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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Journal of General Procedural Dermatology and Venereology Indonesia Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of General-Procedural Dermatology & Venereology Indonesia
Githa Rahmayunita
Department Of Dermatology & Venereology, Faculty Of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Cushings syndrome induced by misuse of topical corticosteroids in a child with psoriasis vulgaris Rahmayunita, Githa; Pulungan, Aman B.; Wiryadi, Benny E.; Wisesa, Tina W.; Sugito, Titi L.; Boediardja, Siti A.
Medical Journal of Indonesia Vol 17, No 4 (2008): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (18683.375 KB) | DOI: 10.13181/mji.v17i4.323

Abstract

Prolonged exc)genous corticosteroid aclministration may cause Cushingi syndrome. Howeve7 the development of Cushings syndrome from topical corlico,sleroid therapy is rare. A  7%-year- old boy has sufferedfrom psoriasis vulgaris since the age of nvo. He was treated by a dermatologist with a mixlure of 3% salicylic acid, 50% liquor carbonis delergens, 10 grams of 0.1% mometasonefuroate ointment, ancl 5 grams combination cream consisting of 0.1% gentamycin sulphate and 0.0250 Àfiuocinolone acetonide. The parents continued the treatment without the doctorb supervision. They applied it lo all over the patients body three times dailyfor 3% years. The patient showed milcl hypertension, moonface, btffilo hump, obesity, multiple striae, and suppression of hypothalamus-pituitary-adrenal axis. The bone minerttl density and bone age examinations revealed normal results. Children are more prone to develop systemic side fficts of topical medicalion beccntse o/their higher ratio of btal body surface area to body weight. Corticosteroid must be used with great care, especially in children. It is very important to inform the parents abott polential side effects of corticosteroid. (Med J Indones 2008; 17: 281-6)Keywords: Cushings syndrome - topical corticosleroids, sicle fficts
A double-blind randomized controlled trial of topical Curcuma xanthorrhiza Roxb. on mild psoriasis: clinical manifestations, histopathological features, and K6 expressions Rahmayunita, Githa; Jacoeb, Tjut N.A.; Novianto, Endi; Indriatmi, Wresti; Rihatmadja, Rahadi; Pusponegoro, Erdina H.D.
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (703.258 KB) | DOI: 10.13181/mji.v27i3.2511

Abstract

Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.
Correction Shanthi Narla; Githa Rahmayunita; Rinadewi Astriningrum; Tor Shwayder; Ariyati Yosi; Henry W. Lim
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 4, No 1 (2019): December 2019
Publisher : Universitas Indonesia

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Abstract

Narla S, Rahmayunita G, Astriningrum R, Shwayder T, Yosi A, Lim HW. The use of systemic medications in pediatric dermatoses: A review. J Gen Proced Dermatol Venereol Indones. 2019;4(1):25-38 In the article above, Table 1 is reprinted from Journal of the American Academy of Dermatology, Vol 76, Totri CR, Eichenfield LF, Logan K, Proudfoot L, Schmitt J, Lara-Corrales I, Sugarman J, Tom W, Siegfried E, Cordoro K, Paller AS, Flohr C, Prescribing practices for systemic agents in the treatment of severe pediatric atopic dermatitis in the US and Canada: The PeDRA TREAT survey, Pages 281-285, Copyright 2016, with permission from Elsevier. Table 2 is reprinted from Clinics in Dermatology, Vol 33, Slater NA, Morrell DS, Systemic therapy of childhood atopic dermatitis, Pages 289-299, Copyright 2015, with permission from Elsevier. Table 3 is modified from Journal of the American Academy of Dermatology, Vol 82, Lansang P, Bergman JN, Fiorillo L, Joseph M, Lara-Corrales I, Marcoux D, McCuaig C, Pope E, Prajapati VH, Li SZJ, Landells I, Management of pediatric plaque psoriasis using biologics, Pages 213-221, Copyright 2019, with permission from Elsevier.
The management of seborrheic dermatitis 2020 Sandra Widaty; Kusmarinah Bramono; Muhammad Yulianto Listiawan; Ariyati Yosi; Eliza Miranda; Githa Rahmayunita; Herwinda Brahmanti; Henry Wan-Peng Lim
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 1 (2020): December 2020
Publisher : Universitas Indonesia

