Skin and Connective Tissue Diseases Commons^™

Indonesian Clinical Practice Guidelinesfor Systemic And Biologic Agents For Adults With Plaque Psoriasis, Novianto E, Budianti Wk, Fitri Em, Wiryadi Be, Soebaryo Rw, Pusponegoro Ehd, Effendi Eh, Rahmayunita G

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.
Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, …

Plasma Malondialdehyde Levels Related To Acne Vulgaris Severity, Fitri Puspita, Nelva Karmila Jusuf, Ariyati Yosi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris (AV) is a multifactorial disorder characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Oxidative stress plays a role in the pathogenesis of AV. Reactive Oxygen Species (ROS), especially lipid peroxides (LPO), plays a role in mediating acne inflammation. Malondialdehyde (MDA) is one of the byproducts of LPO commonly used as a biomarker of cell damage.
Methods: This cross-sectional analytic study consisted of sixty patients with AV. The samples were taken from the blood plasma of AV subjects. An enzyme-linked immunosorbent assay (ELISA) examination was performed. The normality of data …

Management Of Basal Cell Carcinoma With Excision Followed By Rotation Advancement Flap, Remenda Siregar, Fitri Puspita, Widyaningsih Oentari, Ari Karmila Sari

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect.
Case Illustration: We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of …

Intense Pulsed Light (Ipl) As Adjuvant Therapy For Acne Vulgaris: A Case Series, Widyaningsih Oentari, Angie Regina Sutrisno, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment.
Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the …

The Differences Of Blood Type In Relation To Psoriasis And Its Onset: Cross Sectional Study, Nugrohoaji Dharmawan, Suci Widhiati, Triasari Oktavriana, Irene Jessica Pinarsinta Harahap

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis.
Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of …

Generalized Pustular Psoriasis And Cushing’S Syndrome In Childhood Due To Corticosteroids Misuse, Fitri Azizah, Yusnita Rahman, Rahadi Rihatmadja, Triana Agustin, Rinadewi Astriningrum, Githa Rahmayunita

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.
Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake …

Dermoscopic Features Of Uncomplicated Tinea Versus Steroid-Modified Tinea: An Observational Study In Indian Patients, Mithila Ninad Gadekar, Nausheen Syed, Ashutosh Chate, Sushrut Save

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Tinea is one of the most common superficial fungal skin infections. Steroid-modified tinea infections may present with atypical morphology. This study aims to observe the difference between dermoscopic features of uncomplicated dermatophytosis and steroid-modified dermatophytosis.
Methods: This observational study was conducted in 60 patients with tinea cruris, tinea corporis and tinea faciei in the outpatient dermatology department of a tertiary care center. Patients were divided into group A and group B. Group A included 30 patients with no history of steroid use in the past three months. Group B included 30 patients with a history of steroid …

Platelet-Rich-Fibrin For Venous Leg Ulcer Therapy, Karin Rachmani, Lis Surachmiati Suseno, Mutiara Ramadhiani

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It’s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF.
Case Illustration: A 47-year-old male came with an ulcer on the lower left leg for one year. The ulcer was preceded with a reddish, tender nodule with …

Low-Calorie Diet Improves Pasi Score In Psoriasis Patients With Obesity: An Evidence-Based Case Report, Kristian Kuniawan, Alessa Fahira, Edwin Ti Ramadan, Windy Keumala Budianti

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: The association between psoriasis and metabolic syndrome is appealing as the two may share a similar cross-linking systemic inflammation process. The inflammation processes occurring in obesity and psoriasis may aggravate one another. This raised the question of whether a low-calorie diet would possibly reverse the aforementioned process. This study aims to determine whether calorie restriction reduces psoriasis area and severity index (PASI) in obese patients with moderate-to-severe psoriasis receiving conventional treatment compared to no calorie restriction.
Methods: We searched Pubmed/Pubmed Central, ScienceDirect, Cochrane library, EBSCOhost, and Scopus databases using keywords derived from our clinical question. The inclusion …

Cutaneous Horn On The Right Supraclavicular Region In An Adolescent Female, A Rare Case Report, Rohit Gupta, Manoj Kumar, Ruchi Sinha, Reva Shankar Sahu

The New Ropanasuri Journal of Surgery

Cutaneous horn (CH) is an outgrowth from the skin surface, composed of keratin, and associated with benign to malignant skin lesions. We report a case of CH in a 15-year-old female associated with Keratoacanthoma. It is uncommon in young people and is associated with a good prognosis because of its benign nature. This case needs to be reported as it highlights the rare occurrence of this condition in the younger age group and its good prognosis. Surgical excision is the treatment of choice, with histopathologic diagnosis playing a critical role in determining the nature and further treatment of this condition …

