Background By August 2022, CoronaVirus Disease-2019 (COVID-19) had caused 600 million illnesses a... more Background By August 2022, CoronaVirus Disease-2019 (COVID-19) had caused 600 million illnesses and 6.5 million fatalities globally. A massive vaccination program is being implemented worldwide to suppress this condition. Several works of literature stated that mRNA COVID-19 vaccination, specifically with the mRNA-1273 vaccine, is followed by clear evidence of the COVID arm effects associated with this vaccine. Objective To analyze the latest evidence of COVID arm as a common effect of mRNA-1273 vaccination with the ultimate goal of improving vaccine counseling to help healthcare professionals and reassure patients. Methods A comprehensive search was performed on topics that assess the COVID arm as a cutaneous manifestation following mRNA-1273 vaccination from inception up until July 2022. Results Eighteen studies with a total of 1129 participants after the first and second dose of mRNA-1273 vaccination reported that most participants had COVID arm following the first dose administr...
Epidermolysis bullosa (EB) is a group of inherited blistering skin diseases known to have heterog... more Epidermolysis bullosa (EB) is a group of inherited blistering skin diseases known to have heterogenicity of phenotypes and genotypes. There are four main types of EB: simplex, junctional, dystrophic, and Kindler syndrome, which are further classified into 34 distinct subtypes. Twenty different gene mutations are responsible for the loss of function and integrity of the basal membrane zone. In limited-resource settings such as Indonesia, diagnoses of hereditary skin disease often rely on clinical features. This limitation was managed by using the Clinical Diagnostic Matrix EB for clinical diagnosis support and whole-exome sequencing for genetic analysis. This study is the first whole-exome sequencing analysis of Javanese Indonesian patients with EB. The genetic analysis from four patients with EB identified all novel mutations unreported in the dbSNP database. There are Kindler syndrome with FERMT1 frameshift mutation in exon 4, at c.388A (p.I130fs), which causes truncated protein; j...
Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Resu... more Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Results: There were significant differences in IH size after treatment with timolol maleate 0.5% solution compared with ultrapotent corticosteroids (p < 0.001) and timolol maleate 0.5% gel compared with ultrapotent corticosteroids (p < 0.001). There was no significant difference in IH lesions after treatment with timolol maleate 0.5% solution versus gel (p = 0.744). Conclusion: Timolol maleate 0.5% solution and gel were significantly superior to topical ultrapotent corticosteroids in size reduction of superficial IH.
Diffuse cutaneous mastocytosis is a rare form of cutaneous mastocytosis that can appear in hetero... more Diffuse cutaneous mastocytosis is a rare form of cutaneous mastocytosis that can appear in heterogeneous clinical presentations, including eruption of papules, erythematous plaques, blisters, and erythroderma. We report a 1.5- year-old boy who presented with itchy wheals and blisters spreading on his body. The patient was initially managed as a linear IgA bullous dermatosis of childhood because of the similarity of clinical symptoms and the presenting of linear IgA deposits at the basement membrane. Due to the development of urticarial plaque after the resolution of the blisters, the diagnosis of diffuse cutaneous mastocytosis was made based on clinical, histopathological (hematoxylin-eosin, Giemsa, and toluidine blue staining), and direct immunofluorescent examinations (IgA, IgG, IgM, C3). The symptoms were improved following antihistamines and oral corticosteroid treatment.
Association between atopy and development of allergic contact dermatitis (ACD) remains controvers... more Association between atopy and development of allergic contact dermatitis (ACD) remains controversial. T cell disfunctions in a patient with atopy complicate the process of nickel sensitization. On the other, the decrease of the skin barrier function and overexpression of Langerhans cells in the patient facilitate the sensitization. This study aimed to evaluate the association between atopy and incidence of nickel ACD. A case-control study was carried out in Allergic and Immunology Sub Department of Dermato-Venereology Policlinic, Dr. Sardjito General Hospital, Yogyakarta, involving 54 nickel ACD patients as case group and 74 healthy subjects as control group. All subjects underwent prick test allergens i.e. house dust, dust mite, cockroach, mixed fungi, nuts and egg white. The skin reaction was considered as a positive result if a wheal diameter of at least 3 mm larger than the negative control or a minimum of half of the positive control. The relationship between atopy and the nic...
