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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Prima Medika Sains Cermin Dunia Kedokteran Media Dermato-Venereologica Indonesiana Journal of General-Procedural Dermatology & Venereology Indonesia
Rudi Chandra
Fakultas Kedokteran Universitas Kristen Maranatha
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Nursing Public Health

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Journal : Journal of General-Procedural Dermatology

 1 
Childhood-onset borderline tuberculoid leprosy with reversal reaction Lubis, Ramona D; Darmi, Mila; Chandra, Rudi
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Background: Leprosy is a chronic granulomatous infection caused by Mycobacterium lepraethat predominantly affects the skin and peripheral nerves. Leprosy among children is still common in endemic countries. Case Illustration: A 12-year-old girl complained about a hypopigmented anesthetic patch on her face for 11 years, which became larger and spread slowly to her arms and legs. She had a history of close contact with her aunt, who was diagnosed with multibacillary leprosy. On slit-skin-smear test, acid-fast-bacilli (bacteriologic index +1) were found. She was diagnosed with multibacillary leprosy and treated with children’s multidrug therapy-multibacillary (MDT-MB) regimen. After 2 months of MDT-MB treatment, she complained that the hypopigmented patches became reddish and swollen with enlarged peripheral nerves. She underwent a reversal reaction (RR) and was treated with 40 mg prednisone daily and continued the MDT regimen. Discussion: RR is found less frequently in children than the adult.Accurate diagnosis is vital because of its psychosocial impact on the family. One of the most prominent features of borderline tuberculoid leprosy is its susceptibility to RR. It is characterized by rapid changes from existing plaques to edematous lesions with or without abrupt neuritis. Conclusion: We reported a girl with borderline tuberculoid leprosy with developed RR after taking MDT-MB for 2 months. The risk factors for developing RR were being diagnosed with borderline tuberculoid leprosy, female, multiple and disseminated patches involving larger body areas and multiple nerve involvement, large facial patches, and starting treatment. These risk factors were found in our patient.
Alternative modality in the treatment of acne vulgaris: Low level laser therapy Chandra, Rudi; Jusuf, Nelva K.
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with polymorphic manifestations. The four key elements leading to the formation of acne lesions are alteration of follicular keratinization that leads to comedones, increased and altered sebum production under androgen control, follicular colonization by Propionibacterium acnes, and complex inflammatory mechanisms that involve both innate and acquired immunity. Phototherapy (light, lasers, and photodynamic therapy) has been proposed as an alternative therapeutic modality to treat acne vulgaris and is proposed to have less side effects compared to other treatment options. Recently, low-level laser (light) therapy (LLLT) which refers to the use of red-beam or near-infrared laser with a wave-length between 600 and 1000 nanometers and power from 5 to 500 milliwatts, starts to be used in the treatment of acne. Mechanism of action of LLLT for acne is through photochemical reaction that produces reactive free radicals and singlet oxygen species which in turn lead to bacterial destruction by blue light. Meanwhile, red light can affect the sebum secretion of sebaceous glands, change keratinocytes behavior, and modulate cytokines from macrophages and other cells that reduce inflammation. LLLT is proposed to be effective as an alternative modality for inflammatory type lesions in acne vulgaris.
Dermoscopic and histopathologic findings in diagnosing postpartum pemphigoid gestationis Chandra, Rudi; Roesyanto-Mahadi, Irma Damayanti
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
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Background: Pemphigoid gestationis (PG) is an uncommon autoimmune vesiculobullous skin disorder associated with pregnancy, that occurs during mid-to-late pregnancy and immediate postpartum period. The diagnosis of PG is based on histopathology and direct immunofluorescence. Dermoscopy is a non-invasive diagnostic tool that provides a connection between macroscopic clinical dermatology and microscopic dermatopathology. Case Illustration: We reported a case of a 22-year-old primigravida woman with postpartum PG. This PG case was diagnosed clinically, dermoscopically, and histopathologically. Discussion: Since PG is thought to be a variation of the bullous pemphigoid (BP), the two resemble each other clinically and immunologically. The well-defined structures with brown-black dots in the central, yellowish translucent areas, follicular openings, peri-eccrine and perifollicular pigmentations, and a distorted pigment network were the dermoscopic findings of PG. To date, there is no literature about the dermoscopic features of PG. Conclusion: Dermoscopy is a simple non-invasive tool that can assist in making a rapid diagnosis, as well as in evaluating the prognosis, observing the response to treatment, and helping to determine the appropriate lesion and location for histopathological examination. We recommend that the dermoscopic features of PG in our case as a dermoscopic picture of PG.
Co-Authors Abdul Arif, Abdul Alexander, Rico Antonius, Cayadi S Darmi, Mila Djohan - Djohan Djohan Jusuf, Nelva K. Lubis, Ramona D Mukhtar, Zulfikri Nasution, Syamsul Arifin Natali, Oliviti Norawati, Lilik Oentari, Widyaningsih Rahimi, Armon Roesyanto-Mahadi, Irma Damayanti