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Journal of General Procedural Dermatology and Venereology Indonesia

jdvi
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Published by Universitas Indonesia

ISSN : 24607991 EISSN : 24607991 DOI : 10.191

Core Subject : Health,

Medicine & Pharmacology

The initiation of JDVI (Journal of General - Procedural Dermatology & Venereology Indonesia) was done by leading dermatologists and venereologists from Indonesia who aspired to contribute in the field of scientific publication and research. Knowledge and science continue to evolve in the field of dermatology and venereology, especially with new diagnostic methods, therapeutic and procedural approaches, and new emerging diseases.

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Articles 106 Documents

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The differences of blood type in relation to psoriasis and its onset: Cross sectional study Nugrohoaji Dharmawan; Suci Widhiati; Triasari Oktavriana; Irene Jessica Pinarsinta Harahap
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis.Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of Dermatology and Venereology at Dr. Moewardi General Hospital and UNS Hopital in Surakarta. The blood types were determined by two methods; by using ABD-Pad measurement tools that able to see the reaction of antigen and antibody in short time and by using the hospital’s laboratory facility where sample was taken. Anamnesis were done to collect data about the onset of psoriasis. Chi-square (X2) statistical test was used to analyze the data.Results: Total sample of this study were 62 people with 31 subjects (50%) were psoriasis patients and 31 others (50%) are non-psoriasis patients. Chi-square test (X2) between blood type with psoriasis and blood type with the onset of psoriasis are p = 0.269 and p = 0.188 respectively.Conclusion: The significance level used was p < 0.05, therefore there’s no significant correlation between blood type with psoriasis and the onset of psoriasis. Keywords: blood type, onset of psoriasis, psoriasis

Indonesian clinical practice guidelines for systemic and biologic agents for adults with plaque psoriasis Endi Novianto; Windy Keumala Budianti; Eyleny Meisyah Fitri; Benny Effendi Wiryadi; Retno Widowati Soebaryo; Erdina H. D Pusponegoro; Evita Halim Effendi; Githa Rahmayunita; Anis Irawan; Cita R. S. Prakoeswa; Harijono Kariosentono; Shafira Anindya Purnawan; Arlha Aporia Debinta
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, and outcomes of various treatments options.Results: Modified evidence to decision framework of treatment choices were constructed to aid dermatovenerologists across Indonesia in making a clinical judgment on the size of treatment options of biologic and non-biologic systemic agents for psoriasis treatment in Indonesia.Conclusion: These clinical practice guidelines, accepted and acknowledged by the Indonesian Society of Dermatology and Venereology - Kelompok Studi Psoriasis Indonesia (INSDV-KSPI), have been developed to present the latest and concise evidence- and experience-based guideline targeted towards dermatovenereologists in Indonesia on the management of adult plaque psoriasis. Keywords: biologic agents, guidelines, Indonesian, psoriasis

Plasma malondialdehyde levels related to acne vulgaris severity Fitri Puspita
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Acne vulgaris (AV) is a multifactorial disorder characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Oxidative stress plays a role in the pathogenesis of AV. Reactive Oxygen Species (ROS), especially lipid peroxides (LPO), plays a role in mediating acne inflammation. Malondialdehyde (MDA) is one of the byproducts of LPO commonly used as a biomarker of cell damage.Methods: This cross-sectional analytic study consisted of sixty patients with AV. The samples were taken from the blood plasma of AV subjects. An enzyme-linked immunosorbent assay (ELISA) examination was performed. The normality of data distribution was determined using the Kolmogorov-Smirnov test and the differences of plasma MDA levels based on the severity of AV were determined using the Kruskal-Wallis test. P value<0,001 was considered significant.Results: Acne vulgaris was predominantly found in women (70%), age group of 18 – 25 years old (73,33%), and patients with family history of AV (61,67%). Higher plasma MDA levels were found in women [5,5 (2,53 – 77,6) nmol/mL], age group of 26 – 35 years [5,66 (2,73 – 25) nmol/mL], and subjects with family history of AV [5,49 (2,53 – 77,6) nmol/mL]. Based on the severity of AV, the severe AV group had highest plasma MDA [13,85 (2,69 – 77,6) nmol/mL], followed by moderate AV group [4,46 (2,53-14,3) nmol/mL] and mild AV [3,78 (2,47-6,88) nmol/mL]. There were differences in plasma MDA level based on the severity of AV (p<0,001).Conclusion: There were differences in plasma MDA levels based on the severity of AV. Keywords: acne vulgaris, malondialdehyde, severity

