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Complete Clinical and Trichoscopic Remission of Refractory Patch Alopecia Areata with a Multi-Modal Microneedling and Vitamin D3 Protocol: A Case Report Stephanie Lukita; Ferra Olivia Mawu; Thigita Aga Pandaleke
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1493

Background: Refractory patch alopecia areata (AA) presents a significant therapeutic challenge, as many patients fail first-line treatments. This gap necessitates the exploration of novel, mechanistically-targeted therapeutic strategies. Case presentation: We present the case of a 44-year-old female with a 2.5 × 3.0 cm patch of AA, refractory to a 3-month compliant trial of topical 0.25% desoximetasone and 5% minoxidil. Baseline diagnostics included histopathology (peribulbar lymphocytic infiltrate), quantitative trichoscopy (yellow dots, black dots, exclamation mark hairs), and laboratory workup, which revealed a serum 25-hydroxyvitamin D [25(OH)D] insufficiency (18.2 ng/mL). A multi-modal protocol was initiated: (1) systemic 5,000 IU/day oral cholecalciferol, (2) 10 sessions of 1.5 mm microneedling at two-week intervals, and (3) immediate post-procedure application of topical 100,000 IU cholecalciferol. Significant regrowth of pigmented terminal hairs was observed by week 12. After 20 weeks (10 sessions), complete clinical regrowth was achieved. Final quantitative trichoscopy confirmed the full resolution of all pathological markers, with a healthy density of terminal hairs. The patient’s systemic 25(OH)D level was corrected to 41.5 ng/mL. The treatment was well-tolerated. Conclusion: This case report documents a complete remission associated with a multi-modal protocol. The contribution of the systemic vitamin D repletion is a major, unresolvable confounder, making attribution impossible. However, this hypothesis-generating case suggests a combined (systemic, physical, and topical) approach may represent a potential rescue strategy for refractory patch AA, warranting further controlled investigation.

On Penyuluhan Pencegahan Penyakit Kulit Di Kelurahan Tuminting Health Education on Skin Disease Prevention in Tuminting Village: - Kaseke, Martha Marie; Doda, Diana Vanda Daturada; Pandaleke, Thigita Aga
Vivabio: Jurnal Pengabdian Multidisiplin Vol. 7 No. 3 (2025): Vivabio: Jurnal Pengabdian Multidisiplin
Publisher : Sam Ratulangi University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35799/vivabio.v7i3.65542

Skin diseases are common health problems in the community, particularly in tropical regions such as Tuminting Village. Community knowledge regarding risk factors, prevention methods, and early signs of skin diseases remains limited. This community service activity aimed to improve public knowledge related to the prevention of skin diseases. The activity was carried out in the form of a health education session using an educational video, accompanied by a pre- and post-test questionnaire assessing knowledge about skin disease prevention. The pre-test results showed a knowledge level of 83%, which increased significantly to 94% after the educational intervention. In conclusion, health education on skin disease prevention is essential to enhance community knowledge in Tuminting Village. ABSTRAK Penyakit kulit merupakan masalah kesehatan yang dapat terjadi di masyarakat terutama pada wilayah tropis seperti Kelurahan Tuminting. Pengetahuan masyarakat mengenai faktor risiko, cara pencegahan, dan tanda-tanda penyakit kulit masih terbatas. Kegiatan pengabdian ini bertujuan meningkatkan pengetahuan masyarakat terkait pencegahan penyakit kulit. Pengabdian ini dilakukan dalam bentuk penyuluhan kesehatan kulit melalui video edukasi, dimana dilakukan pengisian kuesioner pengetahuan tentang penyakit kulit sebelum dan sesudah penyuluhan. Pada pengisian kuesioner sebelum penyuluhan pencegahan penyakit kulit hanya didapatkan pengetahuan sebesar 83% dan hasilnya meningkat signifikan menjadi 94% sesudah dilakukan penyuluhan pencegahan penyakit kulit. Sebagai kesimpulan bahwa penyuluhan pencegahan penyakit kulit diperlukan untuk meningkatkan pengetahuan masyarakat kelurahan tuminting.

The Steel-Blue Peppering and Systemic Eosinophilia: Dermoscopic-Histopathological Correspondence of the Tyndall Effect in Generalized Fixed Drug Eruption William Yudistha Anggawirya; Shienty Gaspersz; Ferra Olivia Mawu; Thigita Aga Pandaleke; Anggi Anastasia Ursula Dien
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1538

