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Journal of General Procedural Dermatology and Venereology Indonesia
Published by Universitas Indonesia
ISSN : -     EISSN : 24607991     DOI : https://doi.org/10.19100/jdvi.v1i1.8
Core Subject : Health,
Medicine & Pharmacology
Journal of General-Procedural Dermatology & Venereology Indonesia is an open access and peer-reviewed journal that focuses on dermatology and venereology. This journal publishes original articles, reviews, case reports, and brief communications which contain short features of medicine, current developments in diagnostic procedures, treatments, or other health issues that are relevant and important.
Arjuna Subject : Kedokteran - Dematologi
Articles 8 Documents
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Search results for , issue "Vol. 5, No. 1" : 8 Documents clear
Cutaneous candidiasis mimicking inverse psoriasis lesion in a type 2 diabetes mellitus patient Surya, Steven Philip; Dewi, Kardiana Purnama; Regina, Regina
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Type 2 diabetes mellitus (T2DM) condition could affect the skin. The disease is among the greatest risk factors of skin infection such as cutaneous candidiasis and is also associated with autoimmune skin diseases such as psoriasis, which lesion morphologies and predilection areas are quite similar. These similarities are a source of confusion to clinicians. Case illustration: We present a 60-year-old female patient with uncontrolled T2DM and multiple erythematous plaques in the form of shiny lesions at the intertriginous area that developed 1 week prior to her hyperglycemic state. The lesions had recurred at the same site for approximately 10 years and were initially diagnosed as intertriginous candidiasis. Bedside testing revealed a positive Auspitz sign, while the patient’s fungal culture was unremarkable. She was diagnosed with inverse psoriasis (IP) and treated with 0.1% mometasone furoate cream twice a day. The lesions improved but were not completely resolved. Discussion: Inverse psoriasis is a subgroup of psoriasis characterized with thin, non-layered scales, and various predilection areas. The features of the primary lesion may be altered by a patient’s activities, such as use of cleansing soap, which may cause lesions to dry out and ooze, similar to cutaneous candidiasis. Additional examination, such as bedside testing and laboratory work, could help obtain a proper diagnosis. Conclusion: The similar morphologies and predilection areas of IP and cutaneous candidiasis lesions may confuse clinicians. In some limited cases, the correct diagnosis may be obtained by complete history taking, physical examination, and other simple tests.
Efficacy of 3D-pore sanitary napkin on mild-to-moderate irritant contact dermatitis in the female genital area Gondokaryono, Srie Prihianti; Nilasari, Hanny; Krisanti, Inge Ade; Febrianti, Tia; Purba, Herliyani; Toyoshima, Haruko; Yunaidi, Danang Agung
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Women worldwide have their own strategies to cope with menstruation, and unhygienic menstrual practices often cause vaginal diseases. During menstruation, the skin is irritated by the remaining unabsorbed menstrual flow and sweat on sanitary pads. Irritation of vulvar skin by an external agent could cause contact dermatitis, which is an important contributor to vulvar diseases. Various sanitary napkins available today share similar materials. This study compared commonly used sanitary napkin among Indonesian women with 3D-pore sanitary napkin in terms of efficacy. Methods: A randomized, controlled, single blind, crossover study of 72 participants who met the inclusion and exclusion criteria was conducted. Six areas were evaluated by dermatologists using the Grading Scale of Cutaneous Symptoms. The evaluation was performed in five visits. Results: All participants were divided randomly into two groups. Eight of the 72 participants dropped out; thus, 64 participants completed the study. Scores at Visit-2 show a significant difference between group A (3D-pore napkin) and group B (comparator napkin). Group A shows better improvement. The difference in total score at first second visit until end visit from each napkin shows that the 3D-pore napkin reduces the score by 4.77 and the comparator napkin reduces the score by 3.10. The difference between these numbers is statistically significant. The specific area (external genitalia and perianal) of both groups is significantly reduced in visit 1 and visit 2. The 3D-pore napkin reduces wetness better than the comparator napkin. Conclusion: The 3D-pore sanitary napkin significantly improves vulvar skin inflammation compared with the comparator napkin.