An Investigation Of Chronic Pain As A Much-Neglected Symptom Of Hypermobile Ehlers-Danlos Syndrome, Sydney Collins

Honors Theses

Ehlers Danlos Syndrome is a group of heritable loose connective tissue disorders with 13 distinguished subtypes. The hypermobile type of Ehlers Danlos Syndrome (hEDS) is the most common subtype and is caused by a genetic mutation that leads to defective collagen fibrils. This leads to joint instability and hypermobility, skin elasticity, widespread pain, fatigue, and generalized tissue fragility. Chronic pain is reported to be a symptom in as high as 92% of the hEDS population (Voermans et al., 2010); despite this prevalence, there is a significant lack of research, awareness, and treatment standardization regarding pain in hEDS. This literature review …

Kindlin-1 Is Involved In Spreading, Migration, And Protein Regulation In Epidermal Scc-13 Cells, Naomi Mishan

Electronic Thesis and Dissertation Repository

Kindlin-1 is a scaffold protein linking the cytoskeleton to the extracellular matrix. Loss of function mutations in the FERMT1 gene (encoding Kindlin-1) cause gastrointestinal and skin defects associated with increased susceptibility to aggressive epidermal squamous cell carcinoma (SCC). This study investigated the consequences of targeted FERMT1 inactivation in the SCC-13 cell line of epidermal SCC. My studies demonstrate Kindlin-1 is not essential for SCC-13 proliferation or clonogenic potential in culture. Kindlin-1 was required for cell spreading on collagen I, but not on laminin-332, and its absence enhanced SCC-13 directional migration. Finally, I identified several proteins involved in tumor formation and …

Ecthyma Gangrenosum And Panniculitis Secondary To Acute Pseudomonas Myositis Without Bacteremia, Heather Gosnell, Matthew Burke, Joseph Shnouda

HCA Healthcare Journal of Medicine

Introduction

Ecthyma gangrenosum (EG) is a relatively uncommon cutaneous manifestation of an underlying Pseudomonas aeruginosa infection and is clinically described as necrotic with gangrenous ulcers surrounded by erythematous halos. Cases of EG may occur in the absence of bacteremia and have been increasingly reported in literature. Here we present a patient with features of both EG and panniculitis, despite the lack of underlying bacteremia.

Clinical Findings

A 57-year-old male presented to the emergency department with unrelenting right-sided lower back pain and an “itchy and painful” rash of four to five day duration. The patient had an extensive history of intravenous …

Complications And Dosing Frequency Of 5% Imiquimod For Genital Warts In A Young Man, Sebastian A. Hoak

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Fife KH, Ferenczy A, Douglas JM Jr, et al. Treatment of external genital warts in men using 5% imiquimod cream applied three times a week, once daily, twice daily, or three times a day. Sex Transm Dis. 2001;28(4):226-231. https://doi.org/10.1097/00007435-200104000-00007

for a patient with genital warts and an unstable social support network.

Collagen-Based Biomaterials With Possible Therapeutic Effects, Ramona Mihaela Nedelcuţă, Gigi Călin, Mihai Cristian Nedelcuţă, Vlad Dumitru Baleanu, Dragos Virgil Davitoiu, Bogdan Socea, Bogdan-Petre Stănoiu

Journal of Mind and Medical Sciences

Epidermolysis bullosa (EB) is a rare, serious genetic disease, incurable through the current means. Apart from this initial definition, there was later some ease in the definition of the disease, including the manifestations of toxic epidermal necrolysis and Stevens Johnson syndrome in this entity. In medical practice, there are cases that do not overlap with the description in the literature, thus the treatment must be adapted and personalized to the particularities. We present the case of a female new-born, with "de novo" mutation for the early-onset antenatal epidermolysis and our personalized therapeutic management, based on collagen from bovine corneas by …

The Role Of Photography In Increasing Efficiency Of Dermatologic Inpatient Consulting Service, Ritu Swali, Tyler D. Evans, Dillon Clarey, Corey Georgesen, Ashley Wysong

Graduate Medical Education Research Journal

Abstract

Introduction:

Inpatient dermatology consultations can bring a mixed bag of pathologies. Due to the highly specialized nature of dermatology and the lack of dermatologic training in medical school, the dermatologic team is consulted for matters that range from non-urgent to pressing. Pictures are a critical component of dermatology and greatly aid in the diagnosis of cutaneous diseases. In the inpatient setting, pictures can help streamline diagnosis and prevent unnecessary tests or procedures. The purpose of this study was to evaluate for the presence of pictures in patients’ chart after a dermatology consult had been placed through EPIC at the …