Intense pulsed light (IPL) as adjuvant therapy for acne vulgaris: A case series Widyaningsih Oentari; Angie Regina Sutrisno; Nelva Karmila Jusuf; Khairina Nasution
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment. Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the morning, and the other patient was given clindamycin gel applied twice a day, benzoyl peroxide 2.5% cream applied once a day at night, and sunscreen in the morning. Both patients were treated using IPL as their adjuvant therapy every three weeks, with a total of 2 IPL sessions in 2 months. Evaluation using clinical and ultraviolet-induced red fluorescence (UVRF) examination showed gradual improvement. Discussion: IPL as an adjuvant therapy of acne vulgaris has been thought to interfere with the function of the sebaceous glands by its direct phototoxic effects and thermal damage. It also has bactericidal effects on C. acnes through the formation of free radicals. The combination of topical treatment and IPL yielded clinical improvements in both patients. Conclusion: IPL may be beneficial as adjuvant therapy in acne vulgaris in this case series.Keywords: acne vulgaris, adjuvant therapy, intense pulsed light, UVRF

Management of basal cell carcinoma with excision followed by rotation advancement flap Remenda Siregar; Fitri Puspita; Widyaningsih Oentari; Ari Karmila Sari
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect. Case Illustration: We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of the defect with a rotation advancement flap was performed with good results. Discussion: The diagnosis of BCC in this patient was based on history taking, dermatological and histopathological examination. According to the dermatological examination, the patient presented with superficial ulcers with hyperpigmented bases, irregular margins and raised edges, partly covered by crust in the left zygomatic region, consistent with typical clinical manifestation of BCC. Histopathological findings of BCC may vary according to the subtype. However, most cases of BCCs usually have similar histological characteristics. Conclusion: The functional and cosmetic result of BCC following excision and defect closure with rotation advancement flap yielded good results with a shorter healing time. Keywords: basal cell carcinoma, excision, management, rotation advancement flap

Generalized pustular psoriasis and Cushing’s syndrome in childhood due to corticosteroids misuse Fitri Azizah
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake of pus along with red-purple striae all over the body.Discussion: Adverse effects of steroid-induced adrenal insufficiency are time-dependent and generally reversible. Gradual discontinuation of steroids must adhere to physiological dose of steroids, mostly in 3.49 ± 2.92 months. Other treatments available are emollients, salicylic acid, calcipotriol, coal tar, topical steroids, phototherapy, retinoids, and cyclosporine. Topical steroids cannot be the main therapy in severe psoriasis due to the possible side effects of excessive usage. Conclusion: Misuse of topical and systemic steroid in children could lead to Cushing’s syndrome, a multisystem disorder resulting from prolonged exposure to excess glucocorticoids, either both systemic or topical. Children could easily develop systemic reactions to topical steroids due to their higher total body surface area to body weight ratio. Keywords: childhood, Cushing’s syndrome, pustular psoriasis, steroid misuse

Platelet-rich-fibrin for venous leg ulcer therapy Karin Rachmani; Lis Surachmiati Suseno; Mutiara Ramadhiani
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It’s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF.Case Illustration: A 47-year-old male came with an ulcer on the lower left leg for one year. The ulcer was preceded with a reddish, tender nodule with a pustule, which then ruptured, resulting in a wound. There was intermittent pain at the lesion with a limb cramp. The patient had used compression stocking, leg elevation, normal saline compress, and topical antibiotics with no improvement. PRF was given for 12 weeks along with compression stocking and leg elevation, which resulted in a clinically improved lesion.Discussion: Wound therapy has greatly improved over the past decades. The interest in the wound care field has led to advancements in biological products as one of its modalities. Platelet-rich-fibrin is an autologous platelet and leucocyte-rich fibrin material which forms an organized network where the platelets and leucocytes are concentrated, leading to the sustained release of various growth factors, and promoting wound healing. Previous studies have shown PRF to be effective and low-cost for VLU.Conclusion: The use of PFR on VLU is an alternative method, low cost, and simple technique with good healing potential. Keywords: chronic ulcers, platelet-rich-fibrin, venous ulcers

Allergen profile of facial ACD to cosmetics among patients at Tertiary Referral Hospital in Yogyakarta
Journal of General - Procedural Dermatology and Venereology Indonesia ##issue.vol## 6, ##issue.no## 1 (2022): June 2022
Publisher : Universitas Indonesia

