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Berkala Ilmu Kesehatan Kulit dan Kelamin

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Published by Universitas Airlangga

ISSN : 19784279 EISSN : 25494082 DOI : 10.20473

Core Subject : Health, Science,

Immunology & microbiology Public Health

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Articles 505 Documents

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Parker ink-KOH stain, Chicago Sky Blue (CSB) stain, and Fungi Culture, for The Diagnosis of Superficial Dermatomycoses Sunarso Suyoso; Anggraeni Noviandini; Linda Astari
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 1 (2017): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Superficial dermatomycoses are infections of skin, nails, and hair that can be divided into dermatophyte, pityriasis versicolor (PV), and candidiasis based on the causative pathogens. Rapid diagnosis is important to initiate the treatment earlier. To establish the diagnosis, direct microscopy using potassium hydroxide and culture examinations could be performed. Although the routine examination using Parker ink-KOH staining could be done in very short time, it was lacking of color contrast and requiring considerable skill interpretation. Various contrast dyes are available including a new contrast Chicago Sky Blue (CSB) staining. Purpose: To evaluate the result of Parker ink-KOH stain, CSB stain, and culture for the diagnosis of superficial dermatomycoses. Methods: The study was an observational descriptive research. Skin scrappings from patients with clinical diagnosis of superficial dematomycoses in Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital were examined using Parker ink-KOH stain, CSB stain, then interpreted by a researcher and analysts. The samples were also cultured. Results: A total of 45 samples, 71.1% revealed dermatophyte patients, 22.2% PV patients, and 6.7% candidiasis patients. The fungal filaments were detected in Parker ink-KOH stain by researcher 91.11% of the samples and by analysts 95.56%. CSB stain were detected 100% in all the samples by both observers. The culture was positive in 71.1% samples. Conclusion: CSB stain provides a good color contrast and shown a promising examination as it is rapid, simple, and easy to interpret for the diagnosis of superficial dermatomycoses, thus it is suitable to apply for inexperienced clinicians in dermtology clinical setting and laboratory.

Severe Cutaneous Adverse Drug Reaction Damayanti Damayanti; Sylvia Anggraeni; Cita Rosita SP; Marsudi Hutomo; Hari Sukanto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Cutaneous adverse drug eruption (CADR) are frequently found. A systematic review showed, the incidence of severe CADR (SCADR) ranging from 0-8%. Few studies have assessed the severe form of CADR, which has high mortality rate. The epidemiological study was needed to show the profile of SCADR, especially in the setting of general hospital. Purpose: To evaluate clinical and epidemiological profile of SCADR in Dermatology and Venereology Ward Dr. Soetomo Hospital Surabaya. Methods: All SCADR patients in the period of January 2015–January 2016 was evaluated clinically and epidemiologically. Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic reaction (DRESS) cases were included in the study. Results: There were 14 patients in this study, consist of 10 SJS cases (71.4%), 2 TEN patients, and 2 AGEP patients. The highest frequency of age group was 25-29 years old (57.1%). Man to woman ratio was 3:4. The most common offending drug was paracetamol (50%), followed by amoxicillin (28.6%). Antibiotic was the highest frequent offending drug-group (64.3%), followed by antipiretics (50%). In this study, all patients got systemic corticosteroid and the mortality was 0%. Conclusion: The most common type of SCADR was SJS. The most common offending drug was paracetamol, and antibiotic was the highest frequent offending drug-group. Systemic corticosteroid therapy showed good result in severe CADR management.

