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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

Arjuna Subject : -

Articles 481 Documents

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Retrospective Study: The Use of Chemical Peeling with A Modiï¬ed Jessners in Melasma Patients Effendy, Zada Febrial; Setyaningrum, Trisniartami
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 2 (2015): BIKKK AGUSTUS 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Melasma is a hipermelanosis that lead to brownish or brownish-grey discoloration on the face. Chemical peeling is one ofÂ the additional therapy for melasma. The right indication using modiï¬ed Jessners solution give a good result for melasma. Purpose: To evaluateÂ new patients of melasma which underwent chemical peeling therapy with Jessners modiï¬ed in Medical Cosmetics Division of Dermato-Venerology Department,Â Dr. Soetomo General Hospital Surabaya in 2010-2013. Methods: Retrospective study of the new medical records of melasma, including the number of patients, age distribution, gender, occupation, risk factors, history of previous treatment, duration of treatment, location of melasma, color of melasma, size of melasma, additional test results, type of melasma, melasma side effects, the use of priming, chemical peeling, post-peels, and follow up. Results: The number of new patients with melasma which underwent chemical peeling were 108 patients from 1544 (14.2%) new melasma patientsÂ visiting Cosmetics Division of Dermato-Venerology Department, Dr. Soetomo General Hospital. All patients were women with the largest age group of 40-49 years, which is 66 (61.1%) patients. Highest risk factor was a mixture of sun exposure and use of cosmetics product, which is 56 (51.8%) patients. Most melasma type was mixed melasma. Patients who used a Jessners modiï¬ed peels, mostly used alpha hydoxy acid (AHA), Kligmans formula, and tretinoin as priming as many as 28 (25.9%) patients and majority post-peels used a moisturizer, sunblock, hydrocortisone, which is 57 (52.8%) patients. Erythema after peeling were complained from 50Â (46.3% ) patients. Conclusion: The use of chemical peeling is one of adjunctive therapy in melasma with a proper diagnosis.Keywords: melasma, chemical peeling, modiï¬ed Jessners, retrospective.

Kesesuaian Gambaran Klinis Patognomonis Infestasi Skabies dengan Kepositifan Pemeriksaan Dermoskop dan Kerokan Kulit Kurniati, Kurniati; Zulkarnain, Iskandar; Listiawan, M. Yulianto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 1 (2014): BIKKK APRIL 2014
Publisher : Faculty Of Medicine Airlangga University

Latar belakang: Diagnosis infestasi skabies oleh klinisi umumnya ditegakkan dengan gejala klinis patognomonis skabies. Tetapi gejala skabies seringkali tidak khas akibat adanya kemiripan dengan penyakit lain terutama pada anak-anak dan kondisi imunokompromais, sehingga diagnosis klinis seringkali keliru dan mengakibatkan kesalahan pemberian terapi. Diperlukan penegakan diagnosis definitif untuk menemukan Sarcoptes scabiei (S. scabiei) atau telurnya, yang secara konvensional dapat dilakukan dengan pemeriksaan mikroskopik dari kerokan lesi kulit penderita. Namun metode tersebut tidak praktis, membutuhkan keterampilan khusus, cenderung invasif, seringkali memerlukan beberapa kali kerokan, serta sulit dilakukan pada anak-anak, sehingga diperlukan metode yang mudah, non-invasif, dan akurasi yang baik. Pemeriksaan dermoskop menawarkan solusi tersebut. Tujuan: Mengevaluasi kesesuaian gambaran klinis patognomonis infestasi skabies dengan kepositifan dermoskop dan pemeriksaan kerokan kulit Metode: Studi analitik observasional cross sectional, total sampling dalam satu kali observasi pada 243 populasi terjangkau yang berusia 5-14 tahun di satu pondok pesantren. Terdapat 44 sampel yang memenuhi kriteria penerimaan sampel yang dilakukan anamnesis dan pemeriksaan fisik untuk menentukan gejala klinis patognomonis skabies, selanjutnya diperiksa dengan dermoskop dan mikroskop dari kerokan kulit pada lesi. Analisis hasil dengan menghitung kappa agreement dan nilai prediksi positif. Hasil: Dari 44 sampel didapatkan 25 sampel klinis patognomonis skabies dan 19 sampel klinis non patognomonis skabies. Pemeriksaan dermoskopi ditemukan positif pada 25 sampel dan mikroskopik kerokan kulit positif pada 18 sampel. Kesesuaian dermoskopi dan kerokan kulit adalah 79,5%, kappa 0,601. Simpulan: Dermoskop berpotensi digunakan sebagai alat diagnostik definitif skabies pada lingkungan dengan prevalensi tinggi skabies. Kata kunci: skabies, dermoskop, kerokan kulit.

