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All Journal Journal of General-Procedural Dermatology & Venereology Indonesia
Azizah, Fitri
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Medicine & Pharmacology

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Journal : Journal of General-Procedural Dermatology

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The effectiveness of laser therapy in onychomycosis patients: An evidence-based case report Prayogo, Rizky Lendl; Gaol, Evangelina Lumban; Azizah, Fitri; Lusiana, Lusiana; Rachmawati, Yenny; Rahman, Yusnita; Saldi, Siti Rizny
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 2, No. 1
Publisher : UI Scholars Hub

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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.
Generalized pustular psoriasis and Cushing’s syndrome in childhood due to corticosteroids misuse Azizah, Fitri; Rahman, Yusnita; Rihatmadja, Rahadi; Agustin, Triana; Astriningrum, Rinadewi; Rahmayunita, Githa
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 3
Publisher : UI Scholars Hub

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Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake of pus along with red-purple striae all over the body.Discussion: Adverse effects of steroid-induced adrenal insufficiency are time-dependent and generally reversible. Gradual discontinuation of steroids must adhere to physiological dose of steroids, mostly in 3.49 ± 2.92 months. Other treatments available are emollients, salicylic acid, calcipotriol, coal tar, topical steroids, phototherapy, retinoids, and cyclosporine. Topical steroids cannot be the main therapy in severe psoriasis due to the possible side effects of excessive usage. Conclusion: Misuse of topical and systemic steroid in children could lead to Cushing’s syndrome, a multisystem disorder resulting from prolonged exposure to excess glucocorticoids, either both systemic or topical. Children could easily develop systemic reactions to topical steroids due to their higher total body surface area to body weight ratio.
Co-Authors Astriningrum, Rinadewi Gaol, Evangelina Lumban Githa Rahmayunita Lusiana Lusiana Prayogo, Rizky Lendl Rachmawati, Yenny Rahadi Rihatmadja Rahman, Yusnita Saldi, Siti Rizny Triana Agustin