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Anak Agung Gde Putra Wiraguna
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Dermatology and Venereology Department, Medical Faculty, Universitas Udayana/Prof. dr. I G. N. G. Ngoerah General Hospital, 3rd Floor (Jl. Diponegoro, Dauh Puri Klod, Kecamatan Denpasar Barat, Kota Denpasar, Bali 80113)
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Bali Dermatology Venereology and Aesthetic Journal
Published by Universitas Udayana
ISSN : 30467985     EISSN : 30467993     DOI : https://doi.org/10.51559/balidervenaesthj.v6i1.33
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Bali Dermatology Venereology and Aesthetic Journal is an open access; peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the Dermatology, Venereology and Aesthetic field. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of Dermatology, Venereology and Aesthetic and to encourage a vigorous dialogue between researcher, medical scholars and practitioners. The scope of this journal includes: General dermatology Venereology Cosmetic dermatology/aesthetic Pediatric dermatology Allergy and immunology Skin and tumor surgery Tropical dermatology Genodermatosis (hereditary skin disease) Travel dermatology Traditional, Complementary, and Integrative medicine in dermatology Diagnostic method and artificial intelligence in dermatology
Arjuna Subject : Kedokteran - Dematologi
Articles 75 Documents
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Steven johnson syndrome induce by carbamazepine in epileptic patient: a case report Nyoman Yoga Maya Pramita; Prima Saraswati Sanjiwani Sudarsa; Ratih Purnamasari Nukana
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/dz26cj70

Abstract

Introduction: Steven Johnson Syndrome (SJS) is life-threatening skin reaction, it is a mucocutaneous disorder induced by immune complex-mediated hypersensitivity reaction. Most frequent offending agents are antibiotic, antiretroviral and aromatic anticonvulsants. Problems arise when these drugs are required for long-term use and necessary for several health conditions. These case series aim to describe SJS and provide replacement therapy especially inpatient with epilepsy. Case report: A 37 years old female was consulted from neurology department with chief complaints an erythematous rash on her chest, back upper and lower extremities accompanied with fever, the patient also complaint erosions on her lips. She had history of seizure and was prescribe Carbamazepine. Carbamazepine was replaced and patient treated with dexamethasone intravenously. After 1 week of admitted there is an improvement. Conclusion: Steven Johnson Syndrome (SJS) is a life-threatening disease, the replacement of the suspected drugs and appropriate therapy can improve the prognosis of patient.
High plasma dopamine level as a risk factor for atopic dermatitis Made Swastika Adiguna; Made Wardhana; Ermon Naftali Limbara
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pnkrda77

Abstract

Background: Dopamine is responsible for inflammatory response and plays a role in the skin immune system by modulating T-cells, dendritic cells, and keratinocytes which increases skin inflammatory response in atopic dermatitis (AD). Elevation of dopamine level will affect IL-6, IL-8, IL-23, Th-17, and TNF-α, which promotes keratinocyte proliferation and differentiation, infiltration of inflammatory cells, angiogenesis, vasodilation, and skin barrier disruption on AD. Objective: This study aimed to establish whether the increase of plasma dopamine level contributes to a risk factor for AD occurrence. Methods: This is a matched-pair case-control observational analytical study which involves patients with AD and without AD as control. Samples were taken using a consecutive sampling method which fulfilled inclusion and exclusion criteria, matched for gender and age. Plasma dopamine level was measured from venous blood and processed using enzyme-linked immunosorbent assay (ELISA) method. The collected data were then analysed using SPSS version 20.0 with Pearson chi-square test for the odds ratio. Results: A total of 30 samples with AD (case group) and 30 samples without AD (control group) involved in this study. This study proves that plasma dopamine levels in the case group were significantly higher than the control group (p<0.05). Odds ratio for plasma dopamine was 42.2 (95%CI: 9.5-187.2, p < 0.001). Conclusion: This study concludes that high plasma dopamine level is a risk factor for AD.
High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris Anak Agung Gde Putra Wiraguna; Made Wardhana; Made Kusuma Dewi Maharani
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vacekd89

Abstract

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion. Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne. Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS. Results: H2O2 mean level in the case and control group, respectively 0.68 ± 0.03 and 0.42 ± 0.04 µmol/ml. High H2O2 level was determined from cut-off point >0.62 µmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p<0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 ± 0.06 and 0.74 ± 0.07 U/ml. Low catalase level was determined from the cut-off point <0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p<0.001; 95% CI: 5.18-77.21; OR: 20.00). Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.
The positive correlation between serum malondialdehyde levels with vitiligo severity and activity I Gusti Ayu Agung Praharsini; Anak Agung Gde Putra Wiraguna; Putu Nila Wardhani Batan
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/y650jm10