Studi Retrospektif: Pemahaman Klinis Liken Simplek Kronikus Ariyanti, Pramita; Suyoso, Sunarso
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 2 (2014): BIKKK AGUSTUS 2014
Publisher : Faculty Of Medicine Airlangga University

Latar belakang: Liken Simplek Kronikus (LSK/neurodermatitis sirkumskripta) adalah suatu kelainan kulit yang sangat gatal dan bersifat kronis dengan ditandai satu atau lebih plak yang mengalami likenifikasi yaitu penebalan pada kulit dan permukaan kulitnya seperti kulit pohon. Tujuan: Mengevaluasi gambaran serta penegakkan diagnosis LSK. Metode: Penelitian dilakukan secara retrospektif dengan melihat laporan tahunan/catatan medik pasien LSK di Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo periode 2009-2011 (3 tahun). Hasil: Insidensi pasien baru LSK periode 2009-2011 sebesar 0,14%. Kelompok usia terbanyak 25-44 tahun (38,7%) dan pasien perempuan lebih banyak (64,5%) dibandingkan pasien laki-laki (35,5%). Keluhan utama terbanyak yaitu gatal (90,3%) dan terdapat 19,4% pasien yang terjadi kekambuhan. Distribusi lama keluhan terbanyak yaitu selama 1 bulan (61,2%). Lokasi lesi yang sering terjadi pada kaki (45,2%) dan jarang pada genitalia. Gejala klinis terbanyak adalah likenifikasi (6,5%). Penggunaan terapi paling banyak menggunakan kortikosteroid topikal desoksimethasone 0,25% (35,5%). Simpulan: Kasus LSK sebenarnya adalah yang sangat mudah untuk didiagnosis, namun kurangnya pemahaman dalam mendiagnosis menyebabkan kasus ini tampak jarang ditemukan.Kata kunci: liken simplek kronikus, studi retrospektif.

Profile of Peanut Spesific-IgE in Atopic Dermatitis L, Indiarsa Arief; Lumintang, Hans; Ervianti, Evy
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 3 (2014): BIKKK DESEMBER 2014
Publisher : Faculty Of Medicine Airlangga University

Background : Atopic Dermatitis (AD) is a chronic reccurent disease. One of the environmental factors which possibly involved in the reccurency of AD is food allergy such as peanut. Peanut allergy in the pathogenesis of AD is by induction IgE and T cells. Peanut-spesific IgE allergen are observed in AD patient. Purpose: To identify the distibution of serum IgE concerning the peanut antigens according to AD. Methods:This trial was cross sectional descriptive study, which studied 33 atopic dermatitis patients, which fulfill inclution criterias.We describe the anamnesis, physical examination, peanut-spesific IgEÂ and the severity of AD using SCORAD index. Results: There were 7 patients (21,2%) with positive result of peanut-spesific IgE. The positive result of peanut-spesific IgE were noted most often on AD patients who suffer from severe grade of AD severity score (85,7%) but not found in class 3 or more (where antibody can detect significanly, often clinical manifestasion appeared when had sensitisation). Conclusion: The positive result of peanut-spesific IgE class 1 (0,35- 0,7 IU/mL)Â 5 people (15,1%) andÂ class 2 (0,7-3,5 IU/mL) 2 people (6,1%) were noted most often on AD patients who suffer from severe grade of AD severity scoreKey words: atopic dermatitis, peanut-spesific IgE.

Pure Neural Leprosy Verdy, Verdy; Budiyanto, Arief; Siswati, Agnes Sri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Pure neural leprosy (PNL) is an infection by Mycobacterium leprae with clinical manifestation as nerve thickening, sensory nerve impairment, with or without motoric nerve involvement, and without skin lesion. Pure neural leprosy causes progressive degeneration of nerve function. Diagnosis establishement of PNL is difficult. Purpose: To discuss about PNL especifically in aspects of the diagnosis and therapy. Reviews: Gold standard in diagnosis of PNL is histopathological examination from nerve biopsy but this procedure is still difficult for various reasons. Some investigations can be done for PNL such as cytological fine needle aspiration, Mitsuda test, serology test for antibody anti-PGL1, electroneuromyography (ENMG), and polymerase chain reaction (PCR). Pure neural leprosy classification is based on findings of abnormality in neurological, immunological, and histopathological. Pure neural leprosy therapy is based on the classification of paucibacillary or multibacillary. Conclusions: The clinical and epidemiological findings plus with the electroneuromyography alteration were finally accepted as sufficient criteria to diagnose PNL. Pure neural leprosy therapy follows WHO regiment in accordance with the paucibacillary or multibacillary classification.Key words: pure neural leprosy, Mycobacterium leprae, nerve biopsy, anti-PGL-1, electroneuromyography.

