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All Journal Universa Medicina Journal of General Procedural Dermatology and Venereology Indonesia Majalah Kedokteran Andalas Journal of General-Procedural Dermatology & Venereology Indonesia Ebers Papyrus
Kusmarinah Bramono
Department Of Dermatology And Venereology, Faculty Of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Journal of General-Procedural Dermatology

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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
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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
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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
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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
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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.
Item generation in the development of a questionnaire for predicting multidrug therapy compliance in leprosy Siskawati, Yulia; Asih, Sali Rahadi; Kekalih, Aria; Menaldi, Sri Linuwih; Herqutanto, Herqutanto; Bramono, Kusmarinah
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 2
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Background: Lengthy therapeutic regimens in leprosy are prone to defaults, contributing to more antibiotic-resistant Mycobacterium. Intervening patients’ medical habits midway would be more complicated than understanding their perception of undergoing such regimens in advance. We study the factors considered relevant to leprosy patients’ compliance to construct a novel self-reporting questionnaire that can predict the patients’ adherence before initiating multidrug therapy. Methods: According to the Delphi methods, we conducted three rounds of interviews with twenty-three respondents from various backgrounds, including dermatologists, government officials, healthcare workers, and patients with leprosy, to infer the associated factors of the included items. Each item was scored using the Likert scale, and accepted items (scores above 75%) were classified into six-dimensional categories based on the health belief model theory. Result: The initial 236 items were simplified to 72 items. Then, a panel discussion was conducted to score each item. Finally, 48 items were accepted and categorized into 12 indicators from 6 dimensions. The 12 indicators encompass knowledge about leprosy, its severity, therapeutical options, stigma, challenges in the treatment maintenance, availability of medical facilities and workers, therapeutic impact, drug regulation, health personnel, personal beliefs, attitude, and motivation. (p Conclusion: The study identified 12 critical factors influencing adherence to leprosy treatment, contributing to the prevention of antibiotic-resistant mycobacterium and providing valuable insights through the predictive self-reporting questionnaire.
User acceptance of DeSkab mobile application for early detection of scabies in Indonesia Widaty, Sandra; Friska, Dewi; Bramono, Kusmarinah; Sari, Siti Maulidya; Darmawan, Irene; Kekalih, Aria
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 7, No. 2
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Background: Individual case management strategy is not suitable for reducing scabies transmission, especially in high prevalence settings. A community-based approach has been proposed to control scabies. We developed a mobile application, called DeSkab, to empower non-medical personnel in crowded populations e.g., boarding schools, and to aid the identification of skin lesions suggesting scabies based on the cardinal signs of scabies. Early treatment and prevention of scabies transmission is expected to follow this approach. This was the initial development of the DeSkab mobile application which aims to assess user acceptance. Methods: The DeSkab mobile application was designed using Java and XML, supported by Google's Android. The scabies detection and education features were the app’s key distinctive aspects. An online survey was performed, aimed at potential users, including boarding school teachers and healthcare workers. The survey was divided into four sections: application design and user-friendliness, early detection data entry and interpretation, education features, and user recommendations. Result: Overall, users' acceptance of this application was good. More than 70% of the users gave good feedback for the application. Using mobile health makes it easier for the users to find information about scabies and check whether their skin lesions are suggestive of scabies. Conclusion: This application is expected to help expand scabies detection, especially in crowded communities. Improvements must be made to the interface, data entry, and educational material for the app's next iteration. Further study is needed to determine how mobile health application can improve scabies detection in communities.
