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Journal of General-Procedural Dermatology & Venereology Indonesia
Published by Universitas Indonesia
ISSN : 24607991     EISSN : 24607991     DOI : -
Core Subject : Health,
The initiation of JDVI (Journal of General - Procedural Dermatology & Venereology Indonesia) was done by leading dermatologists and venereologists from Indonesia who aspired to contribute in the field of scientific publication and research. Knowledge and science continue to evolve in the field of dermatology and venereology, especially with new diagnostic methods, therapeutic and procedural approaches, and new emerging diseases.
Arjuna Subject : -
Articles 45 Documents
Atypical mycobacterial infection resembles sporotrichosis in elderly patient Siti Nurani Fauziah; Lili Legiawati; Sri Adi Sularsito; Shannaz Nadia Yusharyahya; Rahadi Rihatmadja; Sondang P Sirait; Fifi Mifta Huda; Indah Widyasari
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 1, ##issue.no## 2 (2016): June
Publisher : Universitas Indonesia

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Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis. An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no fungal element nor acid-fast bacilli (AFB). Culture and polymerase chain reaction (PCR)of M. tuberculosis were negative. The working diagnosis was atypical mycobacterial infection and treatment with 450 mg rifampicin and 100 mg minocycline daily were administered accordingly. In two months observation following the treatment, the pain was no longer exist, the ulcers were completely healed, and some nodules were in the process of healing Among other Mycobacterium spp, M.marinum is the most common cause of AM infrections. Clinical manifestation of M. marinum infection may present as solitary or multiple nodules on the hands, feet, elbows and knees with sporotrichoid spreading  patern. The diagnosis of AM was established based on clinical and laboratory examination. The diagnosis was also confirmed by good clinical response to minocycline and rifampicin.   Keywords: atypical, mycobacterium,  minocycline, rifampicin  
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 & Venereology Indonesia ##issue.vol## 1, ##issue.no## 3 (2016): December
Publisher : Universitas Indonesia

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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 Conduction Study revealed multiple demyelinating mononeuropathy of upper and lower extremities. Her serum anti-PGL-1 IgM level was 1721 μ/mL, but after three months of treatment with MDT-PB regimen, it increased to 2815μ/mL. Therefore, the treatment was switched to MDT-MB regimen and 30 mg prednisone. The patient is still undergoing treatment. There has been a slight improvement after treatment with MDT-MB regimen.  Nerve biopsy is the gold standard for diagnosis but has its limitations. However, serological test of anti PGL-1 can be a marker and a useful tool as an additional test to confirm the diagnosis, especially for patients with nerve impairments. Difficulties are due to the absence of skin lesions and neuropathy which may be caused by other diseases. Both diagnosis and treatment require multidisciplinary approach. Treatment given is intended to correct nerve damage and prevent further disabilities. Keywords: Neural leprosy, anti-PGL-1, systemic corticosteroid, multidisciplinary approach
Suspected resistance of MDT-MB in Multibacillary Leprosy of Hansens disease: Two case reports Yudo Irawan; Sri Linuwih Menaldi; Emmy Soedarmi Sjamsoe-Daili; Melani Marissa; Erika Zoulba
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 1, ##issue.no## 3 (2016): December
Publisher : Universitas Indonesia

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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 with paresthetic lesions on his face, chest, back, both arms and legs since 2 years ago, accompanied by thickening of ulnar and lateral peroneal nerve. The BI was 12/5 and the MI was 0.40%. Both patients were diagnosed with borderline lepromatous type of MH and received MDT-MB for 12 months. Diagnosis of suspected resistance was established because no clinical improvement or any significant decrease of AFB index after completing the MDT treatment. The patients had secondary resistance after polymerase chain reaction evaluation showed that they were still rifampicin-sensitive. There was clinical improvement and significant decrease in FAB index after the patients continued the MDT-MB treatment with 600 mg additional rifampicin. The diagnosis of bacterial resistance should be made based on clinical evaluation before completion of treatment. Based on the two case reports, the resistance suspected may be secondary. Treatment using additional regimen can be initiated once the resistance has been proven. Keywords: Hansen’s disease, MDT resistance, clinical improvement, acid fast bacilli index
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 & Venereology Indonesia ##issue.vol## 1, ##issue.no## 3 (2016): December
Publisher : Universitas Indonesia

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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 molecular mechanism of action of laser on abnormal vessel growth. In this article, we report a psoriasis vulgaris case in adult whose lesions responded well to NBUVB phototherapy. The psoriatic plaques on her extremities were stable despite NBUVB therapy and some topical treatments afterwards. With knowledge of emerging role of PDL in inflammatory skin disease such as psoriasis, we conducted a literature search and critically appraised the resulting articles. The systematic review article found evaluates PDL efficacy as a treatment for inflammatory skin diseases, including psoriasis, and was appraised using a worksheet from British Medical Journal Evidence-Based Medicine Toolkit. Its validity, importance, and applicability aspects were evaluated, leading to a conclusion that PDL can be used as an alternative treatment for psoriasis plaques in trunks, extremities, hands, or feet (both stable and unstable), with minimal and transient side effects (hyperpigmentation, hypopigmentation, and blistering). Keywords: psoriasis, treatment, pulsed-dye laser
Papuloerythroderma of Ofuji: A first case report from Indonesia Graciella Regina; Listya Paramita; Sunardi Radiono; Yohannes Widodo Wirohadidjojo; William Faber
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 1, ##issue.no## 3 (2016): December
Publisher : Universitas Indonesia

