Nugrahani, Aninda Fitri
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Tuberous Sclerosis Complex : A Case Report Rofiq, Aunur; Setyowati, Lita; Nugrahani, Aninda Fitri
Saintika Medika: Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol 15, No 2 (2019): December 2019
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (252.228 KB) | DOI: 10.22219/sm.Vol15.SMUMM2.9935

Abstract

Tuberous Sclerosis Complex (TSC) is an autosomal dominant inherited neurocutaneous disorder. Tuberous Sclerosis Complex is caused by mutations in tumor suppressor gene (TSC), both TSC1 and TSC2.  In approximately two-thirds of cases neither parent has signs of TSC and the disease is caused by a de  novo mutation. Tuberous Sclerosis Complex is classically identified by the Vort's triad in the presence of angiofibroma, mental retardation, and epilepsy. A 17-year-old woman with a major complaint of a facial bump that appeared at birth and got bigger when she reached puberty. There are white patches on the patient's body from birth. On the scalp obtained the presence of skin color plaque, while at the back and right knee obtained shagreen patch. Patientwas diagnosed with epilepsy and mental retardation by the pediatric department. No family history has the same complaints as patient. Histopathologic examination of facial bumps taken by shaving biopsy suggests the presence of hemangiomas. Based on the clinical diagnostic criteria from International Tuberous Sclerosis Complex Consensus Conference 2012, the patient meets two major criteria, macular hypopigmentation and shagreen patch so it is included in "definite diagnosis".
Mixed-Type Melasma Treated with Low Fluence Q-Switched Nd-YAG 1064 nm Laser: A Case Report Nugrahani, Aninda Fitri; Murlistyarini, Sinta
Indonesian Journal of Medicine Vol 5, No 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Melasma is an acquired, chro­nic hypermelanosis condition. Melasma is more common in women of all races and occur espe­cially on the face. The pathogenesis of melasma is very complex and the treatment is still a challenge. The purpose of this study was to report mixed-type melasma treated with low fluence Q-switched Nd-YAG 1064 nm laser.Case Presentation: A case of melasma in 54 year old woman was reported. Dermatological examination showed presence of brownish macules and patches in the centro facial area with symmetrical distribution. Examination with wood lamp showed mixed type. Patients have received topical therapy but there were no improvement.Results: The patient was then treated with low fluence Q-switched Nd-YAG 1064 nm laser for three sessions with an interval of 2 weeks. At 6 weeks of treatment the modified MASI (mMASI) value was reduced from 8.4 to 4.6 and the VAS value was increased from 2 to 8.Conclusion: The depth of the pigment deter­mined the response to therapy. In the mixed type melasma the response for therapy is only partial. The low-fluence Q-switched Nd-YAG 1064 nm laser can penetrate deeper into the dermis and damage melanin in a short time.Keywords: mixed typed melasma, low fluence, Q-switched Nd-YAG laserCorrespondence: Aninda Fitri Nugrahani. Department of Derma­tology and Venereology, DR. Saiful Anwar Hospital, Malang, East Java/ Faculty of Medi­cine, Universitas Brawijaya, Malang, East Java. Email: aninda16fitri@gmail.comIndonesian Journal of Medicine (2020), 05(02): 95-101https://doi.org/10.26911/theijmed.2020.05.02.01