Integumentary System Commons^™

Diagnostic Procedures In Pediatric Dermatology, Arini Astasari Widodo, Githa Rahmayunita, Triana Agustin, Rinadewi Astriningrum

Journal of General - Procedural Dermatology and Venereology Indonesia

Diagnostic procedures in pediatric dermatology are different and significantly more challenging than those in adult patients, especially on how to approach the patients. We need to acknowledge that pediatric patients have unique anatomical, physiological, and psychological aspects. Compared to adults, children have smaller procedure area, are less cooperative, and more difficult to understand. For these reasons, we should perform diagnostic procedures on children cautiously. Having extensive knowledge in this field can facilitate us to carry out an ethical, efficient, targeted procedure with less risk. This article reviewed the most appropriate, most comfortable, and least invasive diagnostic procedures for children. Some …

Profile Of Vitiligo Patients And Distribution Of Narrowband-Uvb Therapy At Dr. Cipto Mangunkusumo General Hospital, Lis Surachmiati Suseno, Putu Martha Gerynda Sukma, Rahadi Rihatmadja, Triana Agustin, Githa Rahmayunita, Endi Novianto

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Vitiligo is a disease marked by depigmented macules. Prevalence of vitiligo varies between 0.1- 2.3% worldwide. The objectives of this study are to identify the socio-demographic profile of vitiligo patients and distribution of narrowband-UVB given as a treatment modality. However, in Indonesia, including at dr. Cipto Mangunkusumo General Hospital, there has not been any study on the profile of vitiligo patients. Therefore, a preliminary study on the patients’ profile would be very useful for healthcare providers in calculating the need for narrowband-UVB equipment and evaluation of its current use.

Methods: A retrospective descriptive study, using secondary data …

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 and 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+ …

Double-Blind Randomized Trials Once A Week Narrowband Ultraviolet B (Nb-Uvb) Phototherapy In Vitiligo, Retno Dwi Utami, Mira Trisna Murti, Muhammad Risman, Arie Kusumawardhani

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Vitiligo is a skin pigmentation disorder, affecting approximately 1-2% population worldwide. Currently, there are wide varieties of treatment to achieve re-pigmentation, and phototherapy is one of the effective treatments. Narrowband ultraviolet B (NB-UVB) is administered twice a week according to the phototherapy protocol for vitiligo. Some vitiligo patients have difficulty following this schedule, leading to decrease of patient’s compliance. Therefore, we performed study comparing the efficacy of phototherapy frequency, once a week and twice a week NB-UVB in vitiligo.

Methods: This preliminary study divided 10 patients into 2 groups of 5 patients each with randomized, double-blind method. …

Non-Standard Patch Test, Astri Adelia, Windy Keumala Budianti, Melani Marissa, Evita Halim Effendi

Journal of General - Procedural Dermatology and Venereology Indonesia

In managing contact dermatitis, identification of the causative agent is essential to prevent recurrent complaints. Patch test is the gold standard to identify the causative agent. Nowadays, there are many patch test standard materials available in the market, but do not include all the materials that potentially cause contact dermatitis. Patch test using patient’s own products or later we refer to as non-standard materials, is very helpful in identifying the causative agents of contact dermatitis. Guidance is needed in producing non-standard patch test materials in order to avoid test results discrepancy.

Comparative Study Of Two Diagnostic Methods Of Demodicosis In Patients With Acne And Rosacea, Anzhela Kravchenko

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Demodicosis is a disease, caused by parasitisation of the opportunistic parasites from the acariasis group – Demodex mites. This article presents a comparative study of two methods (light microscopy of skin scrapings and confocal laser scanning in vivo microscopy) for identification of Demodex mites on the facial skin in acne and rosacea patients. The use of confocal laser scanning in vivo microscopy in dermatology today is considered as one of the most promising methods.