Acute Generalized Exanthematous Pustulosis Induced By Cetuximab, Sadia Masood, Mohammad Rizwan, Saira Fatima, Palwasha Jalil

Department of Medicine

A wide variety of diseases and drugs can cause cutaneous pustular eruptions. Acute generalized exanthematous pustulosis (AGEP) is a unique drug-induced dermatosis clinically presented as erythematous papular and pustular eruption, usually caused by certain systemic drugs. We are presenting a very rare association of AGEP with a biological agent, cetuximab. A male aged 66 years, who was recently diagnosed with a case of squamous cell carcinoma of glottis, presented in the dermatology clinic with a recent onset of fever and widespread pustular eruption over the face, trunk, and limbs. The eruption was noted after the injection of cetuximab given for …

Gene Expression Profiling Of Mapk Pathway Inhibitor Resistance In Cutaneous Melanoma: Can Bioinformatics Be Used To Select Better Melanoma Cell Lines?, Stephen Luebker

Theses & Dissertations

Melanoma is the deadliest form of skin cancer, and incidence has continued to increase. Half of all melanomas have a BRAF V600E mutation and respond to MAPK pathway inhibitors, including BRAF inhibitor therapy or BRAF/MEK inhibitor combination therapy, but nearly all patients develop treatment resistance. Melanoma cell lines produce variable results as models of MAPK pathway inhibitor resistance. To better understand how the genomic similarity of a melanoma cell line to patient-derived tumors affects resistance mechanisms, differences in DNA mutations and copy-number alterations were compared between melanoma cell lines profiled by the Cancer Cell Line Encyclopedia and cutaneous melanoma tumors …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

The Regulation Of Pannexin1 And Pannexin2 In The Skin In Health And Disease, Rafael E. Sanchez Pupo

Electronic Thesis and Dissertation Repository

Pannexins (PANX1, 2, 3) are a family of channel-forming glycoproteins that mediate intracellular and paracrine signaling. In contrast to PANX2, PANX1 has been extensively investigated in the skin, modulating cell differentiation, wound healing, and melanoma development. PANX1 and PANX2 can co-exist in the same cell and form mixed channels where their glycosylation seems to regulate their intermixing. N-glycosylation and caspase cleavage have been proposed as modulators of the function of PANX1, but their effects on PANX2 are unknown. We explored the PANX2 expression in mouse skin and showed that a Panx2 splice variant (PANX2-202) is continuously expressed throughout aging skin. …

Predicting The Environmental Suitability For Onchocerciasis In Africa As An Aid To Elimination Planning, Elizabeth A. Cromwell, Joshua C P. Osborne, Thomas R. Unnasch, Maria-Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where …

Hypertrophic Gastric Folds With Hypomagnesemia, Linking The Dots, Mansoor Zafar, Tila Muhammad, Najam-Us-Saher Rizvi, Muhammad Toqeer

Section of Internal Medicine

A Caucasian man in early 80s was seen in Gastroenterology Clinic, following, referral from the Endocrinology Clinic for concerns for CT Abdomen requested for tiredness and weight loss of three kilograms. The patient also had microcytic picture with low MCV and Ferritin and hypomagnesemia. The CT suggested gross circumferential thickening of the wall of stomach with advice for invasive investigations to further characterise the CT findings. The Endoscopy suggested grossly enlarged rugae in the stomach, and enlarged gastric polyps. Patient was assured no new sinister abnormality. Treatment challenges to consider were to stop acid suppression by prescribing Proton Pump Inhibitors …

Childhood-Onset Borderline Tuberculoid Leprosy With Reversal Reaction, Ramona D. Lubis, Mila Darmi, Rudi Chandra

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Leprosy is a chronic granulomatous infection caused by Mycobacterium lepraethat predominantly affects the skin and peripheral nerves. Leprosy among children is still common in endemic countries.

Case Illustration: A 12-year-old girl complained about a hypopigmented anesthetic patch on her face for 11 years, which became larger and spread slowly to her arms and legs. She had a history of close contact with her aunt, who was diagnosed with multibacillary leprosy. On slit-skin-smear test, acid-fast-bacilli (bacteriologic index +1) were found. She was diagnosed with multibacillary leprosy and treated with children’s multidrug therapy-multibacillary (MDT-MB) regimen. After 2 months of …

Clinical Characteristics And Treatment Regimen Of Pemphigus Patients: A Retrospective Study, Windy Keumala Budianti, Eyleny Meisyah Fitri, Puti Rineska Meilinda, Endi Novianto, Shafira Anindya, Arlha Aporia Debinta

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Pemphigus is a potentially life-threatening autoimmune bullous disease. In pemphigus, the therapeutic options are based on the clinical characteristics of each patient. However, other than corticosteroids, most therapeutic options for pemphigus are currently limited. Steroid-sparing agents might be considered since the initiation of therapy to prevent the side effects of corticosteroid. The objective of this study is to identify the clinical characteristics and therapy of choice in patients with pemphigus at Dr. Cipto Mangunkusumo General Hospital.

