Integumentary System Commons^™

The Epidemiology Of Skin Cancer At Dr. Cipto Mangunkusumo National Central General Hospital From 2014 To 2017, Larisa Paramitha Wibawa, Melody Febriana Andardewi, Inge Adi Kristanti, Riesye Arisanty

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: The incidence of skin cancer has been increasing over the past decades globally. At present, there is no valid national cancer data in Indonesia. The purpose of this study is to evaluate the increment of skin cancer cases at Dr. Cipto Mangunkusumo National General Hospital, Jakarta.

Methods: In this retrospective descriptive study, we evaluated all pigmented skin tumor cases from June 2014 to June 2017. Data were obtained from the Department of Anatomical Pathology and medical records at Dr. Cipto Mangunkusumo National General Hospital. Data were compared with previous reports.

Results: From 263 skin cancer cases, …

Langerhans Cell Histiocytosis: Diagnosis And Management, Lusiana Lusiana, Hikari Ambara Sjakti, Githa Rahmayunita, Tjut Nurul Alam Jacoeb, Inge Ade Krisanti

Journal of General - Procedural Dermatology & Venereology Indonesia

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by abnormal clonal proliferation of Langerhans dendritic cells. The incidence of LCH is 1 to 3 cases per 1 million children worldwide, and occurs most frequently in children of 1–4 years of age. The etiopathogenesis of LCH, whether it is neoplastic or reactive, is still controversial. Langerhans cell histiocytosis has a wide spectrum of clinical features, and dermatological abnormalities usually occur early. The most frequent lesions are elevated yellowish-red translucent papules about 1–2 mm in diameter and generally located in seborrheic areas. The most recent classification (the Histiocyte Society study 2017) …

Recurrent Basal Cell Carcinoma With Maxillary Bone Invasion, Adhimukti T. Sampurna, Eva Riani, Inge Ade Kristanti, Yayi Dwina, Kuniaki Ohara

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Basal cell carcinoma (BCC) is a malignant, slow growing, and locally invasive skin tumor. Advanced and neglected BCC may invade adjacent structures. The 5-year recurrence rates of facial BCCs are 4.1% after excision and 2.5% after Mohs Micrographic Surgery (MMS). The number of BCC cases invading the bones of the head and neck region is limited.

Case Illustration: A 75-year-old male complained of bleeding and ulcer enlargement on the right cheek expanding to the right nasal ala for 1 month. The patient had a history of an enlarged and painful lenticular nodule with a hyperpigmented spot that …

Treatment Of Multibacillary Leprosy Following The Development Of Dapsone Hypersensitivity Syndrome, Sudarsono Sudarsono

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: World Health Organization (WHO) multi-drug therapy (MDT) is the current standard treatment for leprosy. A wide range of frequency of adverse effects caused by MDT has been reported. Dapsone hypersensitivity syndrome (DHS) is a serious adverse effect caused by dapsone. Prompt withdrawal of dapsone is important aspect in the management of DHS. Alternative regimens are needed to treat leprosy patient with DHS.

Case Illustration: A 37-year-old man with multibacillary (MB) leprosy developed DHS in 39 days after the initiation of WHO MDT. Dapsone was withdrawn and methylprednisolone of 75 mg/day was prescribed. Twelve days after admission the …

The Use Of Systemic Medications In Pediatric Dermatoses: A Review, Shanthi Narla, Githa Rahmayunita, Rinadewi Astriningrum, Tor Shwayder, Ariyati Yosi, Henry W. Lim

Journal of General - Procedural Dermatology & Venereology Indonesia

Research has begun to illustrate a favorable efficacy and side-effect profile for many systemic agents used in pediatric dermatological conditions (i.e. atopic dermatitis, psoriasis, scleroderma, alopecia areata, chronic spontaneous urticaria, autoimmune blistering disorders, and hidradenitis suppurativa) despite not having extensive randomized clinical trials. The purpose of this article is to summarize the available data on the treatment regiments, safety, and efficacy of systemic immunosuppressants, including the newer biologics, focusing on the most up-to-date systematic reviews or randomized clinical trials. The review demonstrates that many of the present studies lack data on long-term efficacy and consist of small patient populations. Further …

Prevalence And Risk Factors Of Bacterial Vaginosis Among Female Sex Workers In Surakarta, Rini Hastuti, Danu Yuliarto, Agung Triana, Willa Damayanti, Rakhma Tri Irfanti, Mardiana Mardiana, Putti Fatiharani Dewi, Ambar Aliwardani, Ervianti Abas, Sulistyo Sulistyo, Prasetyadi Mawardi, Endra Yustin Ellistasari

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age and increases the risk of acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). Data regarding the association between sexual activity and BV acquisition is contradictory. Thus, tracking the prevalence and associated risk factors of BV among female sex workers (FSWs) is necessary to improve our understanding and control of STDs and the HIV epidemic.