Background: Beautifully and colorfully dyed batik cloth is an Indonesian cultural heritage. Batik... more Background: Beautifully and colorfully dyed batik cloth is an Indonesian cultural heritage. Batik production exposes workers and the environment to various physical and chemical hazards. This interdisciplinary study aimed to assess the environmental and health parameters of batik workers, and apply environmental and health interventions to achieve environmentally friendly batik production with no human hazards.Methods: To assess the environmental pollutants, the wastewater quality parameters were measured. Air pollutant assessment was done using a low volume sampler. Liver, kidney function and blood chromium were compared between batik workers and healthy controls. Health interventions were done to choose the best gloves for the batik workers followed with assessing convenience level of selected gloves and identifying obstacles that prevent them from using gloves properly. The effectiveness of nerve gliding and wrist exercises in improving carpal tunnel syndrome clinical symptoms we...
A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days... more A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days after systemic symptoms appeared such as mild fever and mild dyspnoea. The rashes were a characteristic of follicular eruption, which started on his stomach and spread all over his body. After a thorough evaluation, he was diagnosed with COVID-19 and was started on COVID-19 regimens. Skin lesions disappeared on the ninth day of treatment. Our findings contribute to the growing awareness of dermatological manifestations in patients with COVID-19.
Lupus pannikulitis (LP), suatu variasi klinis kulit yang jarang pada lupus eritematosus kutan, ja... more Lupus pannikulitis (LP), suatu variasi klinis kulit yang jarang pada lupus eritematosus kutan, jarang terjadi pada anak. Perjalanan penyakit lambat sehingga penegakan diagnosis sering terlambat.Anak laki-laki 13 tahun mengeluh area cekung pada wajah sejak usia 11 tahun diikuti cekung pada kepala. Benjolan sewarna kulit pada kedua lengan dirasakan selama 1 bulan. Terdapat atrofi pada kedua pipi dengan tepi lesi dikelilingi bercak merah keunguan. Pada skalp tampak alopesia dengan atrofi multipel, dikelilingi bercak eritematosa di tepinya. Pada kedua lengan atas terdapat nodul subkutan sewarna kulit, multipel, perabaan keras, dan tidak nyeri. Pemeriksaan histopatologis lesi wajah dan skalp dengan pewarnaan HE didapatkan ortokeratosis linear dengan sumbat keratotik pada epidermis. Pada dermis atas terdapat sebukan sel radang didominasi limfosit, dermis tengah kolagenisasi hingga jaringan subkutan, tampak sel radang pada jaringan subkutan septal-lobular dengan dominasi limfosit dan nekro...
Nekrosis lemak subkutan pada bayi lelaki baru lahir merupakan panikulitis yang jarang terjadi. Ke... more Nekrosis lemak subkutan pada bayi lelaki baru lahir merupakan panikulitis yang jarang terjadi. Kelainan ini dijumpai pada bayi baru lahir (BBL) cukup bulan atau lebih bulan, ditandai dengan nodus atau plak subkutan di area kulit yang terbatas/terlokalisasi. Kutis marmorata fisiologis ditandai oleh “patch” eritematosa yang tersusun retikuler dan membentuk gambaran seperti marmer. Lesi kulit ini merupakan respons vaskular tubuh bayi terhadap suhu dingin. Kondisi ini hilang timbul sesuai perubahan suhu lingkungan. Pada makalah ini dilaporkan satu kasus nekrosis lemak subkutan pada BBL disertai dengan kutis marmorata fisiologis. Diagnosis ditegakkan berdasarkan pemeriksaan klinis dan histopatologis. Faktor risiko yang ditemukan berupa riwayat asfiksia saat lahir dan riwayat preeklamsi berat pada ibu selama hamil. Tujuan laporan kasus ini adalah untuk meningkatkan kewaspadaan klinisi terhadap kelainan kulit yang mungkin dijumpai pada bayi baru lahir dan diharapkan dapat meningkatkan kema...
Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal ... more Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal barrier alteration and reduced epidermal water content. It is an important part of a dermatologist's strategy to maintain skin health as well as treating various dermatoses which co-exist with skin dryness, linked to impaired skin barrier function such as in atopic disorder as well as other types of dermatitis. Mastering the knowledge regarding action mechanism, application, dosage, adverse effects as well as specific clinical usage of moisturizers is must for a dermatologist, in order to support the capability to recommend their use, particularly for therapeutic purposes, in accordance with evidence-based medicine. This review is aimed to discuss the use of moisturizer both as skin health maintenance as well as a definitive or adjuvant therapy, particularly for many kinds of dermatitis.
Mal de Meleda (OMIM# 248300; keratosis palmoplantaris transgrediens) is an autosomal recessive fo... more Mal de Meleda (OMIM# 248300; keratosis palmoplantaris transgrediens) is an autosomal recessive form of palmoplantar keratoderma, clinically characterized by sharp demarcated erythema and hyperkeratosis of the palms and soles that progress with age and extend to the dorsal aspects of the hands and feet. The mal de Meleda is caused by mutations in the SLURP1 gene that encodes secreted lymphocyte antigen 6/urokinase-type plasminogen receptor-related protein 1 (SLURP1). To date no reported cases from Indonesia. The aims of the study were to describe the typical features of mal de Meleda cases in a Javanese family in Indonesia and identify the mutation in the ARS B gene which encodes SLURP1. In this study, three Javanese patients, siblings from nonconsanguineous nonaffected parents, presented with classical symptoms of mal de Meleda. Genetic analysis screening SLURP1 gene was conducted for the specimens from the patients and other family members. A novel homozygous three-nucleotide delet...
Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are currently reg... more Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are currently regarded to be same disease entity which differs only in the extent and severity of epidermal sloughing. Both are potentially life-threatening mucocutaneous immunologic reaction, which are most frequently induced by drug consumption. The epithelial destruction of skin and mucosal membrane can cause both acute as well as chronic/ long term outcomes in term of late sequelae during the course of the disease. Sequelae often occur during the late phase of SJS/TEN and become a significant problem due its chronicity and severe degree of impairment, which leads to deterioration of quality of life for the patients. This may prevented or decreased in terms of intensity if the patient&#39;s received prompt and sufficient topical therapy, particularly in managing lesions on the mucosa of the eye, oral, and genital. Objective : This review underlines topical therapies which could be delivered for management of mucocutaneous lesions from SJS/ TEN, aimed to prevent late sequelae due to SJS – TEN in order to improve the life quality of SJS – TEN survivors. Conclusion: SJS/ TEN frequently lead to late sequeale which includes skin, ocular, oral, and genital involvement. These sequelaes are often severe and chonic. Thus, may cause significant decrease in quality of life of SJS/TEN survivors. It is therefore most important to detect them early in order to manage them adequately. To date, we still have an impression that the specific sequelae of SJS – TEN are often late diagnosed and insufficiently treated. Finally, we want to emphasize that for mucosal involvement in particular, such as ocular, genital and oral involvement, a careful topical treatment have to be taken into special consideration in order to prevent severe late sequelae.
Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Resu... more Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Results: There were significant differences in IH size after treatment with timolol maleate 0.5% solution compared with ultrapotent corticosteroids (p < 0.001) and timolol maleate 0.5% gel compared with ultrapotent corticosteroids (p < 0.001). There was no significant difference in IH lesions after treatment with timolol maleate 0.5% solution versus gel (p = 0.744). Conclusion: Timolol maleate 0.5% solution and gel were significantly superior to topical ultrapotent corticosteroids in size reduction of superficial IH.
