Tri Irfanti, Rakhma
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Diaper Dermatitis Tri Irfanti, Rakhma; Imelda Betaubun, Ance; Arrochman, Ferry; Fiqri, Ahmad; Rinandari, Ummi; Anggraeni, Reti; Yustin Ellistasari, Endra
Cermin Dunia Kedokteran Vol 47, No 5 (2020): CME - Continuing Medical Education
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (877.502 KB) | DOI: 10.55175/cdk.v47i5.362

Abstract

Diaper dermatitis (juga dikenal sebagai ruam popok, nappy rash, atau dermatitis iritan karena popok) adalah istilah umum untuk meggambarkan inflamasi akut pada area terkena popok; kondisi ini umumnya terjadi pada bayi. Etiologi dermatitis popok adalah multifaktorial. Diagnosis dan penatalaksanaan tepat mendapatkan hasil optimal; diperlukan kerjasama antara orang tua, pengasuh, dan tenaga medis.Diaper dermatitis (also known as diaper rash, nappy rash, or irritant dermatitis due to diapers) is a general term used to describe acuteinflammation in an area affected by a diaper; this condition generally occurs in infants. The etiology of diaper dermatitis is multifactorial. Proper diagnosis and management get optimal results; collaboration between parents, caregivers, and medical personnel is needed.
Profil Penggunaan Kortikosteroid Sistemik untuk Terapi Sindrom Stevens Johnson (SSJ) – Nekrolisis Eepidemal Toksik (NET) di Instalasi Rawat Inap RSUD DR. Moewardi Surakarta, Indonesia - Januari 2016 -Desember 2017 Tri Irfanti, Rakhma; Imelda Betaubun, Ance; Fiqri, Ahmad; Anggraeni, Reti; Rinandari, Ummi; Kariosentono, Harijono
Cermin Dunia Kedokteran Vol 48, No 4 (2021): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (128.835 KB) | DOI: 10.55175/cdk.v48i4.1364

Abstract

Latar belakang: Nekrolisis epidermal disebut Sindrom Stevens Johnson (SSJ) apabila yang terlibat kurang dari 10% dari area tubuh, 10% sampai 29% disebut SSJ overlap NET dan lebih dari 30% NET. Tujuan : Untuk mengetahui gambaran umum pasien SSJ-NET serta penggunaan kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2016 – Desember 2017. Metode : Studi deskriptif retrospektif dengan populasi dan sampel penelitian pasien rawat inap di Instalasi Rawat Inap RSUD Dr. Moewardi, Surakarta, periode Januari 2016 – Desember 2017. Sampel menggunakan data sekunder dari status rekam medis di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta. Hasil: Total pasien 26 orang terutama berusia 46 – 55 tahun dan 56 – 65 tahun (23%). Laki-laki lebih banyak (57%). Diagnosis SSJ (61%) terbanyak dibandingkan SSJ overlap NET (19%) ataupun NET (19%). Hipertensi sebagai penyakit penyerta terbanyak (15%). Keterlibatan mukosa terbanyak pada mulut (88 %) dan penyebab terbanyak SSJ-NET melibatkan lebih dari satu macam obat (53%). Obat penyebab yang dicurigai terutama adalah antibiotik golongan sefalosporin dan parasetamol (23%). Rerata lama terapi deksametason adalah 10 hari dengan dosis rata-rata 25 mg per hari. Simpulan: Pengobatan kortikosteroid sistemik pada kasus SSJ – NET di RSUD dr. Moewardi Surakarta pada umumnya menghasilkan perbaikan klinis dengan rata-rata perawatan 10 hari dan dosis rata-rata deksametason 25 mg per hari.Background: Epidermal Necrolysis is classified into several degree of severity based on the area of the body involved, below 10% is SJS, 10% - 29% is SJS overlap TEN and 30% is TEN. Objective: To provide general description of SJS-TEN patients and systemic corticosteroids therapy in Dr.Moewardi General Hospital Surakarta January 2016 - December 2017. Methods: A retrospective descriptive study on in-patients in Dr. Moewardi General Hospital Surakarta between January 2016 and December 2017. Results: Total sample was 26 patients, mostly male (57%) in 46 - 55 year-old and 56 - 65 year-old (23%). The most common diagnosis was SJS (61%) followed by SJS overlap TEN (19%) and TEN (19%). Hypertension was the most frequent comorbid disease (15%). Mostly affected was mouth mucosa (88%) and caused by mostly more than one drug (53%). Suspected causative drugs were mostly cephalosporin and paracetamol (23%). The average duration of dexamethason therapy was 10 days with an average dose 25 mg per day. Conclusion: SSJ - NET cases in Dr. Moewardi General Hospital Surakarta were mostly treated with systemic corticosteroids for an average of 10 days and an average dose of dexamethason 25 mg per day.
Terapi Kortikosteroid Sistemik untuk Sindrom Steven Johnson (SSJ)- Nekrolisis Epidermal Toksik (NET) di RSUD DR Moewardi, Surakarta, Indonesia Novi Diana, Eka Devinta; Tri Irfanti, Rakhma; Rahma, Alfina; -, Frieda; Nugraha, Wibisono; Eko Irawanto, Muhammad
Cermin Dunia Kedokteran Vol 48, No 4 (2021): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1195.538 KB) | DOI: 10.55175/cdk.v48i4.1363

