Skin and Connective Tissue Diseases Commons^™

Torch Re-Activation Concomitant With Drug-Induced Hypersensitivity Syndrome Shows Erythema Multiforme-Like And Vasculitis Clinical Features, Windy Keumala Budianti, Rahadi Rihatmadja, Izzah Aulia, Isaak Effendy

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Drug-induced hypersensitivity syndrome (DIHS) can be associated with cytomegalovirus (CMV) infection, besides induced by drugs. We report a case of DIHS with prolonged atypical clinical features and vasculitis precipitated by drug allergy, CMV, and other viral infections.

Case illustration: A 54-year-old female presented with generalized follicular erythematous papules and waxy palmoplantar keratoderma since one month before admission. The symptoms started as a purpuric lesion on the upper extremities, spreading as erythematous papules on the trunk with facial edema, accompanied by fever and chronic cough. She had been previously treated with ambroxol and cephalosporin. Cutaneous drug allergy reaction …

The Difference In Transepidermal Water Loss (Tewl) Values Between Sun-Exposed And Non-Sun-Exposed Skin Among Male Medical Students, Ihsany Arafiasetyanto Prihadi, Endra Yustin Ellistasari, Arie Kusumawardani

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Transepidermal Water Loss (TEWL) is the amount of water released from the human body into the atmosphere through a diffusion process per unit of time. Changes in TEWL indicate impaired skin barrier function. Exposure to ultraviolet light for an extended period can cause photoaging, characterized by rough and dry skin (xerosis cutis). TEWL will increase significantly in the skin exposed to ultraviolet radiation. This study aims to determine the difference in the TEWL values among male medical students in the sun-exposed and non-sun-exposed skin areas.

Methods: An analytical observational cross-sectional study was conducted at the Dermatology and …

Correlation Between Serum 25 Hydroxy-Vitamin D Levels And The Worst Pain Intensity In Postherpetic Neuralgia, Wizar Putri Mellaratna, Nelva K. Jusuf, Ariyati Yosi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Postherpetic neuralgia (PHN) is persistent pain in the affected dermatome that occurs more than three months after the eruption of the herpes zoster has disappeared. Vitamin D has a role in Schwann cell regeneration and stimulates the release of nerve growth factors.

Methods: Blood sampling was performed to test serum 25(OH)D levels. Patients filled out their worst pain intensity using the Zoster Brief Pain Inventory questionnaire. The score was reported in Likert score (0-10), 0 indicating no pain and 10 indicating the most severe pain. Spearman correlation test was used, and p 0.05) and PHN durations (p …

Non-Pustular Annular Psoriasis With Signs Of High Disease Activity, Nevi Yasnova, Windy Keumala Budianti, Melody Febriana Andardewi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Non-pustular annular psoriasis is a rare condition in which a type of plaque psoriasis appears with ring-like lesions and a clearer central appearance. The disease activities in psoriasis may be evaluated clinically. It is essential to provide a more meaningful approach to treatment management.

Case illustration: A 33-year-old woman complained of a one-year history of multiple erythematous, scaly, and annular plaques with central clearing. Some lesions were surrounded by discrete pinpoint papules on several parts of her body. The lesions worsened during seven weeks of topical and systemic therapy.

Discussion: Psoriasis is a chronic, multisystem inflammatory …

Haircare Practice And Dandruff Problems Among Indonesian Medical Students, Jessica Rosemary Wikanto, Lorettha Wijaya, Yunisa Astiarani, Regina Regina

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Dandruff is an understated hair and scalp problem that causes striking social and concentration issues among medical students. Haircare practice among them may or may not be related to the dandruff incident.

Methods: A cross-sectional study was conducted on 74 pre-clinical medical students at Atma Jaya Catholic University of Indonesia. Trained health staff assessed dandruff prevalence by physical examination, and the haircare practice was measured using a questionnaire. Bivariate analysis was utilized to assess the association between haircare practice and dandruff prevalence’s.