Lucio’s phenomenon: A report on six patients in a tertiary referral hospital in Indonesia Marissa, Melani; Rihatmadja, Rahadi; Surya, Denny; Lim, Henry W; Menaldi, Sri Linuwih
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Lucio's phenomenon (LP) is a rare variant of leprosy reaction, with the clinical manifestation of “necrotizing erythema.” LP was observed in patients with lepromatous leprosy who have not received or completed the treatment, and it is especially evident in patients with diffuse lepromatous leprosy (DLL), known as Lucio-Latapi’s leprosy. LP occurs due to M. leprae invading the blood vessels, causing endothelial damage that leads to thrombosis, ischemia, infarction, and tissue necrosis. The clinical features of the disease are erythematous lesions that can be accompanied by vesicles or bullae, with ulcers forming scar tissues. Histopathological examination can help establish the diagnosis of LP. Until now, there is still controversy about LP management. Multidrug therapy for multibacillary leprosy (MDT-MB) is the preferred line of treatment. Lucio-Latapi’s leprosy and LP are commonly found in Mexico and Central America, but rarely reported in Indonesia. Case Illustration: We report here the clinical description and development of six patients with LP observed in the tertiary referral hospital in Indonesia over a five-year period from 2013 to 2017. Discussion: All patients were diagnosed using clinical and histopathological examination, and all of them presented with ulceration and vasculitis. They were treated with MDT-MB WHO regimens and systemic corticosteroids. Five patients were alive, and one died due to extensive cutaneous lesions that lead to sepsis. Conclusion: Early diagnosis and prompt institution of multidrug therapy with systemic corticosteroids may improve the prognosis and outcome of LP.
Correlation between clinical and histopathological findings of five puzzling cases of cutaneous tuberculosis Miranda, Eliza; Widaty, Sandra; Sirait, Sondang Pandjaitan; Rizky, Luddwi Achmad; Menaldi, Sri Linuwih; Lim, Henry W
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Cutaneous tuberculosis refers to the clinical manifestation of extrapulmonary tuberculosis affecting the skin. Determining the type of cutaneous tuberculosis from a patient afflicted with is challenging because clinical and histopathological similarities exist between types. Moreover, confirming a diagnosis of cutaneous tuberculosis is difficult because of its similarity with other diseases. For instance, typical and atypical cutaneous tuberculosis may have similar manifestations, but each disease is managed by completely different approaches. Microbiological examination with polymerase chain reaction and bacterial culture are the gold standard methods used to confirm a diagnosis of cutaneous tuberculosis. However, results often demonstrate negative findings. Case Illustration: Five cases of cutaneous tuberculosis, which include two cases of tuberculosis verrucosa cutis, two cases of scrofuloderma, and one case of lupus vulgaris were presented in this article. Four of the five cases demonstrated significant improvement after initiation of an antituberculosis drug regimen. Discussion: Diagnosis of cutaneous tuberculosis in these cases was confirmed through clinical findings and histopathological and microbiological examination. Conclusion: A negative result following microbiological examination does not completely exclude the diagnosis of cutaneous tuberculosis. Investigating the pathognomonic findings of cutaneous tuberculosis through histopathological examination is important to differentiate among its types correctly. Therefore, correlations between clinical and histopathological results are essential to establish a diagnosis of cutaneous tuberculosis.
Purpuric lesion in a patient with leprosy: Was it a Lucio’s phenomenon or an epiphenomenon? Menaldi, Sri Linuwih; Marissa, Melani; Chairista, Inadia Putri; Lim, Henry W.; Rihatmadja, Rahadi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Lucio’s phenomenon (LP) is a severe necrotizing cutaneous reaction that occurs in patients with Lucio’s leprosy. The exact pathomechanism is not fully understood, but typically abundant acid-fast bacilli in the walls of blood vessels point to direct perturbation of blood supply to the epidermis. We report a case of LP where epidermal necrosis occurred in the absence of vascular invasion by mycobacteria, raising the question whether this was an epiphenomenon or a true LP. Case Illustration: A 34-year-old male was referred for an episodic swelling of his hands and feet that persisted for two years. There were signs of leprosy (diffuse shiny skin lesions, anesthesia, and anhidrosis of the extremities) with purpuric patches on lower extremities. The slit-skin smear test revealed a high index of acid- fast bacilli. Histopathological examination revealed epidermal necrosis and leukocytoclastic vasculitis without demonstrable bacillus. WHO multidrug regimen for leprosy and corticosteroids successfully cured the patient and prevented ulcer development. Discussion: Despite the presence of classical LP characteristics clinically and histologically, mycobacterium was absent in the vessels’ walls. We hypothesized that, in LP, vascular impairment might also be secondary due to antigen–antibody reaction and hypercoagulable state.Conclusion: Purpuric patches in Lucio’s leprosy might be the first sign of skin necrosis or vascular damage (purpura and ulceration). Besides the antimycobacterial drugs, anti-inflammatory drugs should be administered. Laboratory test for hemostasis might be advised.