Background: Generalized fixed drug eruption (GFDE) represents a severe and distinctive variant of delayed-type hypersensitivity, characterized by widespread, recurrent pigmentary lesions involving at least three anatomical sites. Its clinical presentation often mimics extensive lichenoid dermatoses or infectious conditions such as Hansen’s disease, leading to significant diagnostic delays, particularly in geriatric populations with polypharmacy. While dermoscopy offers a non-invasive bridge to histopathology, specific correlative studies in generalized cases remain scarce. Case presentation: We report the case of a 69-year-old male presenting with diffuse, well-demarcated, violaceous plaques affecting the face, trunk, extremities, and genitalia. The eruption demonstrated a pathognomonic acute latency, recurring at identical anatomical sites within six hours of re-exposure to an unprescribed analgesic cocktail. High-definition non-contact polarized dermoscopy identified two distinct morphological patterns: a brown starburst pattern with central clearing on the extremities and diffuse steel-blue peppering on femoral lesions. Notably, the patient exhibited a mixed immunophenotype characterized by marked eosinophilia (2,080 cells per microliter) and elevated total immunoglobulin E (2,295 IU per milliliter). Parasitic infection was rigorously excluded via negative stool examination and serology, and a Naranjo probability score of 10 confirmed a definite adverse drug reaction. Histopathological examination confirmed interface dermatitis with necrotic keratinocytes and marked pigment incontinence. Conclusion: This study illustrates that steel-blue peppering is a reliable dermoscopic surrogate for deep dermal pigment incontinence via the Tyndall effect. The discrepancy between high systemic eosinophilia and low tissue eosinophilia suggests a complex, potentially mixed-hypersensitivity phenotype in generalized cases, distinct from classic localized fixed drug eruption.

Complete Clinical and Trichoscopic Remission of Refractory Patch Alopecia Areata with a Multi-Modal Microneedling and Vitamin D3 Protocol: A Case Report Stephanie Lukita; Ferra Olivia Mawu; Thigita Aga Pandaleke
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1493

Background: Refractory patch alopecia areata (AA) presents a significant therapeutic challenge, as many patients fail first-line treatments. This gap necessitates the exploration of novel, mechanistically-targeted therapeutic strategies. Case presentation: We present the case of a 44-year-old female with a 2.5 × 3.0 cm patch of AA, refractory to a 3-month compliant trial of topical 0.25% desoximetasone and 5% minoxidil. Baseline diagnostics included histopathology (peribulbar lymphocytic infiltrate), quantitative trichoscopy (yellow dots, black dots, exclamation mark hairs), and laboratory workup, which revealed a serum 25-hydroxyvitamin D [25(OH)D] insufficiency (18.2 ng/mL). A multi-modal protocol was initiated: (1) systemic 5,000 IU/day oral cholecalciferol, (2) 10 sessions of 1.5 mm microneedling at two-week intervals, and (3) immediate post-procedure application of topical 100,000 IU cholecalciferol. Significant regrowth of pigmented terminal hairs was observed by week 12. After 20 weeks (10 sessions), complete clinical regrowth was achieved. Final quantitative trichoscopy confirmed the full resolution of all pathological markers, with a healthy density of terminal hairs. The patient’s systemic 25(OH)D level was corrected to 41.5 ng/mL. The treatment was well-tolerated. Conclusion: This case report documents a complete remission associated with a multi-modal protocol. The contribution of the systemic vitamin D repletion is a major, unresolvable confounder, making attribution impossible. However, this hypothesis-generating case suggests a combined (systemic, physical, and topical) approach may represent a potential rescue strategy for refractory patch AA, warranting further controlled investigation.

The Steel-Blue Peppering and Systemic Eosinophilia: Dermoscopic-Histopathological Correspondence of the Tyndall Effect in Generalized Fixed Drug Eruption William Yudistha Anggawirya; Shienty Gaspersz; Ferra Olivia Mawu; Thigita Aga Pandaleke; Anggi Anastasia Ursula Dien
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1538

Background: Generalized fixed drug eruption (GFDE) represents a severe and distinctive variant of delayed-type hypersensitivity, characterized by widespread, recurrent pigmentary lesions involving at least three anatomical sites. Its clinical presentation often mimics extensive lichenoid dermatoses or infectious conditions such as Hansen’s disease, leading to significant diagnostic delays, particularly in geriatric populations with polypharmacy. While dermoscopy offers a non-invasive bridge to histopathology, specific correlative studies in generalized cases remain scarce. Case presentation: We report the case of a 69-year-old male presenting with diffuse, well-demarcated, violaceous plaques affecting the face, trunk, extremities, and genitalia. The eruption demonstrated a pathognomonic acute latency, recurring at identical anatomical sites within six hours of re-exposure to an unprescribed analgesic cocktail. High-definition non-contact polarized dermoscopy identified two distinct morphological patterns: a brown starburst pattern with central clearing on the extremities and diffuse steel-blue peppering on femoral lesions. Notably, the patient exhibited a mixed immunophenotype characterized by marked eosinophilia (2,080 cells per microliter) and elevated total immunoglobulin E (2,295 IU per milliliter). Parasitic infection was rigorously excluded via negative stool examination and serology, and a Naranjo probability score of 10 confirmed a definite adverse drug reaction. Histopathological examination confirmed interface dermatitis with necrotic keratinocytes and marked pigment incontinence. Conclusion: This study illustrates that steel-blue peppering is a reliable dermoscopic surrogate for deep dermal pigment incontinence via the Tyndall effect. The discrepancy between high systemic eosinophilia and low tissue eosinophilia suggests a complex, potentially mixed-hypersensitivity phenotype in generalized cases, distinct from classic localized fixed drug eruption.

