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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin

Sylvia Anggraeni

Departemen/Staf Medik Fungsional Ilmu Kesehatan Kulit Dan Kelamin Fakultas Kedokteran Universitas Airlangga/Rumah Sakit Umum Daerah Dr. Soetomo Surabaya

Author-ID : 3287451

Immunology & microbiology Public Health

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Significant Different Level of Malondialdehyde (MDA) as Oxydative Stress Marker in Severity Groups of Acne Vulgaris Sylvia Anggraeni; Trisniartami Setyaningrum; M Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 1 (2017): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Acne vulgaris (AV) is a common chronic inflammatory disease of sebaceous gland that may decrease patient’s quality of life. Oxidative stress is suggested to play role in the pathogenesis of AV. Purpose: To evaluate the differences of malondialdehyde (MDA) level as oxidative stress marker in AV severity. Method: This is an analytic observational cross sectional research of AV patients in Cosmetic Division of Dermatology and Venereology Outpatient Clinic of Dr. Soetomo hospital Surabaya. Subjects were collected through consecutive sampling since May-August 2015. Total samples were 42 patients, classified into 3 severity groups (mild, moderate, severe). Samples were taken from blood vein, examined with Enzyme-linked immunosorbent assay (ELISA) then analyzed statistically. Results: There were differences of MDA mean level among AV severity groups: mild 58.371 ng/ml (SD±25.2141); moderate 99.121 ng/ml (SD±8.5172); and severe 171.779 ng/ml (SD±49.9694). Post hoc analytic revealed that there were statistically differences of MDA level in all stages (mild-moderate p=0.002; mild-severe p=0.000; moderate-severe p=0.000). Conclusions: This research revealed that oxidative stress plays a role in AV pathogenesis. Lipid peroxidation process in sebum produced lipid oxidant that could induce inflammatory process in sebaseous gland via Peroxisome Proliferator-Activated Receptor (PPAR).

Severe Cutaneous Adverse Drug Reaction Damayanti Damayanti; Sylvia Anggraeni; Cita Rosita SP; Marsudi Hutomo; Hari Sukanto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Cutaneous adverse drug eruption (CADR) are frequently found. A systematic review showed, the incidence of severe CADR (SCADR) ranging from 0-8%. Few studies have assessed the severe form of CADR, which has high mortality rate. The epidemiological study was needed to show the profile of SCADR, especially in the setting of general hospital. Purpose: To evaluate clinical and epidemiological profile of SCADR in Dermatology and Venereology Ward Dr. Soetomo Hospital Surabaya. Methods: All SCADR patients in the period of January 2015–January 2016 was evaluated clinically and epidemiologically. Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic reaction (DRESS) cases were included in the study. Results: There were 14 patients in this study, consist of 10 SJS cases (71.4%), 2 TEN patients, and 2 AGEP patients. The highest frequency of age group was 25-29 years old (57.1%). Man to woman ratio was 3:4. The most common offending drug was paracetamol (50%), followed by amoxicillin (28.6%). Antibiotic was the highest frequent offending drug-group (64.3%), followed by antipiretics (50%). In this study, all patients got systemic corticosteroid and the mortality was 0%. Conclusion: The most common type of SCADR was SJS. The most common offending drug was paracetamol, and antibiotic was the highest frequent offending drug-group. Systemic corticosteroid therapy showed good result in severe CADR management.