Abstract

Background: There are several theories that suggest melanocyte death in vitiligo, one example is oxidative stress theory. Oxidative stress primarily manifested by lipid peroxidation ultimately produce malondialdehyde. Malondialdehyde is a stable marker to assess an oxidative stress event. The correlation between serum malondialdehyde levels and vitiligo severity and activity remained controversial in previous studies. Objective: This study aimed to verify whether or not the serum MDA levels are positively correlated with vitiligo severity and activity. Methods: This study was an analytical cross-sectional study. which involved 64 subjects with vitiligo and 20 subjects without vitiligo. Serum MDA levels were measured to mark an oxidative stress event, whereas the severity and activity of vitiligo were clinically assessed with vitiligo area severity index (VASI) and vitiligo disease activity (VIDA) scoring system. Results: Total 64 subjects with vitiligo and 20 subjects without vitiligo participated in this study. Serum MDA mean levels of vitiligo subjects were significantly higher compared to subjects without vitiligo (p<0.05). Serum MDA levels had a strong positive correlation with VASI score (r=0.761; p<0.01). The strong positive correlation found between serum MDA levels with vitiligo activity assessed by VASI score in vitiligo subjects (r=0.609; p<0.01), and high serum MDA levels increased the risk for developing vitiligo (PR=7.62; 95% CI: 2.49-23.30; p<0.01). Serum MDA levels influenced vitiligo as much as 10.1%, meanwhile the remaining 89.9% were influenced by other variables apart from high serum MDA levels out of this study (R2=0.101; p<0.05). Conclusion: Serum MDA levels were positively correlated with vitiligo severity and activity, and high serum MDA levels increased the risk of developing vitiligo.
Positive correlation of psoriasis vulgaris severity and HOMA-IR Made Wardhana; Made Swastika Adiguna; Putu Ayu Diah Nareswari
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 1 (June 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/0x8dn445

Abstract

Background: Psoriasis vulgaris is a chronic inflammatory skin disease that its aetiology is still not completely known. A chronic inflammation in psoriasis can cause organ dysfunctions. Elevation of proinflammatory cytokines gives rise to insulin resistance by inhibiting insulin and glucose transport mechanism signals. Insulin resistance is the underlying pathogenesis of metabolic syndrome. Objective: This study aimed to undestand any correlation in the severity of psoriasis vulgaris with HOMA-IR. Methods: A cross sectional research involving 35 subjects with psoriasis vulgaris and 15 subjects without who met the selection criteria. HOMA-IR is a formula used to measure insulin resistance which calculates the fasting insulin value in μU/ml x fasting glucose in mg/DL/405 taken from the blood veins of subjects. PASI score was used to determine psoriasis vulgaris severity. Results: This study shows that the HOMA-IR median value was higher in psoriasis subject than the subjects without psoriasis (p<0.05). The correlaton analysis shows a moderate positive correlation between psoriasis vulgaris severity and HOMA-IR (r= 0.427; p<0.05). The prevalence ratio was 8.57, which means psoriasis vulgaris subjects were 8.57 times more likely to have HOMA-IR compared to those without psoriasis vulgaris (p<0.05; 95%CI: 1.26-58.1). Conclusion: This study concludes that there is a moderate positive correlation between severity of psoriasis vulgaris and HOMA-IR values.
Generalized pustular psoriasis with nail psoriasis in children: a case report Dewi Gotama; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/gm279n15

Abstract

Background: Pustular psoriasis in children is one of the clinical variants of psoriasis. It is classified into generalized pustular psoriasis (GPP) and localized pustular psoriasis. The aetiology of psoriasis in children has not been known but is believed to be multifactorial. Nail psoriasis rarely occurs in children who suffer from skin psoriasis, with an incidence lower than that reported in adults. The diagnosis is generally made from the clinical and histological examination. The choice of therapy depends on the severity of the disease. Until now, there have been no specific guidelines for the management of psoriasis in children. Case report: A-15-years-old Balinese girl presenting with erythema, confluent scaly plaques over the trunk and extremities with pustules localized on the lower extremity. She had a history of fever before the lesions appear. Right third digital nails examination showed subungual hyperkeratosis and onycholysis. Positive auspitz sign and karsvlek phenomena were found. Biopsy result suitable for psoriasis. The patient got improvement after treated with methotrexate tablet orally and desoximetasone cream topically within four weeks without any side effect. Conclusion: Combination therapy with methotrexate tablet and desoximetasone cream give an effective result. However, the safety and side effects of methotrexate in children still need further monitoring.
Lichen amyloidosis with combined topical therapy: a case report Made Sanitca Indah; Ni Made Dwi Puspawati; Herman Saputra
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/24tjs491