Methods: A total of 90 subjects were included in the study, comprising 30 patients with acne and rosacea complicated by demodicosis, 30 patients …

Darier-White Disease: A Rare Genetic Disorder, Cara Lynn Marie N. Chia, Ma. Teresita G. Gabriel, Leilani R. Senador, Ciara Mae Dela Cruz

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The clinical manifestation of Darier-White disease, an autosomal dominant genodermatosis, are greasy hyperkeratotic papules in seborrheic regions with nail abnormalities and mucous membrane changes due to a defective sarcoendoplasmic calcium pump. The clinical appearance and unpleasant odor in some sites of the lesions may cause psychosocial disturbances and pose a major morbidity.

Case Illustration: We report a case of a 20-year old female with clinical manifestations of multiple erythematous to hyperpigmented hyperkeratotic papules, multiple flesh-colored keratotic papules with red and white longitudinal bands on dystrophic fingernails, as well as plantar pits. Skin punch biopsy was performed to …

The Comparison Of Skin Irritation Level Between Topical Cajeput Oil And Telon Oil: A Pilot Study, Sri Esa Ilona, Aris Cahyono, Endra Yustin Ellistasari, Muh. Eko Irawanto, Harijono Kariosentono

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Cajuputi/Cajeput/Melalueca leucadendron oil is a type of essential oil, widely known and used by Indonesian for infants, children, and elderly. It is also included in telon oil compositions (±42%). Excessive application of cajeput oil and telon oil may lead to skin irritation.

Methods: This randomized single-blind control trial was conducted with 10 subjects who met the inclusion criteria. Four areas with diameter of 10 mm each were made on the flexor surface of the upper arm. Area 1 was designated as negative control. Area 2 to 4 were pre-irritated with tape stripping for 40 ± 10 times …

Severe Kerion Celsi Effectively Treated With Skin Debridement And Antifungals, Ismiralda Oke Putranti, Citra Primanita

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Kerion celsi is a severe inflamed deep abscesses form of tinea capitis which mostly occurs in children population. Despite good regular treatment with antifungals, the prognosis of kerion celsi is poor with scarring alopecia.

Case Illustration: A 5-year-old boy had history of an alopecia with locally large painful oedema on his scalp a month before treatment. From the physical examination, a painful large area with alopecia was found with abscess covered by thick crust. Pull test showed hair breakage and right retro-auricular lymphatic nodes enlargement was also found. Endo-ectothrix spores were positive in potassium-hydroxide examination and the …

The Effect Of Injection Of Adsc Compared To Appe On Collagen Density In Aging Skin (Animal Study), Erlina Pricilla, Indah Julianto, Harijono Kariosentono, Dyah R. Budiani, Yuda Heru Fibrianto, Yuyun Rindiastuti, Ainun Veraida

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Aging is a biological process that can induces changes to the structural integrity and physiological function of skin. Structural changes of skin are a result of dermal atrophy, decreased collagen, the loss of subcutaneous fat, the loss of inherent elasticity, and increased melanogen.1,5,6 From the definition itself, a stem cell characterized by its ability to self-renew and also have an ability to differentiate along multiple lineage pathways.2,4 ADSC which is a kind of mesenchymal stem cell from human adipose tissue, have some potential properties as stem cells derived from bone marrow.4,7

Objective: The aim of this study …

Seroprevalence Of Syphilis And Herpes Simplex Virus Type 2 And Its Association With Sexual Behaviour Factors (A Cross-Sectional Study Among Men Who Have Sex With Men In Manado, Indonesia), Nurdjanah J. Niode, Hendra Minarto, Andravita F. Mitaart, Grace M. Kapantow, Renate T. Kandou

Journal of General - Procedural Dermatology and Venereology Indonesia

Aims: This study investigated the seroprevalence and sexual risk behavior factors associated with syphilis and herpes simplex virus type 2 (HSV-2) among men who have sex with men (MSM), in Manado, Indonesia.

Methods: Serum samples and questionnaires regarding their socio-demographic and sexual behaviour were collected from 60 MSM in Manado. Samples were screened for anti-HSV-2 IgG for herpes, the Venereal Disease Research Laboratory (VDRL) and the Treponema Pallidum Haemagglutination (TPHA) test for syphilis. A cross sectional method was used in this study. 

