Paramitasari, Anggana Rafika
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Keratoakantoma Regio Gluteal Paramitasari, Anggana Rafika; Arrochman, Ferry; Dewi, Susanti Rosmala; Imelda Betaubun, Ance; Zulfikar, Dendy; Yustin Ellista Sari, Endra
Cermin Dunia Kedokteran Vol 46, No 5 (2019): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (680.871 KB) | DOI: 10.55175/cdk.v46i5.482

Abstract

Keratoakantoma (KA) adalah neoplasma jinak sel skuamosa yang jarang berkembang menjadi karsinoma dan bermetastasis. Keratoakantoma sering dijumpai pada daerah terpapar sinar matahari dan secara klinis sulit dibedakan dari karsinoma sel skuamosa (KSS). Walaupun jarang, KA dapat muncul di tempat yang tidak terpapar matahari. Kasus seorang wanita 59 tahun dengan benjolan di bokong sejak 15 tahun yang makin membesar. Pasien pernah dioperasi namun lesi muncul kembali. Hasil pemeriksaan fisik menunjukkan tumor soliter regio gluteal 2 x 2,5 x 0,5 cm sewarna kulit terfiksir, bagian inti berbentuk seperti kawah dengan tepi berbatas tegas. Dermoskopi menunjukkan gambaran massa keratin hitam kekuningan di tengah lesi, dengan zona berwarna keputihan dan struktur vaskuler berbentuk hairpin di sekitar lesi. Pemeriksaan histopatologi menunjukkan tumpukan massa keratin dan nekrotik yang mengarah ke diagnosis KA. Pasien diterapi dengan eksisi luas.Keratoacanthoma (KA) is a benign neoplasm usually found in sun-exposed body surface. It is rarely developed into metastatic carcinoma, but difficult to be distinguished with squamous cell carcinoma (SCC). Previous surgery, obesity, and scratching lead to chronic trauma in gluteal region can be rare risk factors. The case is a 59 year-old woman with tumour in buttock area for 15 years. The tumour was previously removed but reccurent. Physical examination shows fixed solitary tumor 2 x 2,5 x 0,5 cm, with central yellowish and hyperpigmentation mass. Dermoscopic examination reveals yellowish and black mass in the centre, whitish halo and hairpin vascular pattern around the lesion. Histopathologic examination results keratin mass in the epidermis consistent to KA. This patient was treated with wide excision. 
Clinical diagnostic matrix (CDM) as a tool to diagnose subtypes of epidermolysis bullosa cases in children Widhiati, Suci; Marcella, Benazier; Dewi, Susanti Rosmala; Paramitasari, Anggana Rafika; Ellistari, Endra Yustin; Julianto, Indah
Journal of General - Procedural Dermatology & Venereology Indonesia
Publisher : UI Scholars Hub

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Abstract

Background: Epidermolysis bullosa (EB) is a rare genetic skin disease characterized by trauma-induced blisters, which appear shortly after birth. Immunofluorescence antigen mapping and mutational analysis are essential for establishing an accurate diagnosis of EB. However, in limited resource settings like in Indonesia, such techniques are not always readily available, forcing many clinicians to diagnose EB based on clinical features alone that is often inaccurate. Recently, a novel clinical diagnostic matrix (CDM) tool has been developed to improve the diagnostic accuracy of EB in such settings. Case Illustration: We examined clinical photographs and medical records of patients registered at the Dr. Moewardi hospital with a provisional diagnosis of EB since 2013 to 2017 and completed the 19 clinical manifestations required for the CDM’s electronic version. Discussion: CDM provides a diagnosis of the EB subtypes, which cannot be concluded in advance from the previous three cases, although histopathological examination have been carried out. Since immunofluorescence examination and genetic mapping are inaccessible in Indonesia, the CDM gave a brief possibility of diagnosing EB subtypes. Completing the CDM took less than five minutes and the result was available immediately after clinical features data input. Conclusion: CDM appears to be practical, easy to be used and helpful in characterizing EB, especially in limited resource settings. Moreover, it helps in clear documentation of clinical features in an EB patient that could be useful for accurate phenotype-genotype correlations in the future.