Integumentary System Commons^™

Drug-Induced Hypersensitivity Syndrome With Liver Injury Due To Phenytoin: A Case Report, Lorettha Wijaya, Stella Adevita, Steven Alvianto, Yoseveline Christiani, Alius Cahyadi, Raesa Yolanda

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare and severe systemic drug reaction characterized by skin involvement, internal organ complications, and hematologic disorders. Management of this condition is challenging due to its wide range of cutaneous manifestations and 10% mortality rate.

Case Illustration: A 52-year-old male presented with widespread redness throughout his body with a prior history of regular phenytoin consumption. The rash continued to spread despite the patient’s abrupt discontinuation of the suspected medication. He was diagnosed with atypical DIHS according to J-SCAR criteria and was given high-dose corticosteroid. Drastic clinical improvement was observed after nine days of therapy, …

The Spectrum Of Cutaneous Manifestations In Covid-19 Patients At Dr. Cipto Mangunkusumo Hospital, Sandra Widaty, Sri Linuwih Susetyo Wardhani Menaldi, Eliza Miranda, Melani Marissa, Hanny Nilasari, Thong Felicia Melinda, Emilina Faradila Cornain

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Cutaneous manifestations are identified in 0.2%–20% of COVID-19 cases, both in adult and pediatric patients. They can occur before, simultaneously with, or after the systemic symptoms of COVID-19. This study aims to analyze the association between cutaneous manifestations, severity, and outcomes of patients with COVID-19.

Methods: This observational study was conducted from April 2020 to April 2021 in Dr. Cipto Mangunkusumo Hospital, a referral center for COVID-19 in Jakarta, Indonesia. Medical records were used to collect demographic, clinical, and laboratory data.

Results: A total of 0.61% (31/5070) of COVID-19 cases showed cutaneous manifestations, consisting of maculopapular (80.6%), vesicular …

Telogen Effluvium Incidence In Women Wearing Hijab Compared To Non-Hijab: A Cross-Sectional Study, Sondang Pandjaitan Sirait, Sandra Widaty, Lili Legiawati, Lis Surachmiati Suseno, Roro Inge Ade Krisanti, Windy Keumala Budianti, Eliza Miranda, Rahadi Rihatmadja, Caroline Oktarina, Paulus Anung Anindita Pandelaki, Irhen Situmeang

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Hair loss is a normal experience, but if the amount of hair loss exceeds what is considered normal, it will usually cause anxiety for the patient. In Indonesia, almost every Muslim woman wears a hijab. The hijab is one of many factors believed to cause hair loss. Telogen effluvium (TE) itself is a hair cycle disorder in which the anagen phase terminates prematurely, resulting in diffuse club hair loss without scarring, and TE itself has many risk factors. The purpose of this study was to determine the relationship between the incidence of TE in women who wear hijabs …

A Prospective Study In The Treatment Of Androgenic Alopecia Using Combination Of Procapil, Capixyl, Redensyl, Garima Bansal, Rishi Bansal

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Androgenic alopecia is characterized by its diffuse loss and the miniaturization of the hair. The study aimed to assess the safety and efficacy of procapil, redensyl, capixyl, bicapil, and anagain in topical hair growth serum in androgenic alopecia.

Methods: A prospective study was conducted on 110 healthy subjects aged 18-60 with androgenic alopecia in the Department of Dermatology, Tundla, Etmadhpur. Each subject applied 1 ml of serum on a dry scalp and was followed up on the 4^th, 8^th, 12^th, and 16^th week. Mean, median, and standard deviation were calculated. A repeated measure …

Acne And The Cutaneous Microbiome: A Systematic Review Of Mechanisms And Implications For Treatments, Alicia Podwojniak, Isabella J Tan, John Sauer, Zachary Neubauer, Hanna Rothenberg, Hira Ghani, Aarushi K Parikh, Bernard Cohen