Results: Of 60 MSM (median age was 20 years), 35% had homosexual orientation and 65% …

Venous Ulcer, Irene Dorthy Santoso, Hanny Nilasari, Shannaz Nadia Yusharyahya

Journal of General - Procedural Dermatology and Venereology Indonesia

Leg ulcers one common problem in the adult population to geriatric with a prevalence about 1-2%. The pattern of life which tends to be sedentary, less activity, obesity, increased the incidence of leg ulcers. The duration of healing and recurrence occurs in majority of patients contributed the decline in quality of life for patients with venous ulcers. Diagnosis, latest treatment and prevention are essential to discuss.

Photodermatoses In Children, Siti Nurani Fauziah, Wresti Indriatmi, Lili Legiawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Photodermatoses cover the skin’s abnormal reactions to sunlight, usually to its ultraviolet (UV) component or visible light. Etiologically, photodermatoses can be classified into 4 categories:  (1) immunologically mediated photodermatoses (idiopathic photodermatoses); (2) drug- or chemical-induced photosensitivity; (3) hereditary photodermatoses; and (4) photoaggravated dermatoses. The incidence of photodermatoses in the pediatric population is much lower than in adults, Polymorphous light eruption (PMLE) is the most common form of photodermatoses in children, followed by erythropoietic protoporphyria. Early diagnosis and investigations should be performed to avoid long-term complications. Photoprotection is the mainstay of photodermatoses management, including use of physical protection and sunscreen.

Efficacy Of Topical Estradiol Compared To Topical Glycolic Acid For Skin Aging Treatment In Postmenopausal Women, Shannaz Nada Yusharyahya, Marsha Bianti

Journal of General - Procedural Dermatology and Venereology Indonesia

Skin aging is a complex biological process in human being, as a result from intrinsic factors (genetic, hormonal, metabolism) and extrinsic factors (UV exposure, pollution, smoking, life style). In postmenopausal women, physiologically, the amount of estrogen are decreased, causing deterioration of their skin’s appearance.

Along with the changes that occur, skin care require more attention. A holistic approach can increase epidermal thickness, therefore, reducing the depth of wrinkles, as well as improving skin texture and moisture. There are various treatments available to improve skin appearance due to aging.

This EBCR is aimed to compare the efficacy of topical estradiol and …

Allergic Contact Dermatitis Due To Nickel In Household Detergent, Dewi Utami Putri, Irma Damayanti Roesyanto-Mahadi

Journal of General - Procedural Dermatology and Venereology Indonesia

Allergic contact dermatitis (ACD) is a cutaneous inflammatory reaction caused by contact with specific exogenous allergen to which a person has developed allergic sensitization. Nickel was reported as one of the most common causes of ACD worldwide, particularly affecting females. It is associated with a variety of nickel-containing products, from jewelry to detergent.

A 32-year-old female was presented with pruritic eruption consist of erythematous papules and vesicles on both hands and extensor forearms since 2 weeks before admission. The patient is a housewife who did handwashing clothes and kitchenware with detergent and soap every day. At first, there were erythematous …

Pattern Of Pigmentation Disorder In Cosmetic Dermatology Clinic H. Adam Malik General Hospital, Medan, 2012 - 2015, Nelva Karmila Jusuf

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Abnormalities of pigmentation is a cosmetic problem which affects the overall appearance of an individual. Pigmentation disorder are caused by the increase (hypermelanosis) or the decrease (hypomelanosis) amount of melanin.

Objective: To determine the pattern of pigmentation disorder in Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012-2015.

Methods: A retrospective study using subject's medical records from the Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012 - 2015, presented descriptively.

Results: In 2012 - 2015 the number of patients who visited the Cosmetic Dermatology Clinic were respectively 210, 228, 211, 142. …

Comparison Of Efficacy Combination Oral Terbinafine Pulse-Dosed And Topical 8% Ciclopirox Olamine With Terbinafine Monotherapy For Onychomycosis: An Evidence-Based Case Report, Marsha Bianti, Teffy Nuary, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis is a fungal infection of the nails, which manifested as nail discoloration, thickening, and detachment from the nail bed. It is not life-threatening, however inappropriate treatment of onychomycosis might lead to complications and affect the patient’s quality of life; making the management of the disease a challenge for clinicians.

