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Subcutaneous mycosis at the Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013 Sammy Yahya; Sandra Widaty; Eliza Miranda; Kusmarinah Bramono; Artini Wijayanti Islami
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usually found in workers of rural tropical and subtropical area. SM occurs due to trauma along with other predisposing factors such as sex, genetic and occupation. Aim: To identify the types of SM, its clinical findings, laboratory work-up and the treatment at the Dermatomycology Division, Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital between the year 1989 and 2013. Method: This retrospective study collected data from medical records and case reports of patients with SM who came at Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital (1989-2013). Results: We found 16 cases of SM, i.e. subcutaneous mucormycosis (5 cases), eumycetoma (4 cases), actinomycetoma (4 cases) and chromoblastomycosis (3 cases). There was a greater number of male than female patients ratio (3:1) and mostly were in the age group of 25-44 years. The direct microscopic examination did not reveal any fungal element, except for black spora in chromoblastomycosis (1 case). The culture revealed Basidiobolus ranarum in subcutaneous mucormycosis (5 cases), Nocardia transvalensis in actinomycetoma (1 case) and Phialophora sp. in 1 case of chromoblastomycosis. On histopathological examination, we found fine granules of actinomycetoma, sulphuric granules of actinomycetoma, coenocytic hyphae of subcutaneous mucormycosis, eosinophilic granule in 1 case of mycetoma and hyphae with black spore in chromoblastomycosis. Conclusion: SM is still a rare disease, comprehensive management of SM needs supporting laboratory work-up, particularly the histopathological examination. Keywords: mycosis, subcutaneous, culture, histological

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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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

Case series of primary psychiatric skin disorders with multi-disciplinary approach Lusiana Lusiana; Rizky Lendl Prayogo; Shannaz Nadia Yusharyahya; Irma Bernadette S. Sitohang; Kusmarinah Bramono
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 4, No 2 (2020): June 2020
Publisher : Universitas Indonesia

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Background: The incidence of psychodermatologic diseases, a group of skin abnormalities associated with psychosomatic factor, are increasing recently. About 20-40% patients with skin symptoms have concurrent psychiatric problems which are often difficult to diagnose and treat. The new classification of primary psychiatric skin disorders are delusional disorders, obsessive-compulsive and related disorders, and factitious disorders. This classification could be used for effective treatment in each patient which involves multi-disciplinary approach, including dermatology, psychiatry and other discipline if necessary. Case Illustration: The first case was a 39-year-old unmarried female, with anemia and dermatitis artefacta occurred as wound due to blade cuts. Patient was with schizoaffective depressive type and was not under regular treatment. The second case was a 61-year-old male referred with unresolved prurigo nodularis for the past 30 years. After in-depth assessment, there were delusional parasitosis and neurotic excoriations disorders. The third patient was a 50-year-old female admitted with recurrent ulcer on her face. She was aware that the lesions were intentionally manipulated by her own fingers when she was depressed. Discussion: All patients were classified as primary psychiatric skin disorders with varied skin manifestations. Symptoms usually occurred when the patient was in the depression state or low compliance for the psychotropic drugs. Patients generally had poor insight and refused to be associated with psychiatric factors. Dermato-venereologists are expected to conduct early detection and treat this disease. Conclusion: It is important to approach psychocutaneous disease in multi-disciplinary manner, especially with the psychiatrist. Keywords: psychodermatologic, dermatitis artefacta, neurotic excoriations, delusion of parasitosis

Asiaticoside induces cell proliferation and collagen synthesis in human dermal fibroblasts Linda Yuliati; Etik Mardliyati; Kusmarinah Bramono; Hans Joachim Freisleben
Universa Medicina Vol. 34 No. 2 (2015)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2015.v34.96-103

BackgroundAsiatiocoside, a saponin component isolated from Centella asiatica can improve wound healing by promoting the proliferation of human dermal fibroblasts (HDF) and synthesis of collagen. The skin-renewing cells and type I and III collagen synthesis decrease with aging, resulting in the reduction of skin elasticity and delayed wound healing. Usage of natural active compounds from plants in wound healing should be evaluated and compared to retinoic acid as an active agent that regulates wound healing. The aim of this study was to compare and evaluate the effect of asiaticoside and retinoic acid to induce greater cell proliferation and type I and III collagen synthesis in human dermal fibroblast.MethodsLaboratory experiments were conducted using human dermal fibroblasts (HDF) isolated from human foreskin explants. Seven passages of HDF were treated with asiaticoside and retinoic acid at several doses and incubated for 24 and 48 hours. Cell viability in all groups was tested with the MTT assay to assess HDF proliferation. Type I and III collagen synthesis was examined using the respective ELISA kits. Analysis of variance was performed to compare the treatment groups. ResultsAsiaticoside had significantly stronger effects on HDF proliferation than retinoic acid (p<0.05). The type III collagen production was significantly greater induction with asiaticoside compared to retinoic acid (p<0.05). ConclusionAsiaticoside induces HDF proliferation and type I and III collagen synthesis in a time- and dose-dependent pattern. Asiaticoside has a similar effect as retinoic acid on type I and type III collagen synthesis.