Neurofibromatosis type 1 (NF1) is a genetic disorder that is most common found. The disorder is a... more Neurofibromatosis type 1 (NF1) is a genetic disorder that is most common found. The disorder is autosomal dominant inheritance with penetrance 98-100% and has 50% mutation rate. Children with NF1 have a skin disorder varies, from mild form of macular café-au-lait spots and axillary freckling until neurofibroma. NF1 is also associated with an increased risk of malignancy, cognition disorders, psychiatric disorders, and epilepsy in children. Reported one case, a 12 years old boy, complained arise brownish spots on his back and armpits since he was 4 years old, history of seizures was denied and academic performance at school was fine. On physical examination found multiple café-au-lait spots and axillary freckling. No Lisch nodule and other abnormalities in the eye examination. Electroencephalography examination found abnormal epileptiform waves and brain mapping does not show focus and asymmetry. Examination of children&#39;s depression inventory is not found depression. Projective drawing showed a tendency dominancy in the group, tend to assert himself, imbalance of desire and ability, hence it may cause inner conflict, anxious, and insecure. NF1 diagnosis should be considered in cases of multiple café-au-lait, because it will affect the prediction of neurological disorders, psychiatric disorders, and the prediction of genetic inheritance. Hence, investigation of neurologic and psychiatric disorders is important related NF1 notion.
Journal of Clinical Images and Medical Case Reports, 2021
Background: Sturge-Weber Syndrome (SWS) is a neurocutaneous defect involving facial Port Wine Sta... more Background: Sturge-Weber Syndrome (SWS) is a neurocutaneous defect involving facial Port Wine Stain (PWS) with vascular deficits in the brain and ipsilateral eyes. Facial PWS can be the initial marker and help predict the severity of SWS. Aims and objectives: To study the association of facial PWS characteristics, neurological and ophthalmological deficits in SWS with the degree of severity. Materials and Methods: A retrospective descriptive study of patients with SWS was conducted at Dr. Sardjito Hospital between January 2010 - December 2020. Facial PWS characteristics were assessed from photographs. Assessments of neurological and ophthalmological deficits used physical and supportive examinations, including Electroencephalogram (EEG), Magnetic Resonance Imaging (MRI), and Intelligent-Quotient (IQ). Results: From 19 female patients aged 1 month to 26 years with facial PWS, seven fulfilled the inclusion criteria. “High risk” facial PWS V1 and P1 b distribution patterns were found i...
Alopesia areata (AA) merupakan penyakit autoimun yang ditandai dengan alopesia non-sikatrisial. K... more Alopesia areata (AA) merupakan penyakit autoimun yang ditandai dengan alopesia non-sikatrisial. Kondisi ini merupakan dermatosis yang umum ditemui pada anak. Gambaran klinisnya berupa alopesia non-sikatrisial fokal, perlu dibedakan dari kondisi dapatan serupa lainnya, terutama yang sering terjadi pada anak. Kami melaporkan 5 kasus AA pada anak berusia di bawah 18 tahun. Diagnosis berdasarkan pemeriksaan klinis dan penunjang. Pemahaman karakteristik AA perlu diketahui untuk diagnosis, terutama pada pasien anak.Alopecia areata (AA) is a chronic autoimmune disease characterized by non-scarring alopecia. It is one of the most commonly found dermatosis in pediatric population. The clinical manifestations of focal non-scarring alopecia must be differentiated from other acquired focal non-scarring alopecia, especially those in children. This paper report 5 AA cases in children. Diagnosis was based on clinical and supporting examinations. Understanding the characteristics of AA, particularl...
During the current Coronavirus Disease 19 (COVID-19) pandemic, regular handwashing and other hand... more During the current Coronavirus Disease 19 (COVID-19) pandemic, regular handwashing and other hand hygiene practices as the primary infection prevention program are highly encouraged. Notwithstanding the noticeable benefits in combating viral infection, hand hygiene practice potentially promotes dysbiosis of the skin microbiome. This review aimed to summarize the possible impacts of hand hygiene practices using soap products and alcohol-based hand rubs (ABHR) on the homeostasis of human skin microbiota. We discuss recent findings to provide evidence of the effectiveness of hand hygiene practices in viral infection control, the role of the skin microbiome in human health and the effects of hand hygiene practice on the homeostasis of the skin microbiome. Finally, this review also suggests improving research and practice of hand hygiene in response to the ongoing COVID-19 pandemic.