Faktor Risiko Kandidiasis Vulvovaginalis (KVV) Dewi Puspitorini; Linda Astari; Yuri Widya; Sylvia Anggraeni; Evy Ervianti; Cita Rosita Sigit Prakoeswa; Sunarso Suyoso
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 30 No. 3 (2018): DESEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Latar Belakang: Kandidiasis vulvovaginalis (KVV) merupakan penyakit inflamasi vulva dan vagina yang disebabkan oleh spesies Candida. Penyakit ini menyerang hampir tiga per empat wanita usia subur. Terdapat berbagai faktor yang berpengaruh terhadap kejadian penyakit ini. Penanganan yang baik terhadap faktor-faktor tersebut diharapkan dapat menurunkan angka kejadian KVV. Tujuan: Mengevaluasi faktor-faktor yang memengaruhi KVV. Metode: Penelitian ini bersifat deskriptif cross-sectional untuk mengamati faktor-faktor predisposisi KVV pada 12 April 2017 hingga 11 Juli 2017 di Unit Rawat Jalan RSUD Dr Soetomo Surabaya. Hasil: Didapatkan 25 pasien KVV dengan distribusi usia terbanyak adalah usia 15-24 tahun, lama keluhan terbanyak adalah 1-9 bulan, riwayat predisposisinya antara lain diabetes melitus, kondisi penurunan sistem imun, dan yang terbanyak adalah pemakai douching vagina. Hasil pemeriksaan klinis didapatkan semua pasien dengan vulva dan vagina eritema dan edema. Hasil pemeriksaan sediaan basah didapatkan blastospora positif dengan pseudohifa negatif sebesar 20%, blastospora positif dengan pseudohifa positif sebesar 48%, blastospora negatif dengan pseudohifa negatif sebesar 32%, dan tidak didapatkan blastospora negatif dengan pseudohifa positif. Pemeriksaan mikroskopis pengecatan Gram didapatkan blastospora positif dengan pseudohifa negatif sebesar 16%, blastospora negatif dengan pseudohifa positif sebesar 4%, blastoposra positif dengan pseudohifa positif sebesar 52%, dan blastospora negatif dengan pseudohifa negatif sebesar 28%. Didapatkan 100% sampel tumbuh koloni pada media Saboroud Dextrose Agar (SDA). Simpulan: KVV disebabkan oleh spesies Candida, yang tumbuh 100% pada media SDA. Terdapat faktor-faktor predisposisi yang sangat berpengaruh terhadap kejadian KVV.

Clinicoepidemiological Profile of Severe Cutaneous Adverse Drug Reaction: A Retrospective Study Damayanti Damayanti; Menul Ayu Umborowati; Sylvia Anggraeni; Cita Rosita Sigit Prakoeswa; Marsudi Hutomo; Hari Sukanto
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 31 No. 1 (2019): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Drug eruption were varied from mild to severe reaction. Few studies have assessed the severe cutaneous adverse drug reaction (SCADR), especially in the setting of general hospital. Purpose: To evaluate clinicoepidemiological profile of SCADR at Dermatology and Venereology Ward Dr. Soetomo Hospital, Surabaya, Indonesia. Methods: All SCADR patients at Dr. Soetomo Hospital, Surabaya, Indonesia in the period of January 2016 – June 2017 was evaluated. Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Acute Generalized Exanthematous Pustulosis (AGEP), Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and exfoliative dermatitis cases were included in the study. Results: There were 24 patients in this study, consisted of 11 SJS cases, 1 TEN case, 2 SJS/TEN-overlap cases, 10 exfoliative dermatitis cases. The mean of latent period between drug intake and onset of symptoms was 15.8 days. The most common offending drug was mefenamic acid (20.9%), followed by cefadroxil and phenytoin (each 16.7%). Antibiotics was the highest frequent offending drug-groups (62.5%), followed by non-steroid anti-inflammatory drugs (NSAIDs). Prompt withdrawal of the offending drugs, systemic corticosteroid, and supported therapy were given to all patients, which gave good results in 21/24 patients (87.5%). Conclusion: Antibiotics were the most common offending drug-groups. SCADR might give high mortality rate, but early diagnosis, prompt withdrawal of the suspected drugs, closed monitoring to evaluate complications can improve the prognosis of SCADR.