In Vitro Susceptibilty Test of Fluconazole to Candida spp in Patients with Oropharyngeal Candidiasis and HIV/AIDS with Vitek II Novianti Rizky Reza; Tantari SHW; Santosa Basuki
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 3 (2017): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Oral candidiasis (OC) was the most common opportunistic infection in HIV/AIDS. Widespread and inadequate use of fluconazole as a prophylaxis and therapy in OC resulted in decreasing susceptibility. Decreased susceptibility of fluconazole will show the increasing in vitro Minimum Inhibitory Concentration (MIC) was reported in some studies. Purpose: To determine in vitro susceptibilty of fluconazole to Candida spp in patients with Oropharyngeal Candidiasis and HIV/AIDS. Methods: The study design was descriptive, observational, cross sectional study for three months in Saiful Anwar Hospital Malang. Species identification and fluconazole susceptibility used Vitek II. Result: Thirty three subject with 36 Candida isolates. Candida albicans was the most common species identified in 86% isolates, C. krusei 8%, and C. glabrata 6%. C. albicans had MIC between ≤ 1 mg/l – 16 mg/l, C. glabrata 4mg/l, dan C. krusei 2 mg/l - 32 mg/l. Sensitivity of C. albicans to fluconazole was demonstrated in 83% isolates and resistance of non-albicans was found in 8% isolates. Conclution: Most common isolates found was C. albicans which show sensitivity to fluconazole, resistance was found in C. krusei isolates.

Studi Retrospektif: Karakteristik Kandidiasis Vulvovaginalis Bella Ayu Paramitha; Septiana Widyantari; Pudji Lestari
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 30 No. 1 (2018): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Pendahuluan: Kandidiasis vulvovaginalis (KVV) merupakan infeksi mukosa vagina dan vulva yang disebabkan oleh infeksi jamur spesies Candida. Kandidiasis vulvovaginalis hampir sering terjadi pada usia reproduktif.Diperkirakan sekitar 75% wanita mengalami kandidiasis vulvovaginalis paling tidak satu kali dalam hidupnya. Tujuan: mengetahui gambaran umum pasien KVV di Unit Rawat Jalan Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo periode 2012-2014. Metode: Penelitian ini merupakan studi retrospektif menggunakan rekam medik pasien dengan melihat gambaran umum pasien yaitu data dasar pasien, keluhan pasien, warna duh tubuh, kemungkinan faktor predisposisi, pemeriksaan penujang, diagnosis, penatalaksanaan, kontrol, dan kekambuhan. Hasil: Berdasarkan hasil penelitian didapatkan rentang usia terbanyak adalah usia 25-44 tahun. Didapatkan bahwa 72.9% pasien telah menikah dan kebanyakan pasien adalah wanita yang bekerja, yaitu 39% pekerjaan formal. Penelitian ini mendapatkan keluhan keputihan dan gatal merupakan keluhan tersering yang dirasakan oleh pasien, yaitu 81.45% pasien merasakan keputihan dan 55.4% pasien merasakan gatal. Antifungal yang paling banyak diberikan adalah ketokonazole (94.5%) Setelah kunjungan pertama nya, 59.7% pasien tidak melakukan kontrol. Hasil kontrol diketahui bahwa hanya 17.9% pasien yang masih harus menjalani terapi lanjutan KVV. Sebanyak 0,4% pasien diklasifikasikan menjadi KVVR. Kesimpulan: Ketepatan dalam anamnesis, pemeriksaan fisik dan penunjang, diagnosis, serta pemilihan terapi dibutuhkan untuk keberhasilan terapi.

Retrospective Study: Atopic Dermatitis in Childhood Kristina Sihaloho; Diah Mira Indramaya
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 3 (2015): BIKKK DESEMBER 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Atopic dermatitis is a chronically and relapsing inflammatory skin disease affecting individuals with atopic history or their families. Atopic dermatitis affects all ageswith percentage 15-30% in children and 1-2% in adults. Chronic pruritus, skin infection, sleep disorder, and growth disorder are signs and symptomps commonly found in childhood atopic dermatitis. Evaluation of the profile and management of DA were needed to improve the management of atopic dermatitis. Purpose:To evaluate the profile of childhood atopic dermatitis. Methods: A retrospective study of all new cases of childhood atopic dermatitis who visited the Pediatric Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya from January 2007 to Desember 2011. Results: Numbers of chilhood atopic dermatitis increased from 2007 to 2011. Itchy was the main complaint of DA, but redness patches (32,3%) and xerosis cutis (9,1%) were also found. Atopic history in patients and or their families were found in 842 patients (74,3%). Treatment was antihistamin in 879 patients (77,5%). Conclusions: Chilhood atopic dermatitis are still increasing by years. Determining and avoiding trigger factors are education for DA's patients and their families in preventing it recurrency.Key words: atopic dermatitis, childhood, retrospective study.