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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 sparing of the cutaneous folds, and it may be considered as pseudo-deck chair sign. The patient showed good response with combination therapy of phototherapy with Narrow-Band Ultraviolet B (NBUVB), oral methotrexate, and corticosteroids. The deck chair sign disappeared after six months therapy, but the patient’s skin was still xerotic. Keywords: Papuloerythroderma of Ofuji, deck chair sign, pseudo-deck chair sign
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 F Saldi
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 2, ##issue.no## 1 (2017): August
Publisher : Universitas Indonesia

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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 were “laser” AND “onychomycosis”.Results: Seventy-nine articles were obtained from the search strategy procedure. After selection based on exclusion and inclusion criteria, and full-text availability, four relevant articles remained.Discussion: The study by Xu et al. was considered as the most valid study while compared to other three studies. This study used intention to treat analysis and had no loss of follow-up patients. Xu et al. compared mycological and clinical clearance rate between patients receiving laser, oral terbinafine, or combination of those two. It showed that laser therapy was less effective when compared to oral antifungal (Number Needed to Harm = 17).Conclusions: Laser has a lower level of effectiveness while compared to oral terbinafine as the current gold standard therapy for onychomycosis. However, laser therapy can still be used as an adjunctive therapy along with oral antifungal to achieve a better cure rate. More studies are needed to prove this hypothesis. Keywords: onychomycosis, laser therapy, effectiveness
Segmental zoster paresis Nahla Shihab; Erdina HD Pusponegoro; Ahmad Yanuar
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 2, ##issue.no## 1 (2017): August
Publisher : Universitas Indonesia

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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 total denervation corresponding to right L5 radix. The patient was diagnosed as herpes zoster on right L5-S1 segment, herpetic neuralgia, and segmental zoster paresis with recurrent liposarcoma under chemotherapy. He was treated with oral acyclovir 800 mg five times a day and gabapentin 300 mg twice a day.  Physical therapy and rehabilitation were started concurrently. Paresis is a rare complication of herpes zoster. Radicular pain and weakness preceded the skin lesion potentially lead to misdiagnoses. The most frequent diagnosis for patient suffering pain and weakness in the extremities is spinal disorder, such as stenosis and disc herniation. EMG can be helpful to recognise motoric involvement of herpes zoster, and preclude other diagnoses.   Keywords: herpes zoster, paresis, radicular pain
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 & Venereology Indonesia ##issue.vol## 2, ##issue.no## 1 (2017): August
Publisher : Universitas Indonesia

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Abstract

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 and Discussion: After critical appraisal, studies by Avner et al. and Jaiswal et al. found to be valid, important, and applicable to the patient. The first study found that oral terbinafine combined with topical 8%  ciclopirox olamine is more effective and safe compared to terbinafine as a monotherapy (p<0.05). The second study found similar results, but without statistical significance (p>0.05). Conclusions: Oral terbinafine combined with topical 8% ciclopirox olamine is more effective than monotherapy, despite statistical irrelevance in one of the studies appraised. Further studies are needed to support the implementation of combination therapy.   Keywords: ciclopirox, efficacy, combination, onychomycosis, terbinafine  
Hypertrophic type actinic keratoses: A case report Febrina Tritama Kurniasih
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 2, ##issue.no## 1 (2017): August
Publisher : Universitas Indonesia

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Actinic keratosis (AK) is a skin neoplasm consists of proliferation of cytologicallyabrnormal epidermal keratinocytes that evolve in response to exposure to prolonged ultraviolet radiation (UV).Signs and symptoms of AK are pruritus, burning, stinging, and bleeding. AK typical lesion is tthe discovery of papule measuring 2-6 mm, flat, rough as sand and squamous. There are some clinical and histopathologic variants, one of the histopathological variants is hypertrophic actinic keratoses (Cutaneous Horn). Which has the  hypertrophic conical skin-colored bulge that come out from the base.   A patient, male, 40 years old, came to the Dermatology Polyclinic at H. Adam Malik Hospital. His main complaint was small nodules that looked like hard white horn on the right cheek curve since 2 years ago.On the status of dermatological, in the region of the sulcus nasobasalisdextra, papule with hypopigmentation, verrucosis surface, demarcated, hard consistency measuring 1 cm x 0.5 cm x 0.5 cm shaped like a horn was found. The shave excision that was done to this patient brought good result.   The establishing actinic keratosis diagnosis of this patient was based on the anamnesis, clinical presentation and histopathologic examination. Management of this patient was shave excision that was done in accordance with the location of the lesion and also aim for in terms of cosmetics and patients comfort.   It was reported a 40 years old patient with actinic keratoses, shave excision was conducted  in the region of the sulcus nasobasalis dextra. One week after surgery,  good result was showed and the patient was satisfied.   Key words : hypertrophic type actinis keratosis, shave excision
Allergic contact dermatitis due to nickel in household detergent Dewi Utami Putri; Irma Damayanti Roesyanto-Mahadi
Journal of General-Procedural Dermatology & Venereology Indonesia ##issue.vol## 2, ##issue.no## 2 (2017): December 2017
Publisher : Universitas Indonesia

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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 papules on the right extensor forearm, then the patient wore rubber gloves to protect hands when washing. However, the lesions spread to the left extensor forearm and there were also vesicles on both hands. There was history of localized reactions to metal items, the latter one was 3 weeks ago after wearing a metal necklace. The clinical presentation were multiple erythematous papules and vesicles, erythematous and hyperpigmented macules. The patch test using Chemotechnique Diagnostics AB and square chamber showed a 2+ reaction to nickel sulphate. The patient was educated to avoid the causative allergen and treated with oral antihistamine and topical corticosteroid. The patient showed significant clinical improvement after 2 weeks.  Nickel as metal catalyst used in detergents is found in small concentration, but can lead to ACD in an already sensitized individual. The lesions persist despite the use of gloves because nickel is absorbed through rubber material.   Keywords: allergic contact dermatitis, nickel, metal catalyst, household detergent, patch test