Abstract

Introduction: Lichen amyloidosis (LA) is a rare case, characterized by circumscribed, highly pruritic, hyperkeratotic, and hyperpigmented papules occurring typically over the shins, outer aspects of upper arms, and on the upper back with amyloid deposits in the papillary dermis. Several therapeutic strategies, including topical steroids, oral antihistamines, cyclosporine, retinoids, laser, phototherapy, cryosurgery, and surgical interventions, have been reported as treatment options for patients with LA, but no standardized treatment has been established. Case report: A 58-year-old man came to the Dermatovenereology Outpatient Department complaints of itchy blackish-brown papules on the shins. Dermatology examination found discrete multiple hyperpigmentation papules and plaque covered with white scale. A scar-like center surrounded by brownish circles or white edges was found from the dermoscopic examination. The histopathological examination found thickened keratin with compact orthokeratosis and hyaline materials in the papillary dermis with dendritic melanophages. The patient diagnosed with LA and treated by combining desoximetasone cream 0.25% with 3% salicylic acid. The papules on the legs had flattened in the patient, with a significant improvement in the severe itching after three weeks. Conclusion: Combination therapy of potent corticosteroids and keratolytic seems to be an appropriate modality and well-tolerated by LA patients. Skin lesion becomes thinner, and pruritus is reduced.
Glucocorticoid-induced hyperglycemia (GIH) in pemphigus vulgaris patient at Bangli District General Hospital: A case report Ni Kadek Setyawati; A. A. I. A. Nindya Sari; Pande Agung Mahariski
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/b53b1w20

Abstract

Background: Pemphigus vulgaris (PV) is an autoimmune disease characterized by mucocutaneous blistering and erosion. This is rare, but greatly affects the patient’s life quality and often cause complication of disease and therapy. Hyperglycemia is a complication due to steroid use called glucocorticoid-induced hyperglycemia (GIH). This case report describes hyperglycemia in PV treatment, which later can be a consideration of PV management. Case: A 44-year-old male patient complained of painful lesions on almost the whole body with a form of bullae, erosion, crusting, brittle, the Nikolsky sign (+), and Asboe-Hansen sign (+). The patient was diagnosed with PV. After he had supportive therapy and high-doses of methylprednisolone, his blood sugar is increased. Patients diagnosed by hyperglycemia state due to steroid use, then given insulin as therapy. The patient diagnosed with PV based on history taking and physical examination, but the histopathologic examination wasn’t done due to lack of modality at the hospital. The steroid was given as an immunosuppressive. Be the main therapy for PV, steroids lead hyperglycemia due to disruption of glucose metabolism, thereby increasing insulin resistance in tissues. The diagnosis of hyperglycemia due to steroid use is made in a patient with a normal sugar level before PV therapy. It occurred within the first 1-2 days of therapy. In these patients, diagnosis confirmed by increasing pre-prandial, 2 h post-prandial, and any-time glucose level, after two days methylprednisolone administration. Collaboration with internal medicine colleagues is needed. Conclusion: PV treatment with steroids can induce hyperglycemia, which is dangerous. The understanding mechanism is needed to make early detection and provide therapy properly.
Update on scrofuloderma Marianto; Hartono Kosim; Pande Agung Mahariski; Paulus Mario Christopher
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vygwv246

Abstract

Tuberculosis is one of the most significant diseases which causes death worldwide. TB infection is assumed to infect the lungs only from a general perspective. In fact, TB infection also causes lesions on the skin. Scrofuloderma, as one of the most common types of cutaneous tuberculosis, often misdiagnosed and managed improperly due to its similarity with abscess. In addition, there were still no national and international guidelines for scrofuloderma. This review to give insights and review about an update in the basic principle of scrofuloderma and management.
Selection of topical corticosteroids in children atopic dermatitis Aurelia Stephanie; Prima Sanjiwani Saraswati Sudarsa; Luh Mas Rusyati
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/xmbe0178

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically starts in childhood with classic symptoms of dry and itchy skin that occurs continuously and recurrences and even causes sleep disorders and skin that is susceptible to infection. AD sufferers often have atopic comorbidities such as asthma and allergic rhinitis in themselves and their families. The effects of this itching cycle result in growth disturbance and decreased quality of life for AD patients and their parents. Moderate and severe AD have an impact on parents, the stress in medication, and care, which takes up time and money. Atopic dermatitis is due to damage to the skin barrier, so the principle of management is to improve the skin barrier so that the inflammatory process can be avoided. The course of AD is chronic and relapsing; generally, patients come for treatment with an acute phase that sometimes requires topical corticosteroids. However, topical corticosteroids (TC) are used only to treat the acute phase for a short period. After the acute lesions have subsided, corticosteroids can be stopped immediately to prevent side effects and continue with daily skincare. Conclusion: Topical corticosteroids are first-line therapy in the acute phase. The choice of TC is based on age, body location, dosage, and severity of AD. If the acute lesion has subsided, then corticosteroids can be stopped and substituted with other antipruritic therapy and moisturizer.

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