Method: All cases of pemphigus from 2016 to 2018 at Dermato-Allergo-Immunology Clinic, Department of Dermatology and Venerology Dr. Cipto Mangunkusumo General …

A Comparison Of Single-Dose Versus Divided-Dose Of Metronidazole On Bacterial Vaginosis Among Female Sex Workers In Surakarta, Willa Damayanti, Rini Hastuti, Agung Triana, Danu Yuliarto, Ardelia Dyah Ayu, Endra Yustin Ellistasari

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Bacterial vaginosis (BV) is the most common vaginal infection in sexually active women. Metronidazole (MTZ) is still one of the recommended regimens for BV either as a single-dose or divided-dose. In addition to its affordability and availability, oral metronidazole also produces fewer adverse effects. This study aimedto determine the efficacy of single-dose versus divided-dose metronidazole for BV among female sex workers (FSWs) in Surakarta.

Methods: A single-blind randomized clinical trial was conducted in Surakarta. FSWswith BV (⩾3 Amsel criteria) were enrolled. The subjects were grouped into two, and treated with MTZ either as a single-dose of …

Alternative Modality In The Treatment Of Acne Vulgaris: Low Level Laser Therapy, Rudi Chandra, Nelva K. Jusuf

Journal of General - Procedural Dermatology & Venereology Indonesia

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with polymorphic manifestations. The four key elements leading to the formation of acne lesions are alteration of follicular keratinization that leads to comedones, increased and altered sebum production under androgen control, follicular colonization by Propionibacterium acnes, and complex inflammatory mechanisms that involve both innate and acquired immunity. Phototherapy (light, lasers, and photodynamic therapy) has been proposed as an alternative therapeutic modality to treat acne vulgaris and is proposed to have less side effects compared to other treatment options. Recently, low-level laser (light) therapy (LLLT) which refers to the use …

Prevalence Of Cutibacterium Acnes And Staph Spp. In The Lesions Of Acne Vulgaris In Jakarta, Melyawati Hermawan, Enty Tjoa, Inneke J. Hidajat, Maria Teressa, Eka B. Layadi, Alegra Wolter

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris (AV) is a chronic skin disorder that is commonly seen in young adults. Recent studies have shown that bacteria other than Cuticubacterium acnes found in the skin microbiota also play vital roles in the pathogenesis of AV. Understanding the skin microbiota and its disruption in patients with AV is paramount in treating patients with AV.

Methods: Samples were obtained from 36 subjects to evaluate the proportion of Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus in lesions of AV by means of bacterial culture.

Results: There were 69 specimens collected from the 36 subjects with …

Basal Cell Carcinoma In A 14-Year-Old: A Rare Case Of A Common Skin Cancer, Danang Tri Wahyudi, Firman Parrol, Aida Sofiati Hoemardani, Agassi Suseno Sutarjo

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. It usually arises in sun-exposed areas of the body, with the face and neck being the most common sites for BCC. BCC is typically found in older individuals, but it is becoming more prevalent in people younger than 50. However, such cases in children under 15 are rarely encountered. Pigmented BCC is a common presentation in people of color, while such presentation is relatively unusual in Caucasians. Pediatric cases could be idiopathic, but it is more commonly associated with a genetic defect, such as basal cell nevus syndrome, …

Multisystem Langerhans Cell Histiocytosis In High-Risk Group: A Case Series Of Two Infants, Anggun Putri Yuniaswan, Putri Rachma Safitri, Diah Prabawati Retnani

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Langerhans Cell Histiocytosis (LCH) has diverse manifestations, from asymptomatic to aggressive, which involves many organs. Histopathological examination playsa crucialrole as a basic diagnostic standard for LCH. Writing Group of the Histiocyte Society proposes a guideline for diagnosing LCH, divided into presumptive, designated, and definitive diagnosis.

Case Illustration: Two cases of a 14 month-old girl and an 18 month-old girl presented similar clinical manifestation and multi-organ involvement. Dermatological examination revealed red papules and plaques covered by brownish scales and crusts on the scalp and body, erosion in some folds of the body. Histopathological examination of the first case …

Dermoscopy-Guided Carbon Dioxide Laser Destruction For Nevus Sebaceous: Two Case Reports, Larisa Paramitha Wibawa, Kuniaki Ohara

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO2) laser therapy.

Case Illustration: Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO­2laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment.

Discussion: The dermoscopy finding …