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Journal : Berkala Ilmu Kesehatan Kulit dan Kelamin

Insufisiensi Adrenal Sekunder pada Eritema Nodosum Leprosum: Studi Profil TNF-α dan Kortisol Serum Irmadita Citrashanty; Sunarso Suyoso; Rahmadewi Rahmadewi
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 26 No. 2 (2014): BIKKK AGUSTUS 2014
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.361 KB) | DOI: 10.20473/bikk.V26.2.2014.1-6

Abstract

Latar belakang: Beberapa studi mengemukakan bahwa peningkatan tumor necrosis factor–alpha (TNF-α) sebanding dengan derajat keparahan Eritema Nodosum Leprosum (ENL), sehingga sitokin ini dianggap sebagai seromarker. Sekresi adrenocorticotropin hormone (ACTH) meningkat akibat pelepasan sitokin proinflamasi, kemudian ACTH akan merangsang pelepasan glukokortikoid adrenal sebagai umpan balik. Apabila rangsangan sitokin ini berlangsung kronis, korteks adrenal akan mengalami kelelahan yang berakibat menurunnya serum kortisol. Pemberian kortikosteroid eksogen jangka panjang diduga menyebabkan terjadinya penurunan kortisol. Tujuan: Mengevaluasi profil TNF-α dan kortisol serum pada pasien ENL yang diterapi kortikosteroid berdasarkan riwayat lamanya ENL. Metode: Dua puluh satu subjek dilakukan pemeriksaan fisik, anamnesis riwayat ENL, dan pengambilan sampel darah jam 08.00-09.00 untuk melihat kadar TNF-α dan kortisol serum. Hasil: Dari 21 sampel didapatkan rerata TNF-α serum sebesar 4,51 ± 1,7 ρg/mL. Rerata kortisol serum pada pasien dengan riwayat ENL 1-12 bulan sebesar 15,23 ± 2,3 μg/dL, riwayat ENL > 12-24 bulan sebesar 8,75 ± 4,8 μg/dL, dan riwayat ENL > 24-36 bulan sebesar 1,17 ± 0,7 μg/dL. Simpulan: Rerata penurunan kortisol serum tampak seiring dengan semakin lamanya pasien menderita ENL dan mendapatkan terapi kortikosteroid. Insufisiensi adrenal sekunder pada penelitian ini dapat disebabkan oleh pemberian kortikosteroid jangka panjang maupun adanya paparan sitokin proinflamasi kronis. Kata kunci: eritema nodosum leprosum, insufisiensi adrenal sekunder, kortikosteroid, TNF-α, kortisol.
Excellent Response of Infantile Hemangioma with Oral Propranolol: A Case Report Denissafitri, Armyta; Pramitha, Riezky Januar; Yuri Widia; Zulkarnain, Iskandar; Irmadita Citrashanty; Sawitri, Sawitri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 3 (2022): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.3.2022.217-222

Abstract

Background: Infantile hemangioma (IH) is the most common benign tumor in infancy. Most IHs resolve spontaneously and do not require treatment. Therapeutic intervention is necessary for life-threatening IH, tumors posing functional risks, ulceration, and severe anatomic distortion, especially on the face. Beta-blockers, most specifically propranolol, have been shown to induce involution of IH, which should be administered as early as possible to avoid potential complications. Purpose: To report a case of IH with visual impairment treated successfully using oral propranolol. Case: A 4-month-old girl weighing, 6.3 kg, with redness plaques on the right face since 3 weeks after birth. The lesions rapidly increased in size within 2 months, and the lesions on her right eyelid made it difficult to open her right eye. Dermatological examination showed erythematous plaques, compressible and varying in size and ptosis. The patient was diagnosed with periocular infantile hemangioma and was given oral propranolol therapy with an initiated dose 3x1 mg. The dose was increased gradually. The lesions were significantly decreased and she could open her right eye normally after 5 months of propranolol therapy. Discussion: Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects. Conclusion: Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes.
A Retrospective Study of Demographic, Clinical, and Histopathological Profiles of Cutaneous Tumors Bintanjoyo, Lunardi; Hidayati, Afif Nurul; Cita Rosita Sigit Prakoeswa; Murtiastutik, Dwi; Bagus Haryo Kusumaputra; Listiawan, Muhammad Yulianto; Irmadita Citrashanty; Maylita Sari
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 3 (2022): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.3.2022.149-155

Abstract

Background: In 2007, skin cancers were third most common malignancies in Indonesia. However, profile of cutaneous tumors in our institution has not been studied. Purpose: To evaluate profile of cutaneous tumors in Dermatology and Venerology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: This is a descriptive retrospective study. Inclusion criteria was new cutaneous tumor patients. Exclusion criteria was incomplete data. Medical record and  photograph database from 2019-2020 were assessed for demography, clinical features, histopathological examination and final diagnosis. Results: There were 379 (5,5%) cutaneous tumors among 6896 new patients at Dermatology and Venereology Outpatient Clinic. Overall, there were more female patients (53.7%) and age group of 0-45 years old (70.4%). Cutaneous tumors more commonly presented as papular (50.4%), multiple (56.5%), nonpigmented (58.3%), asymptomatic lesions (62.5%), with time from onset 0-24 months (66.2%) and location on head and face (61.2%). Benign cutaneous tumors showed similar findings. Malignant cutaneous tumors showed differences including predominantly male sex, age above 45 years old, nodular, solitary, pigmented and easily bleeding lesions. Malignant tumors were less common (6.9%). Most common malignant tumor was BCC. Most common benign and overall cutaneous tumor was seborrheic keratosis. Conclusion: Cutaneous  tumors presented across gender and ages, showing heterogenous clinical manifestations. Malignant and benign cutaneous tumors showed similarity on time from onset and location of lesions. However, differences were seen in demographic profiles and majority of clinical features. BCC was the most common malignant cutaneous tumors, while seborrheic keratosis was the most common benign and overall cutaneous tumors.