Background By August 2022, CoronaVirus Disease-2019 (COVID-19) had caused 600 million illnesses a... more Background By August 2022, CoronaVirus Disease-2019 (COVID-19) had caused 600 million illnesses and 6.5 million fatalities globally. A massive vaccination program is being implemented worldwide to suppress this condition. Several works of literature stated that mRNA COVID-19 vaccination, specifically with the mRNA-1273 vaccine, is followed by clear evidence of the COVID arm effects associated with this vaccine. Objective To analyze the latest evidence of COVID arm as a common effect of mRNA-1273 vaccination with the ultimate goal of improving vaccine counseling to help healthcare professionals and reassure patients. Methods A comprehensive search was performed on topics that assess the COVID arm as a cutaneous manifestation following mRNA-1273 vaccination from inception up until July 2022. Results Eighteen studies with a total of 1129 participants after the first and second dose of mRNA-1273 vaccination reported that most participants had COVID arm following the first dose administr...
Epidermolysis bullosa (EB) is a group of inherited blistering skin diseases known to have heterog... more Epidermolysis bullosa (EB) is a group of inherited blistering skin diseases known to have heterogenicity of phenotypes and genotypes. There are four main types of EB: simplex, junctional, dystrophic, and Kindler syndrome, which are further classified into 34 distinct subtypes. Twenty different gene mutations are responsible for the loss of function and integrity of the basal membrane zone. In limited-resource settings such as Indonesia, diagnoses of hereditary skin disease often rely on clinical features. This limitation was managed by using the Clinical Diagnostic Matrix EB for clinical diagnosis support and whole-exome sequencing for genetic analysis. This study is the first whole-exome sequencing analysis of Javanese Indonesian patients with EB. The genetic analysis from four patients with EB identified all novel mutations unreported in the dbSNP database. There are Kindler syndrome with FERMT1 frameshift mutation in exon 4, at c.388A (p.I130fs), which causes truncated protein; j...
Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Resu... more Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Results: There were significant differences in IH size after treatment with timolol maleate 0.5% solution compared with ultrapotent corticosteroids (p < 0.001) and timolol maleate 0.5% gel compared with ultrapotent corticosteroids (p < 0.001). There was no significant difference in IH lesions after treatment with timolol maleate 0.5% solution versus gel (p = 0.744). Conclusion: Timolol maleate 0.5% solution and gel were significantly superior to topical ultrapotent corticosteroids in size reduction of superficial IH.
Diffuse cutaneous mastocytosis is a rare form of cutaneous mastocytosis that can appear in hetero... more Diffuse cutaneous mastocytosis is a rare form of cutaneous mastocytosis that can appear in heterogeneous clinical presentations, including eruption of papules, erythematous plaques, blisters, and erythroderma. We report a 1.5- year-old boy who presented with itchy wheals and blisters spreading on his body. The patient was initially managed as a linear IgA bullous dermatosis of childhood because of the similarity of clinical symptoms and the presenting of linear IgA deposits at the basement membrane. Due to the development of urticarial plaque after the resolution of the blisters, the diagnosis of diffuse cutaneous mastocytosis was made based on clinical, histopathological (hematoxylin-eosin, Giemsa, and toluidine blue staining), and direct immunofluorescent examinations (IgA, IgG, IgM, C3). The symptoms were improved following antihistamines and oral corticosteroid treatment.
Association between atopy and development of allergic contact dermatitis (ACD) remains controvers... more Association between atopy and development of allergic contact dermatitis (ACD) remains controversial. T cell disfunctions in a patient with atopy complicate the process of nickel sensitization. On the other, the decrease of the skin barrier function and overexpression of Langerhans cells in the patient facilitate the sensitization. This study aimed to evaluate the association between atopy and incidence of nickel ACD. A case-control study was carried out in Allergic and Immunology Sub Department of Dermato-Venereology Policlinic, Dr. Sardjito General Hospital, Yogyakarta, involving 54 nickel ACD patients as case group and 74 healthy subjects as control group. All subjects underwent prick test allergens i.e. house dust, dust mite, cockroach, mixed fungi, nuts and egg white. The skin reaction was considered as a positive result if a wheal diameter of at least 3 mm larger than the negative control or a minimum of half of the positive control. The relationship between atopy and the nic...