Objective: Investigate the efficacy of pulse-dosed oral terbinafine combined with topical 8% ciclopirox olamine to treat onychomycosis.

Methods: Literature search was performed in Pubmed and Cochrane databases using the keywords 'combination' AND 'oral terbinafine' AND 'ciclopirox' AND ‘onychomycosis treatment’ along with their synonyms and related terms.

Results …

The Role Of Oral Vitamin D In Several Skin Diseases, Astri Adelia, Larisa Paramitha Wibawa, Adhimukti T. Sampurna, Windy K. Budianti, Farida Zubier

Journal of General - Procedural Dermatology and Venereology Indonesia

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with …

Segmental Zoster Paresis, Nahla Shihab, Erdina Hd Pusponegoro, Ahmad Yanuar

Journal of General - Procedural Dermatology and Venereology Indonesia

Herpes zoster is often associated with neurological manifestation but less frequently associated with motoric nerve involvement. The most common motoric involvement is paresis, seen only in 1-5% of all zoster cases. This case report a 39-year-old male, with recurrent abdominal liposarcoma under chemotherapy, presented with symptoms of fever, and painful and weak right leg for 2 weeks. Vesicles eruption was seen on his right leg nine days after these symptoms occurred. Physical examination revealed groups of haemorrhagic vesicles with erythematous base on the right lower leg. Lumbosacral spine x-ray showed spondylosis with radiculopathy. Electromyography (EMG) examination revealed lower motor neuron …

The Effectiveness Of Laser Therapy In Onychomycosis Patients: An Evidence-Based Case Report, Rizky Lendl Prayogo, Evangelina Lumban Gaol, Fitri Azizah, Lusiana Lusiana, Yenny Rachmawati, Yusnita Rahman, Siti Rizny Saldi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis may cause nail discoloration, thickening, nail bed separation, and other serious complications. For some cases, oral antifungal treatment is not tolerable because of its potential side effects and drug interactions. Laser therapy is considered as an alternative treatment, owing to the features of simple and effective, with only minor potential side effects. This EBCR was made to collect and appraise studies regarding the effectiveness of laser therapy for onychomycosis, and to suggest laser as an alternative treatment.

Methods: Literature searching strategy was performed using Pubmed and Cochrane Library database to address the clinical problem. Keywords used …

Challenge In Diagnosis And Management Of Lentigo Maligna And Lentigo Maligna Melanoma, Ika Anggraini, Elisa Miranda, Larisa Paramitha Wibawa, Roro Inge Ade Krisanti, Adhimukti T. Sampurna

Journal of General - Procedural Dermatology and Venereology Indonesia

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decades. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

An Analysis On Whether Or Not Baldness Can Be Reversed, Spencer Waldman

The Science Journal of the Lander College of Arts and Sciences

Many men experiencing hair loss often wonder: is there a cure? Can I get my hair regrown? This thesis addresses these very issues, the anatomy of the pilosebaceous hair, the hair growth cycle, and the suggested causes of male pattern hair loss are examined. Finally, the various drugs that have been suggested to reduce hair loss and even cause hair regrowth are reviewed. After examining the various treatments, it can be concluded with reasonable certainty that hair loss can be halted and often reversed by using FDA approved drugs finasteride and minoxidil. Other drugs such as ketoconazole and dutasteride have …

Papuloerythroderma Of Ofuji: A First Case Report From Indonesia, Graciella Regina, Listya Paramita, Sunard Radiono, Yohanes Widodo Wirohadidjojo, William R. Faber

Journal of General - Procedural Dermatology and Venereology Indonesia

Papuloerythroderma (PE) is a rare skin disease which was first described by Ofuji et al. in 1984, with a typical sign that the lesions spare the large cutaneous folds, known as the deck chair sign. Due to its recent identification, this disease is still underrecognized and may lead to misdiagnosis. We reported the first case report of PE of Ofuji from Indonesia in which the diagnosis was delayed for two years. Besides the deck chair sign in the large cutaneous fold, we also found that the area between and above his eyebrows that was relatively spared in contrast to the …