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Abstract

Background: Seborrheic dermatitis (SD) is a chronic relapsing dermatitis manifesting in the seborrheic area, affecting infants or adults. In Indonesia, the prevalence of SD is 0.99–5.8% of all dermatology cases from 2013 to 2015. SD has been known to be a prominent manifestation among HIV patients, but there is an increasing trend in the general population. Therefore, in 2017, the Indonesian Society for Dermatology and Venereology proposed a consensus for the management of SD in Indonesia based on the discussion from 12 dermatological centers. Concurrent with the development of new drugs, this study aims to evaluate and develop a guideline for the treatment of seborrheic dermatitis in Indonesia to update the previous guidelines in 2017. Methods: Systematic review was based on evidence-based methods, and scientific evidences were acquired through systematic search. Evidence analysis was in accordance with the level of evidence. The available evidences were evaluated, and conclusion was based on the grade of recommendation. Critical appraisal was conducted by experts in dermatology and venereology.Results: Severity of SD can be determined by using the Seborrheic Dermatitis Area Severity Index. The principle of scalp SD management is controlling the scalp condition in a cost-effective manner to make patients comfortable. The recommendations for treatment of adult SD are topical agents, such as antifungals, nonsteroidal anti-inflammatory agents with antifungal properties, corticosteroids, and calcineurin inhibitors.Conclusion: We have updated and added newer agents for the treatment of SD. The approach is divided into scalp or nonscalp and also adult or infantile SD. Keywords: seborrheic dermatitis, management approach, diagnosis, Seborrheic Dermatitis Area Severity Index, guidelines
Indonesian clinical practice guidelines for systemic and biologic agents for adults with plaque psoriasis Endi Novianto; Windy Keumala Budianti; Eyleny Meisyah Fitri; Benny Effendi Wiryadi; Retno Widowati Soebaryo; Erdina H. D Pusponegoro; Evita Halim Effendi; Githa Rahmayunita; Anis Irawan; Cita R. S. Prakoeswa; Harijono Kariosentono; Shafira Anindya Purnawan; Arlha Aporia Debinta
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 3 (2021): December 2021
Publisher : Universitas Indonesia

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Abstract

Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, and outcomes of various treatments options.Results: Modified evidence to decision framework of treatment choices were constructed to aid dermatovenerologists across Indonesia in making a clinical judgment on the size of treatment options of biologic and non-biologic systemic agents for psoriasis treatment in Indonesia.Conclusion: These clinical practice guidelines, accepted and acknowledged by the Indonesian Society of Dermatology and Venereology - Kelompok Studi Psoriasis Indonesia (INSDV-KSPI), have been developed to present the latest and concise evidence- and experience-based guideline targeted towards dermatovenereologists in Indonesia on the management of adult plaque psoriasis. Keywords: biologic agents, guidelines, Indonesian, psoriasis
Ultraviolet phototherapy for treatment of various dermatoses Irwan Saputra Batubara; Larisa Paramitha Wibawa; Erdina Pusponegoro; Windy Keumala Budianti; Githa Rahmayunita; Shannaz Nadia Yusharyahya
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005304202107

