immunologic cascade of pruritus. These findings provide a crucial clinical baseline for this specific patient population.
A Methodical Approach to a 15-Year Diagnostic Enigma: Unmasking Acrodermatitis Continua of Hallopeau Through Dermoscopy, Histopathology, and Structured Therapeutic Sequencing Luh Putu Sustiana Kartika Sari; Ni Luh Putu Ratih Vibriyanti Karna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1460

Abstract

Background: Acrodermatitis continua of Hallopeau (ACH) is a rare, debilitating variant of pustular psoriasis. Its profound clinical mimicry of common infections, particularly onychomycosis, often leads to extensive diagnostic delays and ineffective treatments, causing significant patient morbidity. This report details a case with a 15-year history of misdiagnosis, illustrating a structured methodological approach to diagnosis and management. Case presentation: A 40-year-old Indonesian woman presented with a 15-year history of painful pustular lesions and severe onychodystrophy affecting seven digits, refractory to numerous antimicrobial therapies. The diagnostic process was systematically re-evaluated; dermoscopy revealed features inconsistent with onychomycosis (dotted vessels, hemorrhagic spots), prompting a definitive skin and nail matrix biopsy. Histopathology confirmed pustular psoriasis with pathognomonic Kogoj's spongiform pustules and Munro's microabscesses. Treatment was initiated with cyclosporine (3.3 mg/kg/day), leading to rapid remission. However, the development of gingival hyperplasia and hypertension necessitated a transition to weekly methotrexate (15 mg). The patient achieved and maintained clinical remission on this regimen. Conclusion: This case underscores the necessity of a high index of suspicion for ACH in chronic, treatment-resistant nail dystrophy. It demonstrates that a methodical application of dermoscopy and histopathology is indispensable for overcoming clinical mimicry. The main lesson is that structured diagnostic evaluation and sequenced therapy, responsive to adverse events, are crucial for achieving long-term remission and restoring quality of life.
A Methodical Approach to a 15-Year Diagnostic Enigma: Unmasking Acrodermatitis Continua of Hallopeau Through Dermoscopy, Histopathology, and Structured Therapeutic Sequencing Luh Putu Sustiana Kartika Sari; Ni Luh Putu Ratih Vibriyanti Karna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1460

Abstract

Background: Acrodermatitis continua of Hallopeau (ACH) is a rare, debilitating variant of pustular psoriasis. Its profound clinical mimicry of common infections, particularly onychomycosis, often leads to extensive diagnostic delays and ineffective treatments, causing significant patient morbidity. This report details a case with a 15-year history of misdiagnosis, illustrating a structured methodological approach to diagnosis and management. Case presentation: A 40-year-old Indonesian woman presented with a 15-year history of painful pustular lesions and severe onychodystrophy affecting seven digits, refractory to numerous antimicrobial therapies. The diagnostic process was systematically re-evaluated; dermoscopy revealed features inconsistent with onychomycosis (dotted vessels, hemorrhagic spots), prompting a definitive skin and nail matrix biopsy. Histopathology confirmed pustular psoriasis with pathognomonic Kogoj's spongiform pustules and Munro's microabscesses. Treatment was initiated with cyclosporine (3.3 mg/kg/day), leading to rapid remission. However, the development of gingival hyperplasia and hypertension necessitated a transition to weekly methotrexate (15 mg). The patient achieved and maintained clinical remission on this regimen. Conclusion: This case underscores the necessity of a high index of suspicion for ACH in chronic, treatment-resistant nail dystrophy. It demonstrates that a methodical application of dermoscopy and histopathology is indispensable for overcoming clinical mimicry. The main lesson is that structured diagnostic evaluation and sequenced therapy, responsive to adverse events, are crucial for achieving long-term remission and restoring quality of life.
Co-Authors I Gusti Ayu Agung Praharsini Ni Luh Putu Ratih Vibriyanti Karna