Background: Beautifully and colorfully dyed batik cloth is an Indonesian cultural heritage. Batik... more Background: Beautifully and colorfully dyed batik cloth is an Indonesian cultural heritage. Batik production exposes workers and the environment to various physical and chemical hazards. This interdisciplinary study aimed to assess the environmental and health parameters of batik workers, and apply environmental and health interventions to achieve environmentally friendly batik production with no human hazards.Methods: To assess the environmental pollutants, the wastewater quality parameters were measured. Air pollutant assessment was done using a low volume sampler. Liver, kidney function and blood chromium were compared between batik workers and healthy controls. Health interventions were done to choose the best gloves for the batik workers followed with assessing convenience level of selected gloves and identifying obstacles that prevent them from using gloves properly. The effectiveness of nerve gliding and wrist exercises in improving carpal tunnel syndrome clinical symptoms we...
A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days... more A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days after systemic symptoms appeared such as mild fever and mild dyspnoea. The rashes were a characteristic of follicular eruption, which started on his stomach and spread all over his body. After a thorough evaluation, he was diagnosed with COVID-19 and was started on COVID-19 regimens. Skin lesions disappeared on the ninth day of treatment. Our findings contribute to the growing awareness of dermatological manifestations in patients with COVID-19.
Lupus pannikulitis (LP), suatu variasi klinis kulit yang jarang pada lupus eritematosus kutan, ja... more Lupus pannikulitis (LP), suatu variasi klinis kulit yang jarang pada lupus eritematosus kutan, jarang terjadi pada anak. Perjalanan penyakit lambat sehingga penegakan diagnosis sering terlambat.Anak laki-laki 13 tahun mengeluh area cekung pada wajah sejak usia 11 tahun diikuti cekung pada kepala. Benjolan sewarna kulit pada kedua lengan dirasakan selama 1 bulan. Terdapat atrofi pada kedua pipi dengan tepi lesi dikelilingi bercak merah keunguan. Pada skalp tampak alopesia dengan atrofi multipel, dikelilingi bercak eritematosa di tepinya. Pada kedua lengan atas terdapat nodul subkutan sewarna kulit, multipel, perabaan keras, dan tidak nyeri. Pemeriksaan histopatologis lesi wajah dan skalp dengan pewarnaan HE didapatkan ortokeratosis linear dengan sumbat keratotik pada epidermis. Pada dermis atas terdapat sebukan sel radang didominasi limfosit, dermis tengah kolagenisasi hingga jaringan subkutan, tampak sel radang pada jaringan subkutan septal-lobular dengan dominasi limfosit dan nekro...
Nekrosis lemak subkutan pada bayi lelaki baru lahir merupakan panikulitis yang jarang terjadi. Ke... more Nekrosis lemak subkutan pada bayi lelaki baru lahir merupakan panikulitis yang jarang terjadi. Kelainan ini dijumpai pada bayi baru lahir (BBL) cukup bulan atau lebih bulan, ditandai dengan nodus atau plak subkutan di area kulit yang terbatas/terlokalisasi. Kutis marmorata fisiologis ditandai oleh “patch” eritematosa yang tersusun retikuler dan membentuk gambaran seperti marmer. Lesi kulit ini merupakan respons vaskular tubuh bayi terhadap suhu dingin. Kondisi ini hilang timbul sesuai perubahan suhu lingkungan. Pada makalah ini dilaporkan satu kasus nekrosis lemak subkutan pada BBL disertai dengan kutis marmorata fisiologis. Diagnosis ditegakkan berdasarkan pemeriksaan klinis dan histopatologis. Faktor risiko yang ditemukan berupa riwayat asfiksia saat lahir dan riwayat preeklamsi berat pada ibu selama hamil. Tujuan laporan kasus ini adalah untuk meningkatkan kewaspadaan klinisi terhadap kelainan kulit yang mungkin dijumpai pada bayi baru lahir dan diharapkan dapat meningkatkan kema...
Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal ... more Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal barrier alteration and reduced epidermal water content. It is an important part of a dermatologist's strategy to maintain skin health as well as treating various dermatoses which co-exist with skin dryness, linked to impaired skin barrier function such as in atopic disorder as well as other types of dermatitis. Mastering the knowledge regarding action mechanism, application, dosage, adverse effects as well as specific clinical usage of moisturizers is must for a dermatologist, in order to support the capability to recommend their use, particularly for therapeutic purposes, in accordance with evidence-based medicine. This review is aimed to discuss the use of moisturizer both as skin health maintenance as well as a definitive or adjuvant therapy, particularly for many kinds of dermatitis.
Mal de Meleda (OMIM# 248300; keratosis palmoplantaris transgrediens) is an autosomal recessive fo... more Mal de Meleda (OMIM# 248300; keratosis palmoplantaris transgrediens) is an autosomal recessive form of palmoplantar keratoderma, clinically characterized by sharp demarcated erythema and hyperkeratosis of the palms and soles that progress with age and extend to the dorsal aspects of the hands and feet. The mal de Meleda is caused by mutations in the SLURP1 gene that encodes secreted lymphocyte antigen 6/urokinase-type plasminogen receptor-related protein 1 (SLURP1). To date no reported cases from Indonesia. The aims of the study were to describe the typical features of mal de Meleda cases in a Javanese family in Indonesia and identify the mutation in the ARS B gene which encodes SLURP1. In this study, three Javanese patients, siblings from nonconsanguineous nonaffected parents, presented with classical symptoms of mal de Meleda. Genetic analysis screening SLURP1 gene was conducted for the specimens from the patients and other family members. A novel homozygous three-nucleotide delet...
Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are currently reg... more Background: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are currently regarded to be same disease entity which differs only in the extent and severity of epidermal sloughing. Both are potentially life-threatening mucocutaneous immunologic reaction, which are most frequently induced by drug consumption. The epithelial destruction of skin and mucosal membrane can cause both acute as well as chronic/ long term outcomes in term of late sequelae during the course of the disease. Sequelae often occur during the late phase of SJS/TEN and become a significant problem due its chronicity and severe degree of impairment, which leads to deterioration of quality of life for the patients. This may prevented or decreased in terms of intensity if the patient&#39;s received prompt and sufficient topical therapy, particularly in managing lesions on the mucosa of the eye, oral, and genital. Objective : This review underlines topical therapies which could be delivered for management of mucocutaneous lesions from SJS/ TEN, aimed to prevent late sequelae due to SJS – TEN in order to improve the life quality of SJS – TEN survivors. Conclusion: SJS/ TEN frequently lead to late sequeale which includes skin, ocular, oral, and genital involvement. These sequelaes are often severe and chonic. Thus, may cause significant decrease in quality of life of SJS/TEN survivors. It is therefore most important to detect them early in order to manage them adequately. To date, we still have an impression that the specific sequelae of SJS – TEN are often late diagnosed and insufficiently treated. Finally, we want to emphasize that for mucosal involvement in particular, such as ocular, genital and oral involvement, a careful topical treatment have to be taken into special consideration in order to prevent severe late sequelae.
Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Resu... more Lesion size was measured from scaled photodocumentation with the software program ImageJ ® . Results: There were significant differences in IH size after treatment with timolol maleate 0.5% solution compared with ultrapotent corticosteroids (p < 0.001) and timolol maleate 0.5% gel compared with ultrapotent corticosteroids (p < 0.001). There was no significant difference in IH lesions after treatment with timolol maleate 0.5% solution versus gel (p = 0.744). Conclusion: Timolol maleate 0.5% solution and gel were significantly superior to topical ultrapotent corticosteroids in size reduction of superficial IH.