Empowering nonmedical personnel to detect scabies in endemic area using DeSkab instrument: A diagnostic study Widaty, Sandra; Kekalih, Aria; Friska, Dewi; Bramono, Kusmarinah; Sari, Siti Maulidya; Darmawan, Irene; Sujudi, Yufanti; Hartanto, David Dwiadiputra; Kartika, Emiliana; Oktavia, Nikken Rima
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
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Background: Scabies has been added to World Health Organization (WHO) list of neglected tropical disease in 2017. Various methods have been developed to control scabies in highly prevalent communities. In this study we conducted a diagnostic study to evaluate the performance of scabies detection by trained nonmedical personnel (NMP) using Deteksi Skabies (Deskab) instrument which has been validated for NMP. Methods: Eight NMPs in a boarding school were trained to detect scabies using DeSkab instrument. The NMPs diagnosis were compared to diagnosis of 10 medical doctors. The study was conducted in a religion-affiliated boarding school in West Java, Indonesia. Both examiners consecutively assessed boarding school students using DeSkab instrument and were blinded to each other findings. Results: Among 140 participants included in this study, scabies was confirmed by medical doctors in 60 participants. Diagnostic accuracy of NMPs examination is 72.14% [95% confidence interval (CI) 64.2-78.9], with sensitivity and specificity 67.42% (95% CI 57.13-76.26), and 80.32% (95% CI 67.54-88.98) respectively. The inter-rater agreement (Cohen’s kappa) for diagnosing scabies is 0.44. Conclusion: NMPs can be trained to detect scabies in their community with acceptable accuracy. Improving training are recommended to further improve the diagnosis skills and maintaining sustainable detection program.
The effects of vitamin D on chronic wounds Priyanto, Mufqi Handaru; Miranda, Eliza; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Novianto, Endi; Bramono, Kusmarinah; Krisanti, Roro Inge Ade
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
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Background: Wounds that fail to proceed through the normal healing process are referred to as chronic wounds, also known as ulcers. Chronic wounds have immeasurable biological, psychological, social, and economic effects, bringing tremendous challenges for patients, doctors, healthcare providers, and healthcare systems. Discussion: This condition is associated with a variety of comorbidities and complex etiologies. The global incidence of chronic wounds is expected to increase with longer life expectancy. Thus, a holistic approach is necessary, such as proper wound management, proper control of comorbidities, and provision of adequate nutrition, including vitamin D supplementation. Vitamin D is an essential pro-hormone for cell differentiation, proliferation, and growth. It affects the skin’s immune response, and is therefore thought to promote wound healing and tissue repair. Many studies have been published on the association between low vitamin D levels and chronic wounds. However, whether or not vitamin D supplementation directly contributes to wound healing still needs to be elucidated. Conclusion: Despite the many reports on vitamin D as an adjuvant treatment for chronic wounds, further large-scale clinical studies are needed to cement the role of vitamin D as an effective standard therapy for chronic wound healing.
Co-Authors Aria Kekalih Ariyati Yosi Artini Wijayanti Islami Astriningrum, Rinadewi Darmawan, Irene Dewi Friska Eliza Miranda Eliza Miranda Etik Mardliyati Etik Mardliyati Githa Rahmayunita Githa Rahmayunita Hans Joachim Freisleben Hans Joachim Freisleben Hartanto, David Dwiadiputra Henry Wan-Peng Lim Herqutanto Herqutanto Herwinda Brahmanti Hoemardani, Aida SD Islami, Artini Wijayanti Kartika, Emiliana Krisanti, Roro Inge Ade Lili Legiawati Lim, Henry W Linda Julianti Wijayadi Linda Yuliati Lusiana Lusiana Lusiana Lusiana M. Yulianto Listiawan Miranda, Eliza Mughni, Fadhli Aulia Novianto, Endi Oktavia, Nikken Rima Prayogo, Rizky Lendi Priyanto, Mufqi Handaru Rizky Lendl Prayogo Sali Rahadi Asih Sammy Yahya Sampurna, Adhimukti T. Sandra Widaty Sandra Widaty Sandra Widaty Sari, Siti Maulidya Satya Wydya Yenny Shannaz Nadia Yusharyahya Siskawati, Yulia Sitohang, Irma Bernadette S. Sitohang, Irma Bernadette Simbolon Sri L. Menaldi Sujudi, Yufanti Sutarjo, Agassi Suseno Wresti Indriatmi B. Makes Yahya, Sammy Yosi, Ariyati Zainal Hakim