Metabolic Syndrome In Psoriasis Vulgaris Patient Wulan Yuwita; Hendra Gunawan; Unwati Sugiri; Dendi Sandiono
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 3 (2016): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Background: The management of metabolic syndrome in psoriasis vulgaris is rather complicated, including lifestyle modification, diet intake intervention, increasing daily activities, and managing the comorbidity factors. Purpose: Management of metabolic syndrome in psoriasis vulgaris requires holistic approach. Case: A case of metabolic syndrome with psoriasis vulgaris in a-56-year-old woman was reported with chief complaint generalized erythematous plaques, papules, scales, and hyperpigmented macules. Blood pressure was 160/90 mmHg with central obesity and waist circumference was 98 centimeters. The patient manifested with onychodystrophy and subungual hyperkeratosis digiti I pedis bilateral. Fasting blood glucose was 119 mg/dL, and triglyceride was 185 mg/dL. Management: Patient management included methotrexate, bisoprolol, captopril, simvastatin, lifestyle modification, and diabetic diet (1300 kkal and protein 0.8 mg/kg/body weight/day). Conclusion: Holistic management revealed a good response in this case. The initial psoriasis area and severity index (PASI) score before therapy was 24.8, became 9.0 after therapy on day 155th of observation.

Compatibility of Clinical Manifestation with Skin Prick Test Result and Food Provocation Test in Food Cross Reaction Azwin Lubis; Wisnu Barlianto; Anang Endaryanto; Ariyanto Harsono
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Subjective diagnostic test of food allergy is hugely biased, resulting in irrational diet avoidance. Additional objective tools by skin prick test following food provocation test resulting more accurate cause and prevalence on population. Purpose: To evaluate the compatibility of clinical symptoms with skin prick test and provocation test for imunoglobulin E (IgE) mediated food allergy in Dr. Soetomo Hospital Surabaya. Methods: Cross sectional observational analytic study. Patient with allergy symptoms, diagnosed with food skin prick test followed by food provocation test. McNemar test and Kappa were used to analyze compatibility of skin prick test with food provocation test. Sensitivity and spesificity test of skin prick test toward food provocation test were done. Results: McNemar test between skin prick test and food provocation test are valued p<0.05 in all food allergen, except fruit p=0.607, but all Kappa test are low p<0.6. Fruit and chocolate showed low sensitivity (0.307;0.409) but with high spesificity (0.823;0.8333); egg and shrimp showed high sensitivity (0.777;1.000) but low spesificity (0.548;0.352); cow’s milk, seafish, and chicken meat showed sensitivity (0.636;1.000;0.785) and high specifity (0.607;0.625;0.631); fresh water fish showed low sensitivity and spesificity (0.500;0.583). IgE mediated symptoms profile is dominated by cough except for shrimp, and non-IgE mediated also is dominated by cough except seafish and shrimp. Conclusion: There is incompatibilty between result of skin prick test and food provocation test in IgE mediated food allergy. IgE mediated and non-mediated food allergy symptoms are dominated by airway, gastrointestinal tract, and skin symptoms. Food allergy symptoms are more related to IgE mediated than non-IgE mediated.