PERBEDAAN SKIN CAPACITANCE DAN TRANSEPIDERMAL WATER LOSS PADA KULIT NON-LESI PASIEN PITIRIASIS VERSIKOLOR DENGAN NON-PITIRIASIS VERSIKOLOR Satya Wydya Yenny; Zainal Hakim; Kusmarinah Bramono; Wresti Indriatmi
Majalah Kedokteran Andalas Vol 32, No 2: Agustus 2008
Publisher : Faculty of Medicine, Universitas Andalas

AbstrakPada pitiriasis versikolor sering timbul kekambuhan, diduga salah satu penyebabnya adalah kelembaban kulit yang tinggi. Kelembaban kulit dipengaruhi oleh skin capacitance dan transepidermal water loss.Mengetahui skin capacitance dan transepidermal water loss kulit pasien pitiriasis versikolor dan perbedaannya dengan non-pitiriasis versikolor.Penelitian ini merupakan studi potong lintang perbandingan antar kelompok, yang dilakukan pada bulan September sampai dengan Nopember 2004 di Rumah Sakit Dr. Cipto Mangunkusumo. Subyek penelitian pasien pitiriasis versikolor dan kontrol non-pitiriasis versikolor yang dipasangkan dalam hal umur dan jenis kelamin dan dilakukan pemeriksaan skin capacitance dan transepidermal water loss pada kulit yang tampak normal di punggung menggunakan alat Tewameter/Corneometer 350.Dalam kurun waktu tersebut telah diperiksa sebanyak 32 pasien pitiriasis versikolor dan 32 kontrol non-pitiriasis versikolor. Skin capacitance pasien pitiriasis versikolor secara statistik tidak berbeda dengan kontrol non-pitiriasis versikolor (p = 0,730). Transepidermal water loss pasien pitiriasis versikolor secara bermakna lebih rendah dari pada kelompok kontrol non-pitiriasis versikolor (p = 0,000).Tidak ada perbedaan skin capacitance kulit pasien pitiriasis versikolor dengan non-pitiriasis versikolor. Transepidermal water loss kulit pasien pitiriasis versikolor lebih rendah daripada non-pitiriasis versikolor.Kata kunci: pitiriasis versikolor, skin capacitance, transepidermal water lossAbstractThe recurrence of pityriasis versicolor is high, it could be caused by high skin hydration. Skin hydration was influenced by skin capacitance and transepidermal water loss.ARTIKEL PENELITIAN168The purpose of this study was to compare the differences of the skin capacitance and transepidermal water loss between the pityriasis versicolor skin and healthy non-pityriasis versicolor skin.The design of this study was comparative cross-sectional study. Pityriasis versicolor subjects and non-pityriasis versicolor subjects were matched in age and sex. The study was done in September until November 2004, at Dr. Cipto Mangunkusumo Hospital. The measurement of the skin capacitance and transepidermal water loss were done on the back at the non-PV area, using Tewameter/Corneometer 350.During that periode there were 32 pityriasis versicolor and 32 healthy non-pityriasis versicolor subjects. No significant differences was observed for skin capacitance of pityriasis versicolor and healthy non-pityriasis versicolor skin (p = 0.730). The transepidermal water loss of PV skin is significantly lower than in the healthy non-pityriasis versicolor skin (p=0.000).There was no differences between skin capacitance of pityriasis versicolor and healthy non-pityriasis versicolor skin, but the transepidermal water loss of pityriasis versicolor skin was significantly. lower than non-pityriasis versicolor.Keywords: pityriasis versicolor, skin capacitance, transepidermal water loss

Subcutaneous mycosis at the Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013 Yahya, Sammy; Widaty, Sandra; Miranda, Eliza; Bramono, Kusmarinah; Islami, Artini Wijayanti
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usually found in workers of rural tropical and subtropical area. SM occurs due to trauma along with other predisposing factors such as sex, genetic and occupation.Aim: To identify the types of SM, its clinical findings, laboratory work-up and the treatment at the Dermatomycology Division, Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital between the year 1989 and 2013.Method: This retrospective study collected data from medical records and case reports of patients with SM who came at Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital (1989-2013).Results: We found 16 cases of SM, i.e. subcutaneous mucormycosis (5 cases), eumycetoma (4 cases), actinomycetoma (4 cases) and chromoblastomycosis (3 cases). There was a greater number of male than female patients ratio (3:1) and mostly were in the age group of 25-44 years. The direct microscopic examination did not reveal any fungal element, except for black spora in chromoblastomycosis (1 case). The culture revealed Basidiobolus ranarum in subcutaneous mucormycosis (5 cases), Nocardia transvalensis in actinomycetoma (1 case) and Phialophora sp. in 1 case of chromoblastomycosis. On histopathological examination, we found fine granules of actinomycetoma, sulphuric granules of actinomycetoma, coenocytic hyphae of subcutaneous mucormycosis, eosinophilic granule in 1 case of mycetoma and hyphae with black spore in chromoblastomycosis.Conclusion: SM is still a rare disease, comprehensive management of SM needs supporting laboratory work-up, particularly the histopathological examination.