Cutaneous Aspergilosis Caused by Aspergillus Flavus: A Case Report Maria Ulfa Sheilaadji; Indropo Agusni; Linda Astari; Sylvia Anggraeni; Evy Ervianti
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.72-77

Background: Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Cutaneous aspergillosis can be as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, intravenous catheter, traumatic inoculation, and associated with occlusive dressings. Secondary lesions result from contiguous extension from infected underlying structures or from widespread blood-borne seeding of the skin. Purpose: To know the skin manifestation, efflorence, examination and therapy of cutaneous aspergillosis. Case: A man complaint itchy redness macule and pimples on the right arm since 2 weeks. Initially just felt a little then expands. Patients with post operative brachial injury and uses a cast during one month. On examination there are erythematous macule unsharply marginated with papules. Potassium hydroxide examination, shows conidiophores, dichotomously branching and septate hyphae appropriate description with Aspergillosis Sp. Cultures found grow granular colonies, flat often with radial grooves, yellow at first but quickly becoming bright to dark yellow-green with age, For the identification microscope from the culture specimen there was conidia, phialde, conidiophore and vesicle that suitable with Aspergillus flavus. Patients received itraconazole 2 x 200 mg for 6 weeks and obtained satisfactory results. Discussion: Healthy hosts can develop cutaneous aspergillosis in surgical wounds, by traumatic inoculation, at sites associated with occlusive dressings. In some instances, a presumptive diagnosis of primary cutaneous aspergillosis can be made immediately by examining a potassium hydroxide preparation and culture. Conclusion: Diagnose of cutaneous aspergillosis can establish by potassium hydroxide and culture examination, therapy with itraconazole 2x 200mg give satisfactory results.

Management of Eumycetoma Tjokorde Istri Nyndia Vaniari; Sunarso Suyoso; Linda Astari; Yuri Widia; Sylvia Anggraeni; Evy Ervianti
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 32 No. 3 (2020): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V32.3.2020.232-238

Background: Mycetoma is a chronic inflammatory disease of the skin that can extend to the fascia, tendons, muscles, and bones. Caused by a bacterium called actinomycetoma and a fungus called eumycetoma are responsible for mycetoma, both of which must be distinguished because they require different medical therapy. Eumycetoma is a localized disease, chronic, and growing slowly. Most of eumycetoma patients had delays in seeking medical care. Purpose: To provide an overview and discuss various aspects of eumycetoma, including its epidemiology, etiology, pathogenesis, classification, clinical picture, diagnosis, differential diagnosis, and therapy. Review: Eumycetoma infection begins as infectious agents enter through the skin with a minor trauma caused by objects contaminated with fungi, forming granular or granulomatous lesions with tract and sinus in there. The infection can spread from the site of inoculation into the muscles and bones. The diagnosis is based on anamnesis (chronic and painless), the triad of tumefaction, draining sinuses and grains, and laboratory investigation. It’s a difficult case, often recur and difficult to be surgical excisison, so that the best first option therapy is the combination of itraconazole and terbinafine itself as an alternative to surgical therapy at least 6 months. Conclusion: Eumycetoma is an infection caused by a fungus with granulomatous lesions with sinus formation and grains in it. The best first option therapy is the combination of itraconazole and terbinafine although it’s still an early case.

The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report Desiana Widityaning Sari; Damayanti Damayanti; Sylvia Anggraeni; Menul Ayu Umborowati; Evy Ervianti
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 3 (2021): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.3.2021.224-231

Background: Pustular psoriasis and Acute Generalized Exanthematous Pustulosis (AGEP) are grouped under pustular diseases, in which their clinical manifestations are similar. Those diseases can lead to exfoliative dermatitis. Purpose:To evaluate a specific histopathological examination in differentiating Pustular Psoriasis and AGEP. Case: A 55-year-old woman presented with sudden redness and diffused scaly skin with multiple pustules and also fever. She had taken Cefadroxil 2 days before the scales and pustules appeared. Leukocytosis and histopathological examination results from biopsy supported the diagnosis of AGEP. The patient was then hospitalