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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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Haemorrhagic Bullous Lesion in Henoch-Schonlein Purpura Renata Prameswari; Diah Mira Indramaya; Sawitri Sawitri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels and the most common type of vasculitis in children. Vesicles and haemorrhagic bullae were thought to be rare in HSP and maybe difficult to diagnose. Purpose: To describe the rare case of haemorrhagic bullous lesion in HSP. Case: A 15-year-old Javanese girl was admitted to Dr. Soetomo General Hospital Surabaya with one week history of multiple haemorrhagic blisters on her extremities, accompanied with joint pain, abdominal pain, and severe nausea. Firstly, it’s only a few redness patches then become numerous and changed to haemorrhagic blisters. A dermatological examination shown multiple bullae and vesicles on multiple palpable erythematous purpura. There were hypokalemia on laboratory examination and histopathological examination concluded a leukocytoclastic vasculitis. Discussion: Fluid balance, oral corticosteroid, oral antihistamine, antiemetic injection, and potassium correction were administered to the patient. Dexamethasone was discontinued because there was a presence of melena. Symptomatic treatment was given and significantly improvement was achieved in one month after treatment. Conclusion: Henoch-Schonlein purpura is diagnosed based on history, physical, clinical, and histopathological examination. Vesicles and haemorrhagic bullae are rare in HSP, and it does not seem to have any prognosis value in the outcome of HSP. Key words: Henoch-Schonlein purpura, haemorrhagic bullous lesion, small vessel vasculitis.

Profile of New Patients with Candida Infection in Skin and Nail Shinta Dewi Rahmadhani Soetojo; Linda Astari
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Candidiasis are different groups of infection which is caused by Candida albicans and other spesies in the genus Candida can invade hair, skin, nail, mucous membrane and systemic. Purpose: To evaluate profile, process of diagnosis, treatment and follow up of patient with candida infection on the skin and nails. Methods: This research was performed retrospectively to new patients with candida infection of skin and nails in period of 2011-2013. Result: There were 137 patients in period 2011-2013, which are 114 new patients with infection in skin and 23 patients with nails involvement. Most of them were women, respectively in 2011 (54.3%) 2012 (80%) and 2013 (56.6%). Most types of skin disorder is candida intertriginosa (62.2%) and candidiasis of skin and nails (91.3%). Conclusion: Overview of new cases of candida infections of skin and nails tend to decrease.Key words: Candidiasis spp, candida infection of skin and nails.

Expression of Transforming Growth Factor–Beta (TGF-β) on Regulatory T (Treg) Cell from Skin Lesion of Leprosy’s Patient Kristina Sihaloho; Afif Nurul Hidayati; Indropo Agusni
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Clinical manifestations of leprosy depends on host’s immunity. Regulatory T (Treg) cells are known as CD4+CD25+FOXP3+ have roles in immune respons to maintain homeostasis. Transforming growth factor (TGF)-β are one of cytokine that is secreted by Treg cells. Treg cells are thought as unresponsiveness T cells (anergy) to Mycobacterium leprae and caused disease’s progression to lepromatosa. Purpose: To evaluate expression of TGF-β on Treg cells from patient leprosy’s skin lession. Methods: Design of study was cross-sectional, descriptive observation involving 18 leprosy patients who visited the Leprosy Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya. Biopsy from skin lession were performed then continued with histopathological examination. The type of leprosy was determined by clinical and histopathological examinations. Expression of TGF-β on Treg cell were performed by double staining immunohistochemistry in Biomoleculer and Pathology and Anatomy Laboratory at Brawijaya University, Malang. Result: Numbers of mid-borderline type (BB) leprosy’s patients were 2 (11,1%), 9 (50%) patients with borderline lepromatosa (BL) type, and 7 (38,5%) patients with Lepromatosa (LL) type. Mean expression of TGF-β on Treg cells from skin lession’s leprosy on BB type was 12 ± 2,12 cells/field of view, on BL type was 16 ± 3,64 cells/fields of view and on LL type was 22± 3,69 cells/field of view. Conclusion: Expression of TGF-β on Treg cells are increasing on skin lession’s leprosy patients might as prognostic indicator of severity of leprosy (lepromatosa type). Key words: immunohistochemistry, leprosy, Morbus Hansen, regulatory T cell, TGF-β.

Characteristic of Tinea Cruris and/or Tinea Corporis in Ciamis District Hospital, West Java Wulan Yuwita; Lies Marlysa Ramali; Risa Miliawati N. H.
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Tinea cruris and/or corporis is one of the most common dermatophytosis in the world, which is still being a health problem in Indonesia. Purpose: The purpose of this study was to find out the characteristic of tinea cruris and/or tinea corporis in Ciamis District Hospital, West Java. Methods: The design was descriptive cross-sectional study, with consecutive sampling methods. The subjects of the study were patients with tinea cruris and/tinea corporis who visited Dermatovenereology Clinic in Ciamis District Hospital, West Java. Data was collected from the history taking, physical examination, microscopic examination from skin scraping using 10% potassium hydroxide solution (KOH), and fungal culture, until 40 patients with positive result of dermatophyte culture were included. The study was conducted from 2015, 1st August to 15th October. Results: Tinea cruris and/or corporis were most commonly found in female (52.5%), age 45-64 years. Duration of illness £1 month (20/40), recurrence(7/40), the source of infection was anthropophylic (10/40), with clinical manifestations were erythematous and hyperpygmented macules and papules, scales, with central clearing (36/40). The most commonly isolated dermatophytes were Trichophyton rubrum (95.8%) followed by Epidermophyton floccosum (4.2%). Conclusion: The most frequent dermatophytes species causing tinea cruris and/or corporis in Ciamis District Hospital, West Java are T. rubrum followed by E. floccosum with minimal inflammation clinical manifestation and source of infection was antropophilic. Key words: tinea cruris, tinea corporis, Ciamis District Hospital.

C-Reactive Protein in Various Degrees Severity of Psoriasis Vulgaris Lita Setyowatie; Hari Sukanto; Dwi Murtiastutik
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Psoriasis vulgaris is an inflammatory, chronic, recurrent, and, non-contangious skin disease. The severity grade of psoriasis is measured with psoriasis area and severity index (PASI) score. C-reactive protein (CRP) is a sensitive, but not specific indicator of inflammation. In the active stage of psoriasis, highly increased CRP levels were found, whereas at remission they present a decrease level. Purpose: To evaluate the profile of CRP level in psoriasis vulgaris patients with various degress of psoriasis vulgaris severity in Dr. Soetomo Hospital Surabaya. Methods: Blood samples were collected in 16 patients to measure the CRP level in psoriasis vulgaris patients with various degrees of severity. Results: There were 16 patients (10 male and 6 female) with various degrees of psoriasis vulgaris severity (5 patients with mild severity, 8 patients with moderate severity, and 3 patients with severe severity). All CRP results were within normal limits. Conclusion: Many factors can influence the CRP levels, CRP can not be as single indicator of inflammation in psoriasis vulgaris. Key words: psoriasis vulgaris, c-reactive protein, PASI score.

The Use of Thalidomide in Steroid Dependent Continous Erythema Nodosum Leprosum Leprosy Patient: A Case Report Dian Pertiwi Habibie; M Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Treatment thalidomide in erythema nodosum leprosum (ENL), can inhibits the transcription repression mediated by tumor necroting factor (TNF). Thalidomide can be used as sparing agents drug to reduce the dependency of steroid. Purpose: To report the effectiveness of thalidomide to treat ENL and of relinquish steroid dependency. Case: A 39 years old patient with leprosy borderline lepromatous type, came with complain bumps on skin accompanied with fever, occurring recurrently since 4 years ago if the steroid’s dose tappered off. He consumed steroid routinely every day for the last 4 years and if the dose was tapered to 4 mg once daily, the painful bumps reappeared often accompanied by fever. Thalidomide 50 mg twice daily and methyl prednisolone 4 mg once daily was given. The constant tapering off of methyl prednisolone done every week. After a month, the patient shown significant improvement. Discussion: Thalidomide is effective in ENL, it is regarded as first line in terms of clinical efficiency because it displays an effect on 90% of ENL patients. In this case, thalidomide was given and steroid dose was reduced slowly while observing the clinical manifestation and patient’s complain. There were no complain of recurrent ENL after discontinuation of steroid and thalidomide, no serious adverse event happened in this patient as well. Conclusion: The effectiveness of thalidomide in ENL is primarily due to its action on TNF but other mechanisms may contribute to its anti-inflammatory effect. Thalidomide is effective in the management of steroid dependent ENL patient. Key words: thalidomide, steroid dependent, methyl prednisolone, erythema nodosum leprosum

Retrospective Study: Management of Atopic Dermatitis Nanny Herwanto; Marsudi Hutomo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Atopic dermatitis (AD) is a chronic skin inflammatory disease, characterized with mild to severe itching, relapses, and mostly appears in infants and children. Although there has been current advances in the management of AD but satisfactory treatment has not been obtained. Purpose: To evaluate the treatment of patients with AD, hence better management can be provided. Methods: Retrospective study of newly diagnosed AD patients in Allergy Immunology Division of Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya during 2012-2014. Result: Antihistamine is the most widely prescribed medication, as many as 234 (36.3%) of all patients visits and cetirizine was the most given antihistamine in 142 (58%) of the patients. Emollients still used minimally, such as urea 10% cream in 71 (11%) patients, ambiphilic cream (biocream®) in 52 (8.1%) patients, and vaseline album in 11 (1.7%) patients. Conclusion: Emollients therapy is important in the management of AD and hence its usage should be adequate.Key words: atopic dermatitis, management, retrospective.

Higher Level Zinc Serum in Multibacillary Leprosy With Erythema Nodosum Leprosum compared to Patients Without Reaction Kinanti Prabawaningrum; Linda Astari; Indropo Agusni
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 1 (2016): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Leprosy is an infectious disease that causes a redistribution of nutrients in the body, including zinc, and low food intake of zinc causes decreased serum zinc levels. The number of bacteria M. leprae in multibacillary (MB) type leprosy and acute inflammatory process in Erythema Nodosum Leprosum (ENL) reaction affect the levels of zinc. Purpose: To analyze differences in the results of serum zinc levels in MB patients without reactions and ENL. Methods: Cross sectional study was conducted on forty-eight patients with a diagnosis of MB leprosy in Dermato and venereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya. Patient's blood had been taken to examine serum zinc levels. Result: The mean serum zinc levels of MB patients without reaction 78.49 g/dL, while ENL 175.83 g/dL. Conclusion: The mean serum zinc levels of MB patients with ENL is higher than without reaction.Key words: MB leprosy, ENL, cross sectional, serum zinc.

A Retrospective Study: The Profile of New Patient with Vitiligo Nurina Dhani Rahmayanti; Rahmadewi Rahmadewi
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Vitiligo occurs worldwide, with prevalence of 0.1 to 2.0 percent, commonly begins in childhood or young adulthood, with peak onset of 10 to 30 years, but it may occur at any age. Based on vitiligo new patient profile, treatment and recovery of patients could be expected to be better. Purpose: To evaluate the profile of new patients with vitiligo. Methods: A restrospective descriptive study was carried out in Medical Cosmetic Division Dermatovenereology Outpatient Clinic Soetomo Hospital Surabaya in 2012-2014. Result: New patient of vitiligo in Medical Cosmetic Division Dermatology and Venereology Out Patient Clinic Soetomo Hospital Surabaya in 2012-2014 were 188, which was 0.2% of total patient. The most frequent age was 25-44 years old as much as 61 patients, and mostly woman (68.1%). Fourty three point one percent came to out patient clinic after having vitiligo for more than 12 months. 78.5% had multiple lesions and 83.5% with lesion less than 10 cm2. Topical corticosteroid were given to 86.2%, sun block in 84%, topical oksoralen in 48.9% and cosmetic camouflage in 10.6% patient. Most of them (69.5%) never came to out patient clinic to check their disease. Conclusion: The average of vitiligo case in Soetomo Hospital Surabaya is 62 patient per year and mostly woman Key words: vitiligo, retrospective, profile.

Serum Level of Vitamin D (25[OH]D) in Patient with Atopic Dermatitis Meidyta Sinantryana Widyaswari; Iskandar Zulkarnain; Diah Mira Indramaya
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 28 No. 2 (2016): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Atopic Dermatitis (AD) is a chronic inflammatory relapsing skin disorder along with itchy sensation. Etiopathogenesis DA remains unclear, however in common are caused by impaired epidermal barrier function of the skin and immune system that tend to ensue infection. Vitamin D is an immunomodulator and plays an important role in the pathogenesis of DA through improving the integrity of skin barrier permeability, expression of antimicrobial peptide (AMP), which inhibit infection, and reduce inflammation. Deficiency of vitamin D may increase the development risk of DA lesion. Purpose: To evaluate the serum levels of vitamin D (25[OH]D) in patients with DA. Methods: A descriptive observational cross-sectional study, in 34 DA patients at Dermatology and Venereology Outpatient Clinic of Dr. Soetomo Hospital Surabaya. Subjects were enrolled through consecutive sampling, serum vitamin D levels were measured using enzyme-linked immunosorbent assay (ELISA) method. Results: Serum levels of vitamin D (25[OH]D) in DA patients was 22.72±14.55 ng/mL. Serum levels of vitamin D based on the severity DA: mild (30.86±22.66 ng/mL); moderate (20.42±10.13 ng/mL); and severe (18.84±8.22 ng/mL). Conclusion: Deficiency of vitamin D can occur in DA patient with low level of serum vitamin D (25[OH]D), but the relationship with the severity of DA remains to be done further research. Key words: atopic dermatitis, vitamin D (25[OH]D).

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