Retrospective Study: Oral Therapy in Children with Atopic Dermatitis Thohiroh, Asmahani; Zulkarnain, Iskandar
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 3 (2015): BIKKK DESEMBER 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Atopic dermatitis (AD) is an inflammation skin characterized by itchy, chronic, residif; can occur in infant, child, and adult. The therapy for AD are divided into systemic and topical therapy. Systemic therapy includes antihistamine and corticosteroid. Purpose: To evaluate pattern of oral therapy in new child AD patient. Methods: Retrospective study methode was performed by evaluating medical records of new child AD patient who received oral therapy in Pediatric Division, Departement of Dermato-veneorology Dr. Soetomo General Hospital 2010 until 2012. The evaluated data include the patients visitation, age, gender, time visit, patients complain, periode of illness, history of atopy, physical examination, management, and follow up. Results: There were 558 patients (88.9%) of 628 new child AD patients who received oral therapy. Oral therapies were provided in form of antihistamine for 518 patients (92.8%), oral antibiotic for 129 patients (23.1%), and corticosteroid for 40 patients (7.2%). Patients who did not return to the hospital after first visitation were 461 patients (82.6%). Conclusions: Most of the child AD patient got an oral therapy. Most of the oral therapy was antihistamine.Key words: atopic dermatitis, child, oral therapy, retrospective.

Kadar Kortisol Serum Pasien Eritema Nodosum Leprosum (ENL) Baru Ayudianti, Prida; Suyoso, Sunarso; Indramaya, Diah Mira
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 2 (2014): BIKKK AGUSTUS 2014
Publisher : Faculty Of Medicine Airlangga University

Latar belakang: Eritema nodosum leprosum (ENL) yang merupakan komplikasi serius dari kusta tipe multibasiler, merupakan bentuk reaksi hipersensitivitas tipe III menurut Gell dan Combs. Karakteristik reaksi ENL adalah peningkatan sitokin proinflamasi TNF-a dan IL-1. Pelepasan sitokin proinflamasi kronis dapat menyebabkan gangguan produksi kortisol. Tujuan: Mengevaluasi kadar kortisol serum pasien kusta dengan ENL baru, berdasarkan lamanya pemberian Multidrugs Therapy (MDT) dan derajat keparahan ENL. Metode: Dilakukan pemeriksaan kadar kortisol serum terhadap 14 pasien ENL baru, yang berusia 15 tahun, belum pernah mendapat terapi kortikosteroid atau telah mendapatkan terapi kortikosteroid maksimal 3 minggu. Hasil: Didapatkan 14 sampel dengan rerata kadar kortisol serum pada pasien BL 9,06 (SE 2,84) g/dL, tipe LL 8,83 (SE 3,37) g/dL, pasien ENL baru yang mendapat MDT < 6 bulan 2,11 (SE 0,51) g/dL, mendapat MDT 6 bulan 14,40 (SE 2,65) g/dL, pasien ENL dengan derajat keparahan ringan 19,05 (SE 0) g/dL, sedang 7,75 (SE 2,75) g/dL, berat 8,56 (SE 3,29) g/dL. Nilai normal kadar kortisol serum adalah 10 g/dl ( 276 nmol/l). Simpulan: Pasien kusta tipe MB dengan ENL baru didapatkan rerata kadar kortisol serum dibawah normal. Hasil yang sama juga didapatkan pada pasien dengan riwayat pemberian MDT < 6 bulan yang memiliki derajat keparahan ENL sedang dan berat.Kata kunci : eritema nodosum leprosum, kortisol serum, MDT, derajat keparahan.