Comparison of May Grunwald Giemsa and Potassium Hydroxide Examination of Malassezia Folliculitis Patient Dermatologic Outpatient Clinic of Dr. Soetomo General Hospital Surabaya Pramita Ariyanti; Afif Nurul Hidayati; Sunarso Suyoso
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 3 (2017): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Malassezia folliculitis (MF) is a pilosebaceous follicle infection caused by Malassezia sp., in the form of papules, solid, diameter <1cm, follicular pustules, moderate itchy, in the upper body, and rarely on the face. Microscopic examination with potassium hydroxide (KOH) found spores. May Grunwald Giemsa (MGG) cytologic staining to diagnose MF spores may demonstrate a more detailed and sharper. Objective: Identification of MF with MGG compared KOH in Dermatology outpatient clinic Dr. Soetomo General Hospital. Methods: The study was observational analytic to identify MF using MGG compared KOH. Involving 52 new patients fulfield the criteria of the study from March to May 2016. Results: An examination of 52 patients with MF, 7 patients (13.5%) were negative with KOH examination, while the examination MGG negative in 2 patients (3.8%), but not statistically significant (p ≥ 0.5 ). PPV=90% ; NPV value=100% ; sensitivity=95,7% ; spesificity=28,5% Conclusion: KOH still a good investigation for diagnose of MF, but if clinically result positive MF whereas negative KOH, MGG examination should be performed as a diagnostic confirmation of MF

Penatalaksanaan Alopecia Areata (Treatment of Allopecia Areata) Agatha Anindhita Ayu Ardhaninggar; Rahmadewi Rahmadewi
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 30 No. 1 (2018): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Alopecia Areata (AA) is a disease characterized by loss of hair from the scalp of a sudden. The main principle of treatment of AA that inhibit or alter the immunological response by modulating the inflammatory process that occurs around hair follicles. There are several options in the treatment of AA Purpose: provide insight into a variety of existing AA management. Review: AA is a form of autoimmune disease mediated by T lymphocytes that attack hair follicles and hair loss is characterized by chronic and recurrent. Based on the latest research results, the onset and severity of AA are determined by the interaction between genetic factors and environmental factors of the originator. Currently the hypothesis of AA focuses on the collapse of immune privilege status of a hair follicle and presentation of self-antigens that cause active lymphocytes. Several factors such as genetics, autoantigen, immune cell activity, and stress factors played a role in the pathogenesis of AA. The basic principle of treatment of AA, can be divided into two, namely Immunosuppressant and immunomodulatory will manipulate the inflammatory process intrakutan. Conclusion: Several therapeutic options in the AA include the injection of corticosteroids, minoxidil, immunotherapies, photochemotherapy, calcineurin inhibitors, metrotrexate, sulfasalazzine, azatioprine, laser therapy, PRP therapy, and therapy with stem cellsKey word: allopecia areata, treatment

Retrospective Study: Type 1 Leprosy Reaction Meita Ardini Pratamasari; M. Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 27 No. 2 (2015): BIKKK AGUSTUS 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Type 1 reaction (T1R) of leprosy occurs due toaltered balance between cell mediated immunity and M. leprae bacilli in the skin and nerves, with upgrading/reversal or downgrading as final result. Leprosy subpolar types have unstable immunity, this cause them often experience recurrence T1R, especially BB type.Clinical findings of T1R are inflammation in the skin or nerves, and can lead to disability if not treated properly. Aim: To evaluate the distribution, diagnosis, trigger factors, and therapy of T1R. Methods: Retrospective study using medical record of leprosy new patients in Dermatology and Venereology Outpatient Clinic, Dr Soetomo General Hospital, Surabaya, during 2010 – 2013. Database, anamnesis, examination, and T1R therapy were recorded. Results: The total of new leprosy patients with T1R within 2010-2013 were 117 patients (19,7% of all new leprosy patients). Most of them were men (70,1%), aged between 15–34 years (42,8%), with BB as the most frequent type (70,9%). Skin symptom of T1R could be thickening of old lesion (52,1%). T1R most occurred when patients still consume MDT (71,8%). NSAID (37,6%) andcorticosteroid (38,5%)were prescribed as T1R therapy. Conclusions: T1R diagnosis should established accurately by history taking and physical examination.For recurrent T1R,trigger factors should be considered.Key words: type 1 reaction, CMI, reversal, downgrading.

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