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Acne vulgaris is a pervasive skin disease characterized by inflammation of sebaceous units surrounding hair follicles. It results from the complex interplay between skin physiology and the intricate cutaneous microbiome. Current acne treatments, while effective, have major limitations, prompting a shift towards microbiome-based therapeutic approaches. This study aims to determine the relationship between acne and the cutaneous microbiome, assess the effects of current treatments on the cutaneous microbiome and explore the implications for developing new therapies. A systematic review was performed using PubMed and SCOPUS databases within the last 10 years. Methodological quality was assessed independently by two authors. The …

Efficiency Of 7-Dehydrocholesterol Vitamin-D3 Complex Cream For Xerosis And Pruritus In Elderly Women, Yulia Farida Yahya, Meirina Rahmadini, Pandu Haryo Jatmiko, M. Afif Baskara Emirzon, Dewa Ayu Bulan Nabila, Yuli Kurniawati, Theresia Lumban Toruan, Nur Riviati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Xerosis and pruritus (XP) are the most common skin conditions in the elderly, manifesting clinically as roughness, scales, fissures, and mild-to-severe itching. Vitamin D improves skin hydration, transepidermal water loss (TEWL), and regulates the immune system. We aimed to determine the efficiency of topical 7-dehydrocholesterol (DHC)-vitamin D3 complex cream in elderly patients with XP.

Methods: An experimental phase III study was performed on elderly women with XP from December 2021 to March 2022 at the Geriatric Dermatology Clinic of Dr. Mohammad Hoesin General Hospital, Palembang. Inclusion criteria were age older than 55 years, healthy or with comorbidity. The exclusion …

Chronic Cutaneous Chromoblastomycosis: A Rare Case, Nanda Earlia, Mimi Maulida, Risna Handriani, Reno Keumalazia Kamarlis, Aldilla Pradistha

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Chromoblastomycosis (CBM) is a rare, chronic granulomatous and suppurative skin infection classified as a subcutaneous mycosis. CBM has a poor prognosis with a low cure rate and a high recurrence rate. The lack of scientific data regarding the diagnosis and treatment of CBM also presents a challenge for clinicians in treating this disease. Appropriate therapy can increase the cure rate and prevent disease recurrence.

Case Illustration: A 66-year-old woman presented with swelling in her left arm since the last 18 years due to wood-related injuries. There were multiple well-defined hyperkeratotic verrucous plaques, papules, and nodules, measuring 6-10 …

Agapanthus Allergic Contact Dermatitis: A Case Report, Yasuhiro Horiuchi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Agapanthus (Lily of the Nile) is a genus in the flowering plant family Amaryllidaceae. Contact dermatitis caused by flowering plants is common, but there are no reports of contact dermatitis caused by this plant, Agapanthus.

Case Illustration: An 82-year-old Japanese man had cultivated Agapanthus in his home garden. After breaking the stem of the leaf while wearing shorts, he noticed erythematous rashes on the thighs. The patch test of the leaf stem sap “as is” showed mildly positive, with erythematous papules.

Discussion: The patch test confirmed the allergic contact dermatitis of Agapanthus with leaf stem sap. There are many …

Facial Skin Rejuvenation With Poly-L-Lactic Acid (Plla): Four Case Studies, Stanley Setiawan, Theressia Handayani, Stefani Luziani

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Facial aging is characterized by the decline and loss of skin structure. Poly-l-lactic acid (PLLA) is a biopolymer and biodegradable injection material that functions as a collagen stimulator. This active ingredient works by stimulating the formation of skin collagen after interacting with the PLLA crystal component. The expected final result is an increase in the skin volume with the thickening and increased density of the skin layers due to collagen remodeling. At present, data on the application of PLLA for facial photorejuvenation remains limited.

Case Illustration: Four patients aged 22-49 years old, with different severity of aging, underwent PLLA …

Dermoscopic And Histopathologic Findings In Diagnosing Postpartum Pemphigoid Gestationis, Rudi Chandra, Irma Damayanti Roesyanto-Mahadi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Pemphigoid gestationis (PG) is an uncommon autoimmune vesiculobullous skin disorder associated with pregnancy, that occurs during mid-to-late pregnancy and immediate postpartum period. The diagnosis of PG is based on histopathology and direct immunofluorescence. Dermoscopy is a non-invasive diagnostic tool that provides a connection between macroscopic clinical dermatology and microscopic dermatopathology.