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Background: Cosmetics are a part of life for most of the population and may cause allergic contact dermatitis (ACD), especially on the face, as the primary exposure of cosmetics is on the face area.Methods: This research was conducted retrospectively using secondary data. The research subjects and demographic data were taken from the registered list of patients at Dermatology and Venereology Outpatient Clinic Dr. Sardjito General Hospital with a clinical picture of facial ACD due to cosmetics. Patch tests were carried out from January 2017 to December 2020.Results: From three years period, 26 patients were diagnosed with suspected facial ACD due to cosmetics and underwent patch tests. Of the total 26 patients, 3 patients did not show any reaction to the patch test. On the 23 patients who had reactions on the patch test, there were 66 points on the skin that showed a reaction to allergens. Of the 66 points, 37 points gave a positive reaction picture, with the most common allergen causing the reaction being cobalt(II) chloride hexahydrate (n=4, 10.8%). Then, from 29 points that gave doubtful reactions, the allergen that caused the most reactions was potassium dichromate 0.5% (n=4, 13,8%).Conclusion: The allergens that most often give a positive or doubtful reaction on the patch test of this study are metal compounds (cobalt and potassium dichromate). This study only looks at the patch test that gives a reaction without looking at the clinical relevance related to cosmetics use. Keywords: cosmetics, facial allergic contact dermatitis, patch test

Bacterial sensitivity pattern to antibiotics in acne vulgaris at Universitas Sumatera Utara Hospital Medan, Indonesia in 2019
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 6, No 1 (2022): June 2022
Publisher : Universitas Indonesia

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Background: Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous unit. Antibiotics play essential roles in the treatment of AV because of their antibacterial and anti-inflammatory properties. With the extensive use of antibiotics, antibiotic resistance patterns in AV lesions should be determined to ensure safe and appropriate administration of antibiotics for the treatment of AV.Methods: This cross-sectional study involved 80 specimens from AV lesions. Each specimen was cultured and underwent susceptibility tests to azithromycin, erythromycin, clindamycin, doxycycline, minocycline, tetracycline, levofloxacin and ciprofloxacin using disc diffusion methods that met Clinical and Laboratory Standard Institute (CLSI) standard.Results: From a total 97 bacterial colonies growth from 80 specimens, 12 species were identified, namely Cutibacterium acnes, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus aureus, Staphyococcys haemolyticus, Leuconostoc mesenteroides, Micrococcus luteus, Kocuria varians, Staphylococcus vitulinus, Staphylococcus cohnii, Staphylococcus arlettae and Dermacoccus nishinomyaensis. Antibiotic with highest bacterial sensitivity rate was minocycline, followed by levofloxacin, ciprofloxacin, doxycycline, tetracycline, azithromycin, erythromycin, and clindamycin. Most of the species were intermediately sensitive to azithromycin, clindamycin, erythromycin, doxycycline, tetracycline, ciprofloxacin, and levofloxacin. Antibiotic with highest bacterial resistance rate was erythromycin, followed by clindamycin, azithromycin, tetracycline, doxycycline, ciprofloxacin, levofloxacin and minocycline.Conclusions: In cases of acne vulgaris, minocycline and levofloxacin were the two antibiotics with the highest bacterial sensitivity, while erythromycin and clindamycin were the two antibiotics with the highest bacterial resistance in AV lesions. Keywords: acne vulgaris, antibiotics, bacterial sensitivity

Comparison between oral pentoxifylline + corticosteroid and oral corticosteroid alone for severe erythema nodosum leprosum
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 6, No 1 (2022): June 2022
Publisher : Universitas Indonesia

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Background: Severe erythema nodosum leprosum (ENL) is common but difficult to treat. Long term use of systemic corticosteroid causes side effects. This study compares the use of a combination of pentoxifylline + oral corticosteroids with a single oral corticosteroid in leprosy patients with severe ENL reactions. Parameters measured include skin RSA score, systemic RSA, total corticosteroid dose, resolution time of skin lesions, improvement of pain VAS and treatment side effects. Methods: 29 subjects with severe ENL reactions are allocated randomly into two groups which receive oral pentoxifylline + methylprednisolone, and oral placebo + methylprednisolone for 12 weeks. The starting dose of pentoxifylline are 400 mg thrice daily for 4 weeks, tapered to 400 mg daily every 4 weeks. Methylprednisolone is based on WHO guideline. Results: In the end, the median of cutaneous RSA score in pentoxifylline vs placebo group is 4 (0-5) vs 3 (0- 5). The median of systemic RSA score in pentoxifylline vs placebo group is 0 (0-6) vs 0 (0-5). The median of total corticosteroid doses in pentoxifylline vs placebo group is 156 (120-200) mg vs 136 (96-200) mg. The median of resolution time in pentoxifylline vs placebo group is 6 (0-12) weeks vs 6 (0-12) weeks. The median of change of pain VAS score in pentoxifylline vs placebo group is 5 (0-6) vs 3 (-3-6). No statistically significant difference (p>0,05) are found in all parameters, including side effects. Conclusion: Combination of oral pentoxifylline + corticosteroid is not proven to be more effective. Both are safe. Keywords: combination, corticosteroid, erythema nodosum leprosum, pentoxifylline

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