Pola Penggunaan Produk Perawatan Kulit Topikal yang Mengandung Antioksidan pada Mahasiswa Fakultas Kedokteran Pengguna Perangkat Digital Kireina Izumi Yonathan; Ferra Olivia Mawu; Thigita Aga Pandaleke
Cerdika: Jurnal Ilmiah Indonesia Vol. 6 No. 4 (2026): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v6i4.3028

Latar Belakang: Peningkatan penggunaan perangkat digital menyebabkan paparan cahaya biru yang dapat memicu stres oksidatif pada kulit. Antioksidan berperan menetralisir radikal bebas sehingga produk perawatan kulit topikal yang mengandung antioksidan penting digunakan untuk menjaga kesehatan kulit. Tujuan: Penelitian ini bertujuan untuk menggambarkan pola penggunaan produk perawatan kulit topikal yang mengandung antioksidan pada mahasiswa Program Studi Pendidikan Dokter Universitas Sam Ratulangi pengguna perangkat digital. Metode: Penelitian ini menggunakan desain deskriptif kuantitatif dengan teknik total sampling terhadap 225 mahasiswa semester 3. Data dikumpulkan melalui kuesioner yang mencakup frekuensi penggunaan, waktu penggunaan, jenis produk yang digunakan, dan kesesuaian penggunaan dengan petunjuk pada kemasan. Analisis dilakukan secara univariat dan disajikan dalam bentuk distribusi frekuensi. Hasil: Pola penggunaan produk perawatan kulit topikal yang mengandung antioksidan pada 225 responden menunjukkan bahwa 51 orang (23%) berada pada kategori baik, 102 orang (45%) berada pada kategori cukup, dan 72 orang (32%) berada pada kategori kurang. Berdasarkan jenis kelamin, penelitian ini melibatkan 163 perempuan (72%) dan 62 laki-laki (28%). Pada kelompok perempuan, pola penggunaan didominasi oleh kategori cukup, yaitu 74 orang (45%), diikuti kategori baik sebanyak 46 orang (28%), dan kategori kurang sebanyak 43 orang (26%). Sebaliknya, pada kelompok laki-laki, pola penggunaan lebih banyak berada pada kategori kurang, yaitu 29 orang (47%), disusul kategori cukup sebanyak 28 orang (45%), dan kategori baik hanya 5 orang (8%). Kesimpulan: Pola penggunaan produk perawatan kulit topikal yang mengandung antioksidan pada mahasiswa menunjukkan variasi pada aspek frekuensi, waktu penggunaan, jenis produk, dan kepatuhan terhadap petunjuk pemakaian.

Serum Vitamin D Levels and Severity of Male Androgenetic Alopecia in North Sulawesi: A Cross-Sectional Study Thigita Aga Pandaleke; Aryani Adji; Shienty Gaspersz; Dwayne Giovano Pandaleke; Paulus Mario Christopher
Glosains: Jurnal Sains Global Indonesia Vol. 7 No. 3 (2026): Glosains: Jurnal Sains Global Indonesia
Publisher : Sekolah Tinggi Agama Islam Kuningan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59784/glosains.v7i3.748

Background: Androgenetic alopecia (AGA) is the most prevalent type of nonscarring hair loss in men, leading to progressive miniaturization of hair follicles and shortened hair growth cycles. Recent evidence indicates the importance of vitamin D and vitamin D receptor-mediated signaling in regulating hair follicle function. Nevertheless, studies investigating this relationship among Indonesian men remain limited. Objective: To investigate the relationship between serum vitamin D levels and the severity of AGA using the Hamilton–Norwood classification in men. Methods: This cross-sectional analytical study included 30 male patients aged 18–70 years who visited a tertiary referral hospital in North Sulawesi and were diagnosed with AGA. AGA severity was classified as mild, moderate, or severe according to the Hamilton–Norwood classification. Serum vitamin D concentrations were assessed, and Spearman’s rank correlation test was used to evaluate the association between vitamin D levels and AGA severity, with p < 0.05 considered statistically significant. Results: The patients’ mean age was 40.27 ± 11.40 years, and the mean duration of AGA was 8.87 ± 6.58 years. The overall mean serum vitamin D level was 26.56 ± 11.36 ng/mL, with the majority (80%) of subjects classified as vitamin D deficient. A progressive decrease in vitamin D levels was observed with increasing AGA severity (mild: 36.34 ± 14.27 ng/mL; moderate: 22.77 ± 4.90 ng/mL; severe: 20.54 ± 5.09 ng/mL). Statistical analysis revealed a significant negative correlation between serum vitamin D levels and AGA severity (r = −0.57; p = 0.001). Conclusions: In this cross-sectional study, lower serum vitamin D concentrations were significantly associated with greater AGA severity (r = −0.57; p = 0.001). These findings suggest a potential role of vitamin D in the pathogenesis of AGA; however, causality cannot be established based solely on this study design.

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