Result: Among respondents, 85.1% of them have dandruff. Respondents who shampooed less than five …

A Case Of Longitudinal Melanonychia In A Child: Benign Or Malignant?, Heffi Anindya Putri, Ennesta Asri, Qaira Anum

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Longitudinal melanonychia (LM) describes a longitudinal brown-to-black band of discoloration affecting a finger, thumb, or toenail. Discoloration of the nails can be a sign of benign or malignant nail disorders. Although nail melanoma rarely occurs in children, health practitioners should be aware of melanonychia. Dermoscopy and histopathology are helpful in the diagnosis.

Case Illustration: A case of LM in a thirteen-year-old girl was reported with a complaint of brownish-black discoloration, sometimes painful, on her right thumb since 1 year ago. She had no history of trauma, nail damage, or bleeding tendency. Dermatological examination found a homogeneous brownish-black …

Seborrheic Keratosis Profile At Dr. Hasan Sadikin Central General Hospital Bandung 2015-2019, Eva Krishna Sutedja, Resti Gradia, Tri Aswila Latifah

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Seborrheic keratosis (SK) is adults’ most prevalent benign skin tumor. SK originates from the proliferation of keratinocyte cells with varying morphology and degree of pigmentation. The lesions often resemble other types of malignancy. There are still many discrepancies in SK in Indonesia; hence, SK needs further understanding. This study aimed to describe the profile of seborrheic keratosis cases based on age, sex, location of lesions, and therapy at Dr. Hasan Sadikin Central General Hospital, Bandung, for five years

Methods: This was a retrospective descriptive study with total sampling. Secondary data were collected from medical records of SK …

Clinicodemographic And Laboratory Characteristics Of Cutaneous Tuberculosis At Tertiary Referral Hospital In West Java, Indonesia, Anisa Sediadini, Hendra Gunawan, Risa Miliawati Nurul Hidayah

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cutaneous tuberculosis (TB) is a chronic infectious disease affecting the skin caused by Mycobacterium tuberculosis (M. tuberculosis). It constitutes 1–1.5% of extrapulmonary TB, with Indonesia being the third-highest TB burden country worldwide. Cutaneous TB is difficult to diagnose due to its varied presentations. This study aimed to describe the clinicodemographic and laboratory characteristics of cutaneous TB in a tertiary referral hospital in West Java, Indonesia.

Methods: This was a descriptive retrospective cross-sectional study. Data were obtained from the medical record of patients with cutaneous TB in the Tropical Dermatology Clinic of Hasan Sadikin Hospital Bandung, West Java, …

Clinicodemographic Characteristics Of Cutaneous Larva Migrans: A 10-Year Study In Tertiary Referral Hospital-West Java, Indonesia, Tuesi Fredella Avissa, Hendra Gunawan, Risa Miliawati Nurul Hidayah

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cutaneous larva migrans (CLM) is the most common helminthic dermatosis caused by animal hookworm, commonly reported in tropical and subtropical regions. Most studies are on travellers returning from endemic areas, paradoxically very few reports in endemic countries, including Indonesia, where they mostly take place. This study aimed to describe the demographic and clinical characteristics of CLM patients for 10 years in a tertiary referral hospital in West Java, Indonesia.

Methods: This was a descriptive retrospective cross-sectional study. The data were obtained from the medical record of patients who was diagnosed as CLM in Tropical Dermatology Clinic Hasan …

Risk Factors For Hiv-Positive Status In Condyloma Acuminata, Izazi Hari Purwoko, Putri Laksmi Karim, Suroso Adi Nugroho, Theresia Toruan, Fitriani .

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Condyloma acuminata (CA) is a sexually transmitted infection (STI) caused by human papillomavirus (HPV), especially types 6 and 11. The number of HPV infections increases in immunosuppressed conditions, such as human immunodeficiency virus (HIV) infection. Risk factors in CA patients such as gender, sexual partner, sexual orientation, and sexual intercourse can increase HIV status.