Pulsed-Dye Laser Efficacy In The Treatment Of Psoriasis In Adult Patients: An Evidence-Based Case Report, Made Ananda Krisna, Hanny Nilasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Psoriasis is a chronic inflammatory skin disease known to be highly responsive to phototherapy. Narrow-band UVB (NBUVB) phototherapy has been one of the standard treatments for its moderate to severe form. However, its lack of efficacy in treating stable psoriatic plaques on extremities has lead researchers to find alternative treatments, one of which is pulsed-dye laser (PDL). Laser has been known to be effective in treating vascular lesions; in psoriasis, elongation of rete ridge along with tortuous dermal capillaries are one of the first pathologies identified early in the disease progression. Several in vivo and preliminary studies have found the …

Occupational Skin Cancer And Precancerous Lesions, Fifinela Raissa, Githa Rahmayunita, Sri Linuwih Menaldi, Dewi Soemarko

Journal of General - Procedural Dermatology and Venereology Indonesia

Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit), ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of …

Vaginal Microbiota In Menopause, Martinus Martinus, Larisa Paramitha Wibawa, Evita Halim Effendi, Shannaz Nadia Yusharyahya, Hanny Nilasari, Wresti Indriatmi

Journal of General - Procedural Dermatology and Venereology Indonesia

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of …

Suspected Resistance Of Mdt-Mb In Multibacillary Leprosy Of Hansen's Disease: Two Case Reports, Yudo Irawan, Sri Linuwih Menaldi, Emmy Soedarmi Sd, Melani Marissa, Erika Zoulba

Journal of General - Procedural Dermatology and Venereology Indonesia

Resistance to multidrug therapy (MDT) is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH). There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB) resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB) index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI) of 15/6 and morphological index (MI) of 0.50%. The second case, a 42-year-old man came …

Neural Leprosy: A Case Report, Alida Widiawaty, Emmy Soedarmi Sjamsoe-Daili, Taruli Olivia, Sri Linuwih Menaldi, Melani Marissa, Fitri Octaviana

Journal of General - Procedural Dermatology and Venereology Indonesia

Neural leprosy is characterized by neurological deficit without skin lesions, with a prevalence ranging from 1% to 17.7%. Diagnosis might be difficult and need a multidisciplinary approach. This is a case of axonal type motor and sensory polyradiculoneuropathy of the peripheral facial nerve. A 26-year-old woman was referred from the neurology clinic with facial paralysis, suspected as leprosy. Physical examinations were as follows: no skin lesions, left eye lagophthalmos, thickening of right lateral peroneal and bilateral posterior tibial nerves, sensory impairment, peripheral bilateral facial palsy, and wasting of bilateral distal small muscles of the hands, with normal autonomic function. Nerve …

Subcutaneous Mycosis At The Department Of Dermatology And Venereology Dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013, Sammy Yahya, Sandra Widaty, Eliza Miranda, Kusmarinah Bramono, Artini Wijayanti Islami

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usually found in workers of rural tropical and subtropical area. SM occurs due to trauma along with other predisposing factors such as sex, genetic and occupation.

Aim: To identify the types of SM, its clinical findings, laboratory work-up and the treatment at the Dermatomycology Division, Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital between the year 1989 and 2013.

Method: This retrospective study collected data from medical …

Atopic Dermatitis In The Elderly, Yudo Irawan, Rahadi Rihatmadja, Lili Legiawati, Shannaz Nadia Yusharyahya, Sri Adi Sularsito

Journal of General - Procedural Dermatology and Venereology Indonesia

Atopic dermatitis (AD) is a recurrent skin inflammation accompanied by itching. The incidence of AD is increasing worldwide. AD, which persists until elderly or with an onset during elderly, is known as senile AD. It has different prevalence and clinical features from other AD stages. Senile atopic dermatitis affects males more than females, which is different from other stages of AD. Skin manifestation of senile AD is similar with the adult stage of Hanifin-Rajka criteria, but can be atypical. The typical feature of senile AD is eczematous dermatitis around a free-lesion fossa. Other common clinical manifestations are erythroderma and non- …