Case series of primary psychiatric skin disorders with multi-disciplinary approach Lusiana, Lusiana; Prayogo, Rizky Lendi; Yusharyahya, Shannaz Nadia; Sitohang, Irma Bernadette S.; Bramono, Kusmarinah
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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Background: The incidence of psychodermatologic diseases, a group of skin abnormalities associated with psychosomatic factor, are increasing recently. About 20-40% patients with skin symptoms have concurrent psychiatric problems which are often difficult to diagnose and treat. The new classification of primary psychiatric skin disorders are delusional disorders, obsessive-compulsive and related disorders, and factitious disorders. This classification could be used for effective treatment in each patient which involves multi-disciplinary approach, including dermatology, psychiatry and other discipline if necessary. Case Illustration: The first case was a 39-year-old unmarried female, with anemia and dermatitis artefacta occurred as wound due to blade cuts. Patient was with schizoaffective depressive type and was not under regular treatment. The second case was a 61-year-old male referred with unresolved prurigo nodularis for the past 30 years. After in-depth assessment, there were delusional parasitosis and neurotic excoriations disorders. The third patient was a 50-year-old female admitted with recurrent ulcer on her face. She was aware that the lesions were intentionally manipulated by her own fingers when she was depressed. Discussion: All patients were classified as primary psychiatric skin disorders with varied skin manifestations. Symptoms usually occurred when the patient was in the depression state or low compliance for the psychotropic drugs. Patients generally had poor insight and refused to be associated with psychiatric factors. Dermato-venereologists are expected to conduct early detection and treat this disease. Conclusion: It is important to approach psychocutaneous disease in multi-disciplinary manner, especially with the psychiatrist.

The management of seborrheic dermatitis 2020 Widaty, Sandra; Bramono, Kusmarinah; Listiawan, Muhammad Yulianto; Yosi, Ariyati; Miranda, Eliza; Rahmayunita, Githa; Brahmanti, Herwinda; Lim, Henry W
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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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.

Recent progress in immunotherapy for skin cancer Mughni, Fadhli Aulia; Astriningrum, Rinadewi; Hoemardani, Aida SD; Bramono, Kusmarinah; Sampurna, Adhimukti T.; Sutarjo, Agassi Suseno
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Skin cancer is a global health concern due to its growing incidence and high mortality rate. The most common therapeutic modalities in skin cancer include surgery, radiotherapy, and chemotherapy. However, those therapies do not specifically target cancer cells and may damage healthy tissues. Cancer induces immune response by releasing soluble antigens and danger signals caused by tumor cellular stress or death, while the immune system continuously monitor and control malignant proliferation through cancer immunoediting. Therefore, targeting this mechanism is a promising approach to manage cancer, especially those unresponsive to conventional therapies. Immunotherapy is a specific therapy that manipulates the immune system to fight the disease. Previous studies have shown promising results in its clinical use in melanoma and non-melanoma skin cancer (NMSC). However, its potential toxicity and tolerability may pose significant obstacles in developing effective cancer immunotherapy. Biomedical, immunological, and clinical research in skin cancer is still needed to elaborate further on its pathogenesis and design safe and effective therapy for each skin cancer.

Study Efficacy Of Centella Asiatica Extract Encapsulated Into Chitosan Nanoparticles As An Inovative Herbal Anti Aging Cosmetic: Proliferative Activity Of Human Dermal Fibroblasts Linda Julianti Wijayadi; Etik Mardliyati; Kusmarinah Bramono; Hans Joachim Freisleben
Ebers Papyrus Vol. 18 No. 2 (2012): EBERS PAPYRUS
Publisher : Medical Faculty Universitas Tarumanagara

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Centella asiatica L (CA) dan kitosan adalah bahan alami yang dapat meningkatkan proliferasi fibroblas dalam proses penyembuhan luka. Tujuan penelitian ini untuk menilai kapabilitas regenerasi ekstrak etanol dan ekstrak air CA yang dikemas dalam nanopartikel kitosan (CNP) dengan metode gelasi ionotropic. Tingkat regerenasi sel kulit menurun seiring dengan proses penuaan. Dalam penelitian ini, fibroblas dermis kulit manusia diberi perlakuan dengan mengoleskan ekstrak air dan etanol Centella asiatica L dan Penilaian ditujukan untuk menilai kemampuan regenerasi dengan bahan tersebut dibandingkan dengan bahan ekstrak yang sama yang dikemas dalam nanopartikel kitosan. Uji viabilitas sel (MTT) digunakan untuk menilai proses proliferasi sel fibroblas dermis manusia. Hasil penelitian ini menunjukkan bahwa ekstrak air dan etanol Centella asiatica L yang dikemaskan dalam nanopartikel kitosan dapat meningkatkan proliferasi fibroblas kulit manusia dan hasil penelitian ini juga menunjukkan potensi teknik nano-enkapsulasi dapat meningkatkan proliferasi sel fibroblas dermis kulit manusia dalam proses penyembuhan luka. Kami menyimpulkan bahwa ekstrak Cente/la asiatica L yang dikemas dalam nanopartikel kitosan juga dapat digunakan sebagai bahan aktif untuk preparat kosmetik anti penuaan kulit

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