Abstract

Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wavelength, UV radiation consists of three types, namely ultraviolet C (UVC), ultraviolet B (UVB), and ultraviolet A (UVA). The types of UV that are widely used in dermatology are narrowband ultraviolet B (NB-UVB), broadband ultraviolet B (BB-UVB), UVA1, and psoralen combined with UVA (PUVA). The interaction between UV and the skin determines the effectiveness of phototherapy. The biological effects of UV are used in the management of inflammatory skin diseases, malignancies, and various rare dermatoses. Apart from these benefits, UV increases the risk of photoaging and skin cancer. Therefore, further researches are necessary to enhance the effectiveness and safety of phototherapy. This literature review discusses the role of phototherapy in various dermatoses other than psoriasis and vitiligo.
BLENDED LEARNING AS A METHOD FOR IMPROVING STUDENTS’ ACHIEVEMENT IN DERMATOTHERAPY: A PRELIMINARY STUDY Sri Linuwih Menaldi; Hanny Nilasari; Githa Rahmayunita; Siti Farida; Nanda L. Prasetya
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 9, No 3 (2020): November
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.55485

Abstract

Background: Dermatotherapy is an important topic in Dermatology and Venereology module. The time allocated for dermatotherapy topic is limited, so that the development of learning method is needed to achieve the learning objectives. Blended learning is a combination of e-learning and face to face lecture session. This method is often used when there is less time available for lecturing and limited number of teachers. This learning method is expected to be more effective and efficient for the students and also the teachers. This study was conducted to examine the effectiveness of blended learning method used in dermatotherapy topic, and to identify the obstacle of using this method. Methods: This study is a cross sectional study, using quantitative and qualitative approach, involving 22 fifth-year medical students of Faculty of Medicine Universitas Indonesia who enrolled in dermatology and venereology module. We collected data from questionnaire, pre and post-test, and feedback from the students. Comparison of pre-test and post-test results were analysed using paired T test, and followed by bivariate test of students’ characteristic, gadget usage and e-learning activities associated with the increased post-test score.Results: An increased in post-test score was found to be statistically significant (p<0.05). Approximately 95,4% of students passed the final exam on the dermatotherapy subject. Bivariate analysis revealed that the number of gadgets owned, digital usage and e- learning activities did not have a significant effect on the post-test score. Based on the students’ feedback, blended learning had a positive impact on helping their learning process; however, the materials of e-learning must be interactive, informative and comprehensive. Face-to-face lecture is still an important component in learning hence it is irreplaceable. Conclusion: Blended learning is an effective method of learning and should be considered if there is limitation of lecture time and number of teachers available. By using this method, medical students are more flexible in their study and it can be adjusted to their own learning style hence heling them understand better. Further development and improvement are needed for this method as to achieve the learning objectives.  Keywords: blended learning, dermatotherapy, medical students
Multiple juvenile xanthogranuloma: A rare case of having clinical appearance mimicking molluscum contagiosum or syringoma Nugraha, Heru; Rosandi, Ridha; Nainggolan, Evelyn; Rahmayunita, Githa; Agustin, Triana; Rihatmadja, Rahadi; Boediardja, Siti Aisah
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Introduction: Juvenile xanthogranuloma (JXG) is an uncommon benign cutaneous fibrohistiocytic, self-healing, class II non-Langerhan’s cell histiocytosis (NLCH). JXG accounts for 80-90% of cases of NLCH. It occurs most commonly on the head and neck of infants and young children and resolves spontaneously. Case: A one year-old boy presented with asymptomatic, multiple yellowish, shiny, and firm nodules with telangiectasia on the surface, measuring around 1 centimeter in diameter, on the face, the trunk, the arms, and lower extremities. The first lesion appeared on the face 8 months prior to consultation then spread gradually to other areas. He was referred from another hospital and was diagnosed as molluscum contagiosum (MC) with differential diagnosis of syringoma. Enucleation had been performed but failed to produce the molluscum bodies. Initial histopathological examination provided the diagnosis of syringoma. The second histopathological examination showed dermal inflammatory cells consisting of eosinophils, lymphocytes, and histiocytes with marked foam cells and giant cells. Eccrine sweat glands were normal. Some lesions decreased in size at subsequent follow-ups; observation was advised until 3-6 years. Discussion: JXG should be suspected in cases with multiple yellowish nodules appearing in the first year of life. MC usually presents with whitish papules, whereas syringoma is more rarely appeared, presenting with yellow-to-brownish papules. Histopathological examination can easily differentiate the suspected diagnoses; however, selection of lesion, timing and complete clinical information was crucial in reaching the final diagnosis. In this case there was a good clinicopathological correlation that the diagnosis of JXG was made with certainty. There was no eye and other organ abnormalities.
Occupational skin cancer and precancerous lesions Raissa, Fifinela; Rahmayunita, Githa; Menaldi, Sri Linuwih; Soemarko, Dewi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 3
Publisher : UI Scholars Hub