Methods: This is a descriptive-analytic study with a cohort retrospective design. The subjects are all CA patients who visited the polyclinic STI Dr. Mohammad Hoesin, General Hospital, Palembang, Indonesia, between 2016-2020. The number of CA patients included in the study were 115 patients …

Congenital Giant Juvenile Xanthogranuloma, Let It Be, Michael Carletti, Daniel A. Nguyen, Joseph S. Susa, Stephen E. Weis

HCA Healthcare Journal of Medicine

Juvenile xanthogranuloma (JXG) is a rare type of non-Langerhans cell histiocytosis. JXGs are benign and have a self-limiting course generally lasting 6 months to 3 years, with some reported durations longer than 6 years. We present a rarer congenital giant variant, defined as lesions with a diameter larger than 2 cm. It is uncertain if the natural history of giant xanthogranulomas is similar to the usual JXG. We followed a 5-month-old patient with a 3.5 cm in diameter, histopathologically-confirmed, congenital, giant JXG located on the right side of her upper back. The patient was seen every 6 months for 2.5 …

Establishment Of An In Vivo Streptozotocin-Induced Type 1 Diabetes Model Recapitulating Early Brain And Retinal Fibrosis, Kia Bourdot, Lucy Dawson, Igor Kuzin, Arturo Bravo Nuevo, Zeus Antonello

Cooper Rowan Medical Journal

INTRODUCTION: Diabetes has risen to one of the top American public health concerns. The hyperglycemic state of chronic diabetes leads to microvascular and macrovascular changes that predispose patients to delayed wound healing and organ fibrosis. The validation of models to specifically detect early, quantifiable fibrotic changes seen in the diabetic state is of fundamental importance for understanding the diabetic pathophysiology and exploring earlier management options. Here, we investigated if we could detect early signs of internal fibrosis in a streptozotocin (STZ) diabetic mouse model by quantifying α-SMA expression in various organs using flow cytometry.

METHODS: We used a low-dose STZ-induced …

Evaluation Of Internalized Stigma And Quality Of Life Of Patients With Psoriasis, Bedriye Cansu Demirkiran, Emine Kiyak

Makara Journal of Health Research

Background: Internalized stigma is defined as individuals’ acceptance of negative stereotypes created by society and then their alienation from society. Psoriasis is a dermatological disease that affects the quality of life. The study evaluated the internalized stigma and quality of life of patients diagnosed with psoriasis.

Methods: This cross sectional study enrolled 222 patients. Data were collected using the internalized stigma scale and the dermatology life quality index questionnaires. Data were analyzed using the Cronbach’s alpha.

Results: The internalized stigma score of the patients was 78.41 ± 23.14, and the quality of life score was 12.30 ± …

A Patient Perspective On Information Provision During The Care Path Of Lentigo Maligna, Louis P. Ter Meer, Marleen De Mul, Jan Hazelzet, Clemens Van Eijk

Patient Experience Journal

Patients sometimes experience complex diagnostic and treatment procedures. During these processes, they need to rely on the information provided by the care providers. In particular, if they would like to play an active role in the shared decision-making process, it is important that this information is accessible, complete and understandable. A patient with Lentigo Maligna on the nose has been followed during the process of diagnosis, shared decision-making and treatment. Using the autoethnographical methodology, it was evaluated which sources of information available to the patient contributed to a better understanding, a more active role in the treatment process and a …

Modification Of The Tumor Microenvironment Enhances Anti-Pd-1 Immunotherapy In Metastatic Melanoma, Guilan Shi, Megan Scott, Cathryn G. Mangiamele, Richard Heller

Bioelectrics Publications

Resistance to checkpoint-blockade treatments is a challenge in the clinic. Both primary and acquired resistance have become major obstacles, greatly limiting the long-lasting effects and wide application of blockade therapy. Many patients with metastatic melanoma eventually require further therapy. The absence of T-cell infiltration to the tumor site is a well-accepted contributor limiting immune checkpoint inhibitor efficacy. In this study, we combined intratumoral injection of plasmid IL-12 with electrotransfer and anti-PD-1 in metastatic B16F10 melanoma tumor model to increase tumor-infiltrating lymphocytes and improve therapeutic efficacy. We showed that effective anti-tumor responses required a subset of tumor-infiltrating CD8⁺ and CD4 …