Methods: The subjects of this study were FSWs in Surakarta. This study adopted a cross-sectional design, and diagnosis was established using Amsel criteria. Interviews were conducted …

A Case Of Ana-Negative Systemic Sclerosis Treated With Methylprednisolone, Carminda P. Rogacion, Veronica S, Uy, Reynaldo L. Ugalde, Emmerson Gale S. Vista

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Systemic sclerosis is a multi-systemic disease characterized by excessive fibrosis, inflammation, and vasculopathy. Common clinical features include skin thickening, telangiectasias, salt and pepper skin, beak-shaped nose, and microstomy. We report a case of ANA-negative systemic sclerosis in a male patient.

Case illustration: Our patient presented with a 10-month history of diffuse hyperpigmentation, skin tightening and decreased mouth aperture, accompanied by digital ulcers, hypopigmented macules and violaceous discoloration of the digits upon exposure to cold temperature. Punch biopsy done revealed mild acanthosis of the epidermis with basal cell layer hyperpigmentation, vacuolar alteration and thickening of the basement membrane …

Dapsone Hypersensitivity Syndrome Overlaps Reversal Reaction In Leprosy Patient, Chesia Christiani Liuwan, Medhi Denisa, M Yulianto Listiawan

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Leprosy is a chronic granulomatous infectious disease that primarily involves the skin and peripheral nerve and is caused by Mycobacterium leprae. Clinical features may vary depending on the patient’s immune response. Reversal reaction due to increased immunity is common after treatment in patients with borderline leprosy. Dapsone hypersensitivity syndrome (DHS) is an adverse effect from dapsone therapy that may occur in 5-6 weeks to 6 months after initial treatment.

Case Illustration: A 47-year-old female complained of a spreading red patches on the skin of her trunk and extremities for three weeks duration. She also felt itchiness and …

Recurrent Perianal Wart Therapy With 90% Trichloroacetate (Tca) Solution In Aids Patients, Sri Linuwih Sw Menaldi, Ika Anggraini, Hanny Nilasari

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Being the most commonly found sexually-transmitted infection (STI), anogenital warts are mainly caused by human papilloma virus (HPV) type 6 and 11. These infections are often recurrent, leading to loss of time and medical expenses. Various therapeutic modalities can be chosen singularly or in combination with varying results. Treatments with less responsive results usually occur when acquired comorbidities are present, such as HIV infection.

Case Illustration: A 28-year-old homosexual male was reported to have a recurrent perianal wart for the duration of eight months. He was also diagnosed with AIDS and pulmonary tuberculosis. Initially, patient was treated …

Efficacy And Safety Of 5% Imiquimod Cream Compared To 10% Koh Solution For Elimination Of Molluscum Contagiosum Lesions In Adults, Marsha Bianti, Agung Muhammad Rheza, Arinda Marina, Rizka Farah Hilma, Sarah Mahri, Teffy Nuary, Rahadi Rihatmadja

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Molluscum contagiosum (MC) is a benign infection caused by the Molluscipox virus that most often affects children and sexually active adolescents. Various topical therapeutic options are available, however, no single intervention is convincingly effective. Potassium hydroxide (KOH) solution is widely used but its usefulness is hampered with adverse effects. Newer preparation, 5% imiquimod cream seems to be as, if not more, effective. However, it is not legally available yet in Indonesia.

Aim: To assess the efficacy and safety of 5% imiquimod cream in treating adult molluscum contagiosum.

Methods: Literature search was done through Pubmed, EBSCO, dan …

Efficacy Of Inosine Pranobex As An Adjuvant Oral Therapy In Anogenital Warts: An Evidence-Based Case Report, Benny Nelson, Indina Sastrini, Lidwina Anissa, Patricsia Manalu, Peppy Fourina, Rahmaniar Desianti Kuraga, Wresti Indriatmi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Human papillomavirus (HPV) causes the most prevalent sexually transmitted infection and is an important etiological factor in genital cancer. HPV infection manifests in broad spectrum, from genital warts to cervical intraepithelial neoplasia and cancers. Genital warts remain a frequent problem in primary care. Current modalities provide unsatisfactory result in curing genital warts completely. To date, there are many convincing studies encouraging oral inosine pranobex as an adjuvant therapy to improve post-conventional therapy cure-rate.

Aim: To assess the efficacy of inosine pranobex as an adjuvant oral therapy in anogenital warts.

Methods: Literature search was performed using Pubmed, …

Ulcus Vulvae Acutum - A Rare Case, Irene Dorthy Santoso, Ika Anggraini, Wresti Indriatmi, Yudo Irawan, Hanny Nilasari, Melani Marissa, Sondang P. Sirait, Rahadi Rihatmadja

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy.

Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of …

The Effect Of Face Washing Frequency On Acne Vulgaris Patients, Rini Hastuti, Etty Farida Mustifah, Imroatul Ulya, Muhammad Risman, Prasetyadi Mawardi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Patients with acne often wash their faces twice a day, but there are not many studies supporting this practice.

Methods: A single-blind randomized clinical trial was conducted in 38 subjects, divided into three groups based on face washing frequency (once, twice, and thrice a day). All groups used the same cleanser. The acne vulgaris severity and the number of lesions were assessed prior to study. After eight weeks, we re-assessed the acne severity, the number of lesions, the adverse event and patient’s self-evaluation. SPSS 17 was used to analyze the face washing frequency and the number of …

Influence Of Demodex Mites On Life Quality Of Patients With Acne And Rosacea, Anzhela Kravchenko

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy.

Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of …

Clinical Diagnostic Matrix (Cdm) As A Tool To Diagnose Subtypes Of Epidermolysis Bullosa Cases In Children, Suci Widhiati, Benazier Marcella, Susanti Rosmala Dewi, Anggana Rafika Paramitasari, Endra Yustin Ellistari, Indah Julianto

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Epidermolysis bullosa (EB) is a rare genetic skin disease characterized by trauma-induced blisters, which appear shortly after birth. Immunofluorescence antigen mapping and mutational analysis are essential for establishing an accurate diagnosis of EB. However, in limited resource settings like in Indonesia, such techniques are not always readily available, forcing many clinicians to diagnose EB based on clinical features alone that is often inaccurate. Recently, a novel clinical diagnostic matrix (CDM) tool has been developed to improve the diagnostic accuracy of EB in such settings.

Case Illustration: We examined clinical photographs and medical records of patients registered at …

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz M.D.

Stratford Campus Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …

Human Anatomy And Physiology I: Course Map With Expected Learning Outcomes, Carlos Liachovitzky

Open Educational Resources

This document contains a list with all the Anatomy and Physiology I expected learning outcomes organized by topics, and grouped into ten units: 1. Introduction to A&P: body plan & organization; 2. Introduction to A&P: homeostasis; 3. The chemical level of organization; 4. Levels of organization: the cellular level of organization; 5. Levels of organization: the tissue level of organization; 6. Support and movement: integumentary system; 7. Support and movement: skeletal system & articulations; 8. Support and movement: muscular system; 9. Regulation, integration, and control: nervous system; 10. Regulation, integration, and control: special senses

Each learning outcome is referred to …

Efficacy Of Low Level Laser Therapy In The Treatment Of Postherpetic Neuralgia, Lili Legiawati, Marsha Bianti

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and defined as pain that persists for more than 90 days after the onset of HZ rash. The chronic pain of PHN is debilitating and often associated with significant morbidity. It is a neuropathic pain and manifests as allodynia, hyperalgesia, or spontaneous pain. Although it is not considered to be life-threatening, sometime HZ is inadequately treated and may result in more severe PHN. Various treatment protocols for PHN are available; however, the result remains unsatisfactorily. The use of low level laser therapy (LLLT) in pain management …

Eccrine Poroma: The Prominent Mimicker, Nahla Shihab, Inge Ade Kristanti, Adhimukti T. Sampurna, Larisa Paramitha Wibawa

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Eccrine poroma (EP) is an adnexal benign tumor arising from the eccrine duct epithelium. The appearance of EP can mimic benign and malignant skin tumors, thus often making the diagnosis delayed or inaccurate.

Case Illustration: We report two cases of EP, with clinical and dermoscopic features mimicking Bowen’s disease, verruca vulgaris, pyogenic granuloma, skin metastases of breast cancer, and amelanotic melanoma. Both patients were surgically excised and biopsied. Histopathology examination of both cases revealed eccrine poroma.

Discussion: Both cases showed similarity with the theories, that EP is most found in middle age population and its predilection …

Cumulative Exposure To Solar Ultraviolet A & B Increases Apoptosis Of Peripheral Blood Cutaneous Lymphocyte Antigen (Cla)+ T-Lymphocytes In Outdoor Workers, Afif Nurul Hidayati, Saut Sahat Pohan, Widodo J. Pudjirahardjo, Isaac Effendy

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Exposure to ultraviolet A & B (UVA-UVB) plays a role in the survival of human life, but it may cause negative effects, such as immunosuppression and skin cancer. The effect of solar UVA-UVB exposure on apoptosis (Bax/Bcl-2 ratio) of peripheral blood cutaneous lymphocyte antigen (CLA)+ T-lymphocyte; the immune competent cells in the skin, has not been investigated. Apoptosis of peripheral blood CLA+ Tlymphocyte affects its function; which serves as the skin's resistance and is involved in infectious diseases, skin inflammation, and malignancies. This study observed the effect of solar UVA-UVB to apoptosis (Bax/Bcl2 ratio) of peripheral blood CLA+ …