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Abstract

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 the skin are actinic keratosis and Bowen’s disease. Particular diagnostic criteria to diagnose occupational diseases has been developed. Early detection of occupational skin cancer and precancerous lesion is necessary. An effective prevention program consists of primary prevention such as prevention of hazardous material exposure, secondary prevention such as early detection of disease for early intervention, and tertiary prevention such as minimizing long-term impact of the disease.
Profile of vitiligo patients and distribution of narrowband-UVB therapy at dr. Cipto Mangunkusumo General Hospital Suseno, Lis Surachmiati; Sukma, Putu Martha Gerynda; Rihatmadja, Rahadi; Agustin, Triana; Rahmayunita, Githa; Novianto, Endi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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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 obtained from dr. Cipto Mangunkusumo General Hospital medical records during the period of 2015-2017. Results: There were 255 vitiligo patients enrolled. Females were greater in number (55.3%). Most patients were distributed evenly in all age groups, highest number of patients were the 21-30 years age group (18.8%). Most patients received elementary school–high school education (56.9%), worked as private employees (36.9%), resided in Jakarta (47.8%). The common diagnosis were unspecified vitiligo (53.3%). Onset of symptoms were mostly around 2 months prior to diagnosis (38.8%) and most of the patients received other treatments other than narrowband-UVB (N=180, 70.6%). Conclusion: The number of vitiligo cases decreased each year with the average vitiligo cases of 85 cases per year and mostly women whereas the number of unspecified vitiligo were quite high. Therefore, more attention is needed from the physicians to treat the patient starting from the establishment of vitiligo to the decision treating with narrowband-UVB.
Co-Authors Aldri Frinaldi Aman B. Pulungan Anis Irawan Arini Astasari Widodo Ariyati Yosi Ariyati Yosi Arlha Aporia Debinta Astriningrum, Rinadewi Azizah, Fitri Benny E. Wiryadi Benny Effendi Wiryadi Cita R. S. Prakoeswa Dewi Sumaryani Soemarko Eliza Miranda Endi Novianto Erdina H. D Pusponegoro Erdina Pusponegoro Evita Halim Effendi Eyleny Meisyah Fitri Hanny Nilasari Harijono Kariosentono Henry W. Lim Henry Wan-Peng Lim Herwinda Brahmanti Hikari Ambara Sjakti, Hikari Ambara Irwan Saputra Batubara Jacoeb, Tjut N.A. Jacoeb, Tjut Nurul Alam Krisanti, Inge Ade Kusmarinah Bramono Larisa Paramitha Lim, Henry W Lim, Henry W. Lusiana Lusiana M. Yulianto Listiawan Miranda, Eliza Nainggolan, Evelyn Nanda L. Prasetya Narla, Shanthi Nugraha, Heru Pusponegoro, Erdina H.D. Rahadi Rihatmadja Rahman, Yusnita Raissa, Fifinela Retno Widowati Soebaryo Rinadewi Astriningrum Rosandi, Ridha Sandra Widaty Sandra Widaty Shafira Anindya Purnawan Shannaz Nadia Yusharyahya Shanthi Narla Shwayder, Tor Siti A. Boediardja Siti Aisah Boediardja Siti Farida Sri L. Menaldi Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Sukma, Putu Martha Gerynda Suseno, Lis Surachmiati Tina W. Wisesa Titi L. Sugito Tor Shwayder Triana Agustin Windy Keumala Budianti Windy Keumala Budianti Wresti Indriatmi B. Makes Yosi, Ariyati