Pleomorphic Dermal Sarcoma: A Clinical And Histopathologic Emulator Of Atypical Fibroxanthoma, But Different Biologic Behavior, Michael Carletti, Daniel A. Nguyen, Peter Malouf, Zachary Ingersoll, Gregory A. Hosler, Stephen E. Weis

HCA Healthcare Journal of Medicine

Pleomorphic dermal sarcoma (PDS) can clinically and histopathologically mimic atypical fibroxanthoma (AFX). However, it has a more aggressive clinical course with a higher recurrence rate and metastatic potential. This case presentation aims to report a rapidly-growing, exophytic, 4 cm tumor following a non-diagnostic shave biopsy 2 months prior and to highlight distinctive features between PDS and AFX needed to make the correct diagnosis. Like AFX, PDS occurs on the sun-damaged skin of the elderly, usually on the head and neck. Also, like AFX, PDS histopathologically consists of sheets or fascicles of epithelioid and/or spindle-shaped cells, often with multinucleation, pleomorphism, and …

Innovative Therapeutic Approach To Chemical Burns Produced By Vesicants; An Experimental Study, Cristina Anca Secara, Otilia Liudmila Cinteza, Diana Popescu, Claudia Valentina Popa, Camelia Andreea Hirjeu, Oana Cristina Voinea, Luiza Georgia Serbanescu, Andreea Marilena Pauna, Mihail Tudosie

Journal of Mind and Medical Sciences

Vesicants are compounds that cause severe toxic effects on various tissues. Such chemical action causes tissue necrosis, with clinical expression of skin lesions with a burning character and characteristic blisters. Clinical toxic effects of cutaneous vesicles are correlated with the absorbed dose and exposure time. The goals of the study are to evaluate in vitro the skin toxicity produced by the vesicant chemical compound 2-chloroethyl-ethyl sulfide (CEES), to develop a complex antidote formula, and to optimize the therapeutic efficacy by inclusion in controlled release systems. The experimental protocol aims at the in vitro evaluation of the cytotoxicity of the vesicant …

Coexistence Of Cutaneous Squamous Cell Carcinoma And Basal Cell Carcinoma In A Renal Transplant Recipient: A Case Report., Diana Voloshyna, Tanveer Ahamad Shaik, Sunita Shrestha, Ajmat Ansari, Faraz Saleem, Muhammad Abu Zar Ghaffari

Faculty Scholarship

In solid organ transplant patients, non-melanoma skin cancer remains a leading cause of mortality. The most common skin malignancies in solid organ transplant patients are squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). In organ transplant patients, SCC is 100 times more prevalent, and BCC is 10 times more prevalent than in the general population. Many risk factors for developing such malignancies are equivalent to those in the general population. However, in the transplant population, such cancers occur at an earlier age, act more aggressively, and often appear at multiple locations. Thus, assiduousness on the patient's part and healthcare …

Acyclovir-Resistant Anogenital Herpes Simplex Virus In An Hiv Patient With Pseudoepitheliomatous Hyperplasia Resembling Squamous Cell Carcinoma, Jean Elizze M. Charles, Stephen E. Weis, Gregory A. Hosler

HCA Healthcare Journal of Medicine

Background

Herpes simplex virus (HSV) is a common infection. However, it may present atypically when patients are immunocompromised, such as with slowly expanding, long-lasting ulcerative or hypertrophic lesions. The histopathologic finding of pseudoepitheliomatous hyperplasia (PEH) can occur in a variety of situations where there is chronic inflammation and can be seen in patients with chronic HSV. Atypical presentations of HSV, particularly hypertrophic lesions with histopathologic findings of PEH, can be misinterpreted as squamous cell carcinoma, create difficulty in diagnosis and hinder appropriate treatment.