Case Illustration: We reported a case of a 22-year-old primigravida woman with postpartum PG. This PG case was diagnosed clinically, dermoscopically, and histopathologically.

Discussion: Since PG is thought to be a variation of the bullous pemphigoid (BP), the two resemble each other clinically and immunologically. The well-defined structures with …

Immunomodulators In Leprosy: A Narrative Review, Kesya Kimberly, Siti Aisha Nabila Ferina, Prima Kartika Esti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Current therapeutic regimen, like the multidrug therapy (MDT), are effective in treating most cases, but new cases continue to emerge in Indonesia every year. While multidrug therapy alone is adequate for treating leprosy, there is a need for adjuvant treatment options to boost the host’s immune system to prevent the worsening of leprosy and reduce the activation of M. leprae, such as immunomodulators.

Discussion: Immunomodulators are drugs that can stimulate the body’s natural and adaptive defense mechanisms, acting as either immunosuppressants or immunostimulants. To understand …

The Effects Of Vitamin D On Chronic Wounds, Mufqi Handaru Priyanto, Eliza Miranda, Shannaz Nadia Yusharyahya, Lili Legiawati, Endi Novianto, Kusmarinah Bramono, Roro Inge Ade Krisanti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Wounds that fail to proceed through the normal healing process are referred to as chronic wounds, also known as ulcers. Chronic wounds have immeasurable biological, psychological, social, and economic effects, bringing tremendous challenges for patients, doctors, healthcare providers, and healthcare systems.

Discussion: This condition is associated with a variety of comorbidities and complex etiologies. The global incidence of chronic wounds is expected to increase with longer life expectancy. Thus, a holistic approach is necessary, such as proper wound management, proper control of comorbidities, and provision of adequate nutrition, including vitamin D supplementation. Vitamin D is an essential pro-hormone for …

Low Plasma Melatonin Levels Negatively Correlate With Melasma Severity, I Gusti Ayu Agung Praharsini, Corry Khathreen, Nyoman Suryawati, I Gusti Ayu Agung Elis Indira, I Gusti Ayu Sattwika Pramita

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Chronic exposure to ultraviolet light plays a role in the pathogenesis of melasma. Exposure to excessive sunlight leads to the formation of free radicals. As a result, the body responds by forming antioxidants such as melatonin, which is activated through the melatoninergic antioxidative system to fight oxidative stress. The relationship between melatonin and melasma is yet to be elucidated. This study aims to determine the correlation between melatonin and the severity of melasma.

Methods: This analytical cross-sectional study involved 50 melasma subjects and 10 non-melasma subjects who met the inclusion criteria and were aged between 21-50 years at Prof. …

Administration Of Vitamin D3 Topical In Increasing Serum Vitamin D Level: A Literature Review, He Yeon Asva Nafaisa, Fajar Waskito, Ronny Martien, Retno Danarti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Vitamin D is an essential fat-soluble vitamin that is required daily by the body. Deficiency in vitamin D is experienced by most of the world's population. Vitamin D plays a role in maintaining the skin barrier by regulating keratinocyte proliferation and differentiation, promoting filaggrin formation, and intraepidermal lipids.

Discussion: The vital role of vitamin D, non-compliance with supplement consumption, and poor nutritional status of adult patients and the elderly with deficiency and insufficiency of vitamin D encourage studies regarding vitamin D delivery via the transdermal route. The lipophilicity of vitamin D allows it to penetrate through the skin barrier. …

The Efficacy Of Baricitinib As A Treatment Option For Alopecia, In Terms Of Promoting Hair Regrowth And Improving Patient Reported Outcomes, Bhaumik Patel, Abhiram Gollapudi, Samrat Gollapudi, Srinidhi Banala, Brian Joseph Mathew, Prince Patel

Rowan-Virtua Research Day

Background: Alopecia, an autoimmune condition characterized by hair loss, significantly impacts millions globally, often leading to psychological distress such as anxiety and depression. Current treatments are variably effective and frequently associated with adverse effects that restrict long-term use. This study evaluates the efficacy of Baricitinib, a Janus Kinase inhibitor, in treating severe alopecia, focusing on hair regrowth and patient-reported outcomes.