Abstract

Latar belakang :Sindrom Steven Johnson (SSJ) dan nekrolisis epidermal toksik (NET) adalah manifestasi reaksi alergi obat paling berat dan mengancam jiwa yang dimediasi sel T. Salah satu terapi SSJ-NET yaitu kortikosteroid sistemik. Tujuan : Mengetahui pola terapi kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Metode : Penelitian deskriptif retrospektif atas data rekam medis pasien SJS-NET di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Hasil : Didapatkan 80 pasien SJS-NET, usia terbanyak 46-65 tahun (39%), lebih banyak laki-laki (52%). Diagnosis SSJ paling banyak (61%) dibandingkan SSJ overlap NET (24%) maupun NET (15%) dengan keterlibatan mukosa mulut terbanyak (64%). Penyakit penyerta terbanyak adalah diabetes melitus (18 %). Penyebab SSJ-NET terbanyak diduga lebih dari satu obat (44%). Terapi kortikosteroid sistemik berupa injeksi metilprednisolon dengan rata-rata dosis 65 mg/hari dan lama perawatan 10 hari. Simpulan :Kortikosteroid sistemik merupakan terapi semua kasus SSJ-NET di RSUD dr. Moewardi Surakarta.Background: Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the severest primarily T-cell mediated manifestation and life threatening drug reaction. Systemic corticosteroid is used for SJS-TEN management. Objective: To study the pattern of systemic corticosteroid therapy for SJS-TEN in Dr.Moewardi General Hospital Surakarta Januari 2014-December 2018. Method: A descriptive retrospective study on medical record data of SJS-TEN patients hospitalized at Dr.Moewardi General Hospital Surakarta between January 2014 and December 2018. Results: From a total 80 SJS–TEN patients in this study, 39% was 46-65 year-old, male (52%). The most frequent diagnosis was SJS (61%) followed by SJS overlap TEN (24%) and TEN (15%), mostly with mucosal mouth involvement (64%). The most frequent comorbidities was DM (18%). More than one drug were related to SJS-TEN (44%). Therapy for all cases was systemic corticosteroids with an average dose of methylprednisolone 65 mg per day in 10 days. Conclusion :Systemic corticosteroids was used in all cases of SSJ-NET in Dr.Moewardi General Hospital Surakarta.  
Terapi Topikal Kombinasi Krim AsamTraneksamat 3%, Nikotinamid 3% Dan Microneedling Pada Pasien Melasma (Pilot Study) Tri Irfanti, Rakhma; Damayanti, Willa; Fatiharani Dewi, Putty; Oktriana, Putri; Mulianto, Nurrachmat; Mawardi, Prasetyadi
Cermin Dunia Kedokteran Vol 48, No 3 (2021): Obstetri dan Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (710.544 KB) | DOI: 10.55175/cdk.v48i3.1332

Abstract

Latar belakang : Melasma adalah hiperpigmentasi wajah pada wanita di area yang sering terpapar sinar matahari, bersifat kronis kambuhan. Saat ini formula Kligman masih menjadi pilihan terapi efektif tetapi mempunyai efek samping terutama pada pemakaian jangka lama. Kombinasi terapi asam traneksamat, nikotinamid dan microneedling merupakan terapi alternatif yang aman dan efektif untuk jangka lama. Tujuan : Untuk mengetahui keberhasilan terapi kombinasi topikal krim asam traneksamat 3%, nikotinamid 3% dan microneedling dalam menurunkan skor MASI dan indeks melanin pasien melasma. Kasus : Dua pasien perempuan umur 45 dan 44 tahun dengan keluhan utama bercak hitam di wajah. Pasien 1 dengan melasma tipe campuran dan pasien 2 dengan melasma tipe epidermal. Pasien diterapi topikal menggunakan krim kombinasi asam traneksamat 3% dan nikotinamid 3% dengan microneedling. Microneedling dilakukan pada minggu ke-0, ke-4 dan ke-8. Evaluasi terapi saat minggu ke-0, 4, 8 dan 12, dengan skor MASI dan indeks melanin menggunakan Mexameter®. Hasil : Terdapat penurunan nilai skor MASI dan indeks melanin. Simpulan : Terapi kombinasi krim asam traneksamat 3%, nikotinamid 3% dan microneedling dapat menurunkan skor MASI dan indeks melanin.Melasma is chronic and recurrent facial hyperpigmentation common in women and in areas frequently exposed to sunlight. Kligman formula therapy is still the effective treatment but has several side effects especially in long-term use. Combination of tranexamic acid, nicotinamide and microneedling is a safe and effective alternative for the long term therapy.Objective: To measure the effectiveness of topical combination therapy of 3% tranexamic acid cream, nicotinamide 3% and microneedling in reducing MASI score and melanin index in melasma patients. Cases: Two females aged 45 and 44 years with facial black spots. First patient diagnosed as mixed type melasma and 2nd patient with epidermal type melasma. Patients were treated with topical combination of 3% tranexamic acid and 3% nicotinamide cream with microneedling. Microneedling were done in the 0th, 4th and 8th weeks. Evaluation and measurement was done at weeks 0, 4, 8 and 12, with MASI scores and melanin index using Mexameter®. Results: There was a decrease in MASI score and melanin index.Conclusion: Combination therapy of tranexamic acid cream 3%, nicotinamide 3% and microneedling could reduce MASI score and melanin index.