Case Description

We report a case of a 59-year-old female with a past medical history of human …

Relieving Immune Suppression In The Melanoma Tumor Microenvironment, Gretel Torres Santiesteban

Dartmouth College Ph.D Dissertations

The high immunogenicity of melanoma tumors makes these malignancies an attractive target for immunotherapeutic treatment, as evidenced by the success of ipilimumab and nivolumab. However, most immunotherapeutic approaches have had limited success, partly due to the suppression of innate and adaptive immune responses by tumor-associated macrophages (TAMs) in the tumor microenvironment (TME). TAM redirection may relieve immunosuppression in the TME, directly inhibiting melanoma growth and potentially enhancing the efficacy of additional targeted and immuno-therapies.

We have shown that synthetic oleanane triterpenoid CDDO-Me (or C-Me) enhances immune activation in the melanoma TME by reprogramming TAMs from immunosuppressive to immunostimulatory. CDDO-Me is …

Rna Isolation In Duchenne Muscular Dystrophy (Dmd) Mice Models, Salem Abu Al-Burak

Undergraduate Student Research Internships Conference

Fibrosis is a progressive and typically irreversible disease process characterized by the excessive deposition of collagen in organs and in tissues of the musculoskeletal (MSK) system^1,2. This process, which causes loss of organ and tissue function, can be initiated by micro-traumas³, an excessive and/or prolonged immune response¹, the activation and proliferation of fibrosis-inducing progenitor cells⁴, and a pro-fibrotic extra-cellular microenvironment⁵. In parallel with the events that initiate fibrosis, genetic or environmental influences may cause cells and tissues to become predisposed to fibrosis development prior to initiation. This suggests that these …

Control Of Scabies In A Boarding School Using 5% Permethrin Applied On Lesion Only, Saleha Sungkar, Sri Wahdini, Aria Kekalih, Risa Rilanda, Hansen Angkasa, Sandra Widaty

ASEAN Journal of Community Engagement

Scabies is one of the most neglected tropical skin diseases in Indonesia. It is usually found in overcrowded communities with poor hygiene. The gold standard for scabies treatment is the whole-body topical application of 5% permethrin cream. However, the treatment causes inconvenience and stickiness for a prolonged period. The modification of topical treatment by applying only to the lesion yielded results similar with whole-body topical application. We consider using this mode of treatment to control the disease in a boarding school. The study was conducted from June to August 2019. All students were examined by dermatologists, and individuals who were …

Reporting Of Mycetoma Cases From Skin And Soft Tissue Biopsies Over A Period Of Ten Years: A Single Center Report And Literature Review From Pakistan, Mohammad Zeeshan, Saira Fatima, Joveria Farooqi, Kauser Jabeen, Arsalan Ahmed, Afreen Haq, Muhammad Omer Arif, Afia Zafar

Department of Pathology and Laboratory Medicine

Background: Mycetoma is an important neglected tropical disease associated with debilitation, disfigurement and death if not diagnosed and treated adequately. In Pakistan, mycetoma cases have frequently been diagnosed in histopathology and microbiology laboratories. However, there is scarcity of published data from this country. Therefore, the objectives of this study were to evaluate the frequency and type of mycetoma reported in skin and soft tissue biopsies from a single center over 10 years and review of published literature from Pakistan.
Method: This descriptive observational retrospective study was conducted at the Aga Khan University Hospital laboratory, Karachi, Pakistan. Laboratory data from 2009-2018 …

Bacterial Sensitivity Pattern To Antibiotics In Acne Vulgaris At Universitas Sumatera Utara Hospital Medan, Indonesia In 2019, Lovena Sari, Nelva Karmila Jusuf, Imam Budi Putra

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 …

Comparison Between Oral Pentoxifylline + Corticosteroid Andoral Corticosteroid Alone For Severe Erythema Nodosum Leprosum, Martinus Martinus, Rahadi Rihatmadja, Sri Linuwih Menaldi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Severe erythema nodosum leprosum (ENL) is common but difficult to treat. Long term use of systemic corticosteroid causes side effects. This study compares the use of a combination of pentoxifylline + oral corticosteroids with a single oral corticosteroid in leprosy patients with severe ENL reactions. Parameters measured include skin RSA score, systemic RSA, total corticosteroid dose, resolution time of skin lesions, improvement of pain VAS and treatment side effects.
Methods: 29 subjects with severe ENL reactions are allocated randomly into two groups which receive oral pentoxifylline + methylprednisolone, and oral placebo + methylprednisolone for 12 weeks. The …