Reversal reaction with nodules clinical manifestations that initially diagnosed as erythema nodosum leprosum in borderline lepromatous leprosy Tsaqilah, Laila; Achdiat, Pati Aji; Gunawan, Hendra
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: The reversal leprosy reaction generally manifest as larger, swollen, red and shiny the pre-existing skin lesions which are accompanied with pain. This reaction can be manifest as infiltration and nodules which resembles the features of erythema nodosum leprosum (ENL) leprosy reaction. Case Illustration: We present a case of 26-year-old woman with erythematous nodules on almost all the body since two weeks ago. She had pre-existing erythema plaque on the right elbow became more erythematous and arouse with partially felt pain, fever, and malaise. Nodule lesions in BL leprosy with reaction need to be distinguished between ENL and reversal reaction because they may affect therapy and prognosis. Discussion: The patient was diagnosed as BL leprosy with ENL reaction erythematous nodules on the face, both upper and lower arms, upper and lower limbs, knees, that partially felt pain, but after more careful history and histopathologic examination of the lesions, the nodules didn’t match to the histopathologic features of ENL reaction. Correlation between the clinical and histopathological findings in the form of acid fast bacilli (AFB) and granulomatous inflammation grenz zone with epithelioid cells and lymphocyte cells infiltrations in the dermis established the diagnosis of BL leprosy with reversal reaction. Conclusion: Erythema nodule lesions in leprosy can be an ENL or reversal reaction or a leprosy lesion in type BL leprosy. Reversal reaction should always be considered when diagnosing a skin-colored nodule in leprosy. Appropriate clinical and histopathological findings of the skin-colored nodules are needed to establish the definite diagnosis of reversal reaction.
Prevalence of nail changes in patients infected with HIV - A cross sectional study Vellaisamy, Seethalakshmi Ganga; Jeyaraman, Priya; Gopalan, Kannan
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Introduction: The spectrum of nail changes is wider and their frequency is higher among HIV patients. These changes magnify the range and multiplicity of AIDS manifestations. Their systematic examination is a non-invasive method of possible diagnostic value. Objective: The present study was conducted to study the frequency and types of nail changes in HIV infected individuals and to correlate the severity of nail changes with CD4 count. Material and Method: This was a cross sectional study, conducted in Skin & STD Out-Patient department in a tertiary care hospital between March 2018 and April 2019. A total of 176 HIV patients were included in the study. Standardized examination was performed in which the changes in surface, color, thickness and curvature of nail plates were recorded. Data were coded and analyzed. Results: The prevalence of nail changes in our study was 60.8%. Majority of the patients were in the age group of 34-41 years(38.1%) with a slight female preponderance Absent lunula (33.5%), diffuse pigmentation of nails (29.54%) and nail dystrophy (18.2%) occupied the top three changes followed by longitudinal melanonychia (13.06%), flat nails (4%), onychomycosis (3.4%) and pterygium (2.8%). Majority of the patients who had abnormal nails had CD4 count in the range of more than 500 cells/mm3(30.68%) because many patients in our study were having CD4 count more than 500 cells/mm3. The strength of association between abnormal nail changes and CD4 count was done by Chisquare test and the p value was 0.575 which was not statistically significant. Conclusion: This study infers that systematic nail examination of HIV patients is necessary, but their relation to the severity of immunosuppression requires further large scale, multicentric studies.
The management of seborrheic dermatitis 2020 Widaty, Sandra; Bramono, Kusmarinah; Listiawan, Muhammad Yulianto; Yosi, Ariyati; Miranda, Eliza; Rahmayunita, Githa; Brahmanti, Herwinda; Lim, Henry W
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
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Background: Seborrheic dermatitis (SD) is a chronic relapsing dermatitis manifesting in the seborrheic area, affecting infants or adults. In Indonesia, the prevalence of SD is 0.99–5.8% of all dermatology cases from 2013 to 2015. SD has been known to be a prominent manifestation among HIV patients, but there is an increasing trend in the general population. Therefore, in 2017, the Indonesian Society for Dermatology and Venereology proposed a consensus for the management of SD in Indonesia based on the discussion from 12 dermatological centers. Concurrent with the development of new drugs, this study aims to evaluate and develop a guideline for the treatment of seborrheic dermatitis in Indonesia to update the previous guidelines in 2017. Methods: Systematic review was based on evidence-based methods, and scientific evidences were acquired through systematic search. Evidence analysis was in accordance with the level of evidence. The available evidences were evaluated, and conclusion was based on the grade of recommendation. Critical appraisal was conducted by experts in dermatology and venereology. Results: Severity of SD can be determined by using the Seborrheic Dermatitis Area Severity Index. The principle of scalp SD management is controlling the scalp condition in a cost-effective manner to make patients comfortable. The recommendations for treatment of adult SD are topical agents, such as antifungals, nonsteroidal anti-inflammatory agents with antifungal properties, corticosteroids, and calcineurin inhibitors. Conclusion: We have updated and added newer agents for the treatment of SD. The approach is divided into scalp or nonscalp and also adult or infantile SD.

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