Occupational Contact Dermatitis: Retrospective Study Witasari, Dinar; Sukanto, Hari
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 3 (2014): BIKKK DESEMBER 2014
Publisher : Faculty Of Medicine Airlangga University

Background: Occupational skin disease is the second largest occupational disease in Europe after musculoskeletal injury.Most common occupational skin disease is contact dermatitis as many as 70-90%. Determining the cause of contact dermatitis in occupational environment is very important to avoid causing substances and to establish healing as well as reducing the recurrence rate. Purpose: To evaluate the management of new patients with occupational contact dermatitis in Allergy Immunology Division, Dermatology and Venerology outpatient clinic Dr. Soetomo General Hospital Surabaya in period of 2010-2012. Methods: Retrospective study of new patients with occupational contact dermatitis in Allergy Immunology Division during 2010-2012. Results: New patient of occupational contact dermatitis during the period of 2010-2012 were 50 new persons, predominantly occured in male in reproductive age (25-44 year old), irritant contact dermatitis (ICD) occured more frequent than allergic contact dermatitis (ACD). The majority of subjects were factory workers, with the most suspected ingredients was chemicals. About 21.7% patients underwent patch test. The therapy mostly given were antihistamines and topical steroids. There were 46% of patients who did not visit outpatient clinic again. Conclusions: New patients of occupational contact dermatitis in Allergy Immunology Division during the period of 2010-2012 were as many as 50 new patients. Patch test should be performed to establish the diagnosis and determine the cause of contact dermatitis materials.Key words: occupational contact dermatitis, patch test, retrospective study.

The Profile of Erysipelas and Cellulitis Patients Novarina, Ryski Meilia; Sawitri, Sawitri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Erysipelas and cellulitis are acute infectious serious skin diseases, due to the entry of bacteria through the unintact skin barrier and can be fatal. Purpose: To determine the clinical manifestation and management of hospitalized erysipelas and cellulitis patients at the dermatolovenerology inpatient Dr. Soetomo General Hospital in period of 2008-2011. Methods: The study was conducted retrospectively based on the medical records of the hospitalized patients include case number, gender, age, main complaint and duration, trigger factors, concomitant factors that can be as the underlying disease, lesion site, laboratory examinations, treatments, length of treatment associated with Erythrocyte Sedimentation Rate (ESR) and the prognosis. Results: The erysipelas and cellulitis cases were 65 cases (1.9%) of the total hospitalized cases of skin diseases, with the number of men and women were 36 and 29 patient, respectively. The highest age group were 45-65 years (35.4%). Main complaint was swelling, redness and pain (66,2%) and the duration of complaints 1-7 days (81.5%), Most triggering factors due to scratching (34%). Anemia (30,8%) is the most underlying disease. The majority of lesion sites are in the lower extremities in 56 patients (86.1%). Laboratory tests showed anemic (30.8%), leukocytosis (44.6%) and (76.9%) ESR > 20mm/h (76.9%). The specimen of the lesion of 18 cases were cultured, there were found majority bacterial were Staphylococcus aureus (37.5%). The managements of treatment of 25 cases (38.5%) were consisted: immobilization, intravenous injection of Ampicillin and wet dressing with normal saline, 15 cases with ESR>50mm/h were treated for 8 -14days. The complications (gangrenosum cellulitis) were found in 1 case (1,5%), and 40 patients (61.5%) discharge from hospital in a recovery state. Conclusion: The management of patients with erysipelas and cellulitis had been appropriate based on the diagnosis and treatment guidelines. Staphylococcus aureus is the most frequent bacteria found in culture.Key words: erysipelas, cellulitis, Staphylococcus aureus.

Secondary Syphilis, Anal Condylomata Acuminata, and HIV in Bisexual Male Patient: Another Point of View, Time Evaluation Based on CD4 and Management Dewi, Vina Ajeng Puspa; Pudjiati, Satiti Retno
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 2 (2015): BIKKK AGUSTUS 2015
Publisher : Faculty Of Medicine Airlangga University

Background: A meta analysis study in China states that male bisexual has higher incidence rate for HIV and syphilis than male-sex-male. Syphilis eases the transmission of HIV, vice versa HIV breaches the integrity of mucosal epithelial barrier, allowing translocation virus and bacterial. Syphilis has higher incidence rates in HIV-infected compare with HIV-uninfected patients. Syphilis influences CD4 of patient. We try discussing a case of secondary syphilis in male bisexual HIV in another point of view, to find which one earlier based on CD4 count. Purpose: to understand another point of view, time evaluation based on CD4 and management in secondary syphilis, anal condyloma accuminata, and HIV in bisexual male patient Case: A 19 years old male bisexual patient complained erythematous rash all over his body, no itch or pain; TPHA 1/2560, VDRL 1/128, positive HIV 3antibody, and CD4 425cell/mm. Case management: HIV onset, considering decrease of CD4 in syphilis or not, are 2-5,8years and 3,08-7,7years, respectively. Therapy was given as single dose benzatin penisilin 2,4billion IU intramuscular. Conclusion:HIV infection occurred before syphilis. No differences in management with HIV-uninfected syphilis patient, more often evaluation interval needed.Key words: syphilis, HIV, bisexual, CD4, onset, management.

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