Methods: This research synthesized data from recent publications (2018-2023) including clinical trials, reviews, meta-analyses, and systematic reviews, sourced from databases such as PubMed, Springer, and Elsevier. The inclusion criteria focused on recent studies in English evaluating Baricitinib's effectiveness in severe …

Facial Skincare Routine Adherence In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: The COVID-19 pandemic sparked an interest in skincare with the closure of spas and salons. “Skincare”, one of the most popular dermatology related hashtags on TikTok in July 2020 received 378 million views. The American Academy of Dermatology (AAD) has shared facial cleansing recommendations; however, it is unclear how many people follow them. Studies have shown a good daily facial cleansing and moisturizing routine can increase microbiome diversity and skin hydration. This can be beneficial in conditions like psoriasis, eczema, and acne.

Purpose: The aim of the study is to assess how well people follow the AAD …

Janus Kinase (Jak) Inhibitors: A New Frontier In The Treatment Of Vitiligo, Catherine F. Alapatt, Amanda Greenspan, Mohammad Fardos

Rowan-Virtua Research Day

Up to 70 million people worldwide suffer from vitiligo, an autoimmune disease characterized by the destruction of melanin. Current treatment options vary in efficacy. The disease manifests clinically as white circular macules of depigmentation seen primarily on the face and appendages.1 The pathophysiology of vitiligo is multifactorial and still being studied. One proposed mechanism behind the pathophysiology of vitiligo involves the upregulation of interferon gamma (IFN-γ) with downstream effects on JAK/STAT pathways resulting in CXCL10 transcription.1,2 Here we discuss Ruxolitinib, a topical JAK inhibitor, that recently passed its clinical trial phase, and Ritlecitinib, an oral JAK inhibitor which is currently …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Chronic Atopic Dermatitis, Cecilia Nguyen, Jordan Thompson, Daniel A. Nguyen, Christopher M. Wong, Christian J. Scheufele, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Atopic dermatitis is a chronic inflammatory skin disorder classically affecting flexural areas of the body. It is present in children and adults, including those with darker skin pigmentation. Chronic lesions are hyperpigmented plaques that are dry, cracked, and/or scaly often with lichenification. Differential diagnoses include psoriasis, seborrheic dermatitis, ichthyosis, and pityriasis rosea. This article will showcase clinical images with varying presentations of chronic atopic dermatitis in a range of age groups and skin colors according to the Fitzpatrick scale.

The Association Of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, And Sun-Protective Behaviors In A Navy Population, Rachel Newnam, Uyen Le-Jenkins, Carolyn Rutledge, Craig Cunningham

Ellmer School of Nursing Faculty Publications

Introduction: U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention …

Item Generation In The Development Of A Questionnaire For Predicting Multidrug Therapy Compliance In Leprosy, Yulia Siskawati, Sali Rahadi Asih, Aria Kekalih, Sri Linuwih Menaldi, Herqutanto Herqutanto, Kusmarinah Bramono

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Lengthy therapeutic regimens in leprosy are prone to defaults, contributing to more antibiotic-resistant Mycobacterium. Intervening patients’ medical habits midway would be more complicated than understanding their perception of undergoing such regimens in advance. We study the factors considered relevant to leprosy patients’ compliance to construct a novel self-reporting questionnaire that can predict the patients’ adherence before initiating multidrug therapy.

Methods: According to the Delphi methods, we conducted three rounds of interviews with twenty-three respondents from various backgrounds, including dermatologists, government officials, healthcare workers, and patients with leprosy, to infer the associated factors of the included items. Each …