Combined Use Of Cross Tca And Modified Subcision With Prp Administration For Acne Scars, Ahmad Fiqri, Moerbono Mochtar, Dendy Zulfikar

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris is a skin disease that can cause permanent scarring. Various therapeutic options are available to treat atrophic scars, but combination therapy is still the best choice according to different types of scars in a single patient. Chemical reconstruction of skin scars (CROSS) trichloroacetic acid (TCA), modified subcutaneous incisionless (subcision), and platelet-rich plasma (PRP) can be used as a combination therapy to treat acne scars.
Case Illustration: A 25-year-old man complained of acne scars on both sides of his face. Dermatologic findings were blackheads, icepick, boxcar, and rolling scars. Clinically he had moderate to severe acne …

Cutaneous Manifestation Of Thyroid Carcinoma In A 64-Year-Old Filipino Woman: A Case Report, Andrean Linata, Benedicto Dl Carpio, Eileen Regalado-Morales

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cutaneous metastasis is a rare phenomenon of thyroid carcinoma. Several mechanisms regarding cutaneous metastasis from internal malignancies have been proposed. Various treatment options are available, including surgical procedures, radioiodine therapy, thyroid hormone therapy, and other possible therapies. The prognosis of thyroid carcinoma with cutaneous manifestation is poor.
Case Illustration: We presented a case of 64-year-old female patient with previously diagnosed thyroid carcinoma admitted with enlarged and tender nodules on the right side of the anterior neck. No surgical intervention was done and patient was treated with chemotherapy using doxorubicin 80 mg as the agent of choice. Levothyroxine …

Allergen Profile Of Facial Acd To Cosmetics Among Patients At Tertiary Referral Hospital In Yogyakarta, Alessandro Alfieri, Niken Indrastuti, Sri Awalia Febriana, Satiti Retno Pudjiati, Fajar Waskito

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cosmetics are a part of life for most of the population and may cause allergic contact dermatitis (ACD), especially on the face, as the primary exposure of cosmetics is on the face area.
Methods: This research was conducted retrospectively using secondary data. The research subjects and demographic data were taken from the registered list of patients at Dermatology and Venereology Outpatient Clinic Dr. Sardjito General Hospital with a clinical picture of facial ACD due to cosmetics. Patch tests were carried out from January 2017 to December 2020.
Results: From three years period, 26 patients were diagnosed …

Microneedling And Platelet-Rich Plasma (Prp) Treatment For Mixed Melasma, Puteri Wulandari, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Melasma, or chloasma, is an acquired pigmentary disorder caused by increased melanin in the epidermal and dermal layers, characterized by brown or gray patches on the face and neck. There are many treatment options available; however, the difficulties in treating melasma are frequent recalcitrants, high recurrence rate, irregularity in treatment, and the tendency of the patients to self-medicate.
Case Ilustration: We report a case of mixed melasma treated by microneedling and topical PRP administration. Thirteen weeks following the therapy, the patient showed a favorable response brighter skin and substantial disappearance of brown patches.
Discussion: Studies assessing …

The Vaginal Microbiota, Indah Kencana, Satya Wydya Yenny

Journal of General - Procedural Dermatology & Venereology Indonesia

The vagina is an ecosystem consisting of various species of microorganisms (microbiota) that play important role in maintaining vaginal health. The vaginal ecosystem includes a variety of species classified into aerobic and anaerobic microorganisms which are vaginal microbiota (VMB). In the vagina of a healthy woman, 70% of normal microbiota is dominated by the Lactobacillus species. Lactobacillus is a Gram-positive, anaerobic bacterium, and belongs to the group of lactic acid bacteria (LAB). LAB produces lactic acid which plays a role in maintaining vaginal acidity at pH