Neurofibromatosis type 1 (NF1) is a genetic disorder that is most common found. The disorder is a... more Neurofibromatosis type 1 (NF1) is a genetic disorder that is most common found. The disorder is autosomal dominant inheritance with penetrance 98-100% and has 50% mutation rate. Children with NF1 have a skin disorder varies, from mild form of macular café-au-lait spots and axillary freckling until neurofibroma. NF1 is also associated with an increased risk of malignancy, cognition disorders, psychiatric disorders, and epilepsy in children. Reported one case, a 12 years old boy, complained arise brownish spots on his back and armpits since he was 4 years old, history of seizures was denied and academic performance at school was fine. On physical examination found multiple café-au-lait spots and axillary freckling. No Lisch nodule and other abnormalities in the eye examination. Electroencephalography examination found abnormal epileptiform waves and brain mapping does not show focus and asymmetry. Examination of children&#39;s depression inventory is not found depression. Projective drawing showed a tendency dominancy in the group, tend to assert himself, imbalance of desire and ability, hence it may cause inner conflict, anxious, and insecure. NF1 diagnosis should be considered in cases of multiple café-au-lait, because it will affect the prediction of neurological disorders, psychiatric disorders, and the prediction of genetic inheritance. Hence, investigation of neurologic and psychiatric disorders is important related NF1 notion.
Journal of Clinical Images and Medical Case Reports, 2021
Background: Sturge-Weber Syndrome (SWS) is a neurocutaneous defect involving facial Port Wine Sta... more Background: Sturge-Weber Syndrome (SWS) is a neurocutaneous defect involving facial Port Wine Stain (PWS) with vascular deficits in the brain and ipsilateral eyes. Facial PWS can be the initial marker and help predict the severity of SWS. Aims and objectives: To study the association of facial PWS characteristics, neurological and ophthalmological deficits in SWS with the degree of severity. Materials and Methods: A retrospective descriptive study of patients with SWS was conducted at Dr. Sardjito Hospital between January 2010 - December 2020. Facial PWS characteristics were assessed from photographs. Assessments of neurological and ophthalmological deficits used physical and supportive examinations, including Electroencephalogram (EEG), Magnetic Resonance Imaging (MRI), and Intelligent-Quotient (IQ). Results: From 19 female patients aged 1 month to 26 years with facial PWS, seven fulfilled the inclusion criteria. “High risk” facial PWS V1 and P1 b distribution patterns were found i...
Alopesia areata (AA) merupakan penyakit autoimun yang ditandai dengan alopesia non-sikatrisial. K... more Alopesia areata (AA) merupakan penyakit autoimun yang ditandai dengan alopesia non-sikatrisial. Kondisi ini merupakan dermatosis yang umum ditemui pada anak. Gambaran klinisnya berupa alopesia non-sikatrisial fokal, perlu dibedakan dari kondisi dapatan serupa lainnya, terutama yang sering terjadi pada anak. Kami melaporkan 5 kasus AA pada anak berusia di bawah 18 tahun. Diagnosis berdasarkan pemeriksaan klinis dan penunjang. Pemahaman karakteristik AA perlu diketahui untuk diagnosis, terutama pada pasien anak.Alopecia areata (AA) is a chronic autoimmune disease characterized by non-scarring alopecia. It is one of the most commonly found dermatosis in pediatric population. The clinical manifestations of focal non-scarring alopecia must be differentiated from other acquired focal non-scarring alopecia, especially those in children. This paper report 5 AA cases in children. Diagnosis was based on clinical and supporting examinations. Understanding the characteristics of AA, particularl...
During the current Coronavirus Disease 19 (COVID-19) pandemic, regular handwashing and other hand... more During the current Coronavirus Disease 19 (COVID-19) pandemic, regular handwashing and other hand hygiene practices as the primary infection prevention program are highly encouraged. Notwithstanding the noticeable benefits in combating viral infection, hand hygiene practice potentially promotes dysbiosis of the skin microbiome. This review aimed to summarize the possible impacts of hand hygiene practices using soap products and alcohol-based hand rubs (ABHR) on the homeostasis of human skin microbiota. We discuss recent findings to provide evidence of the effectiveness of hand hygiene practices in viral infection control, the role of the skin microbiome in human health and the effects of hand hygiene practice on the homeostasis of the skin microbiome. Finally, this review also suggests improving research and practice of hand hygiene in response to the ongoing COVID-19 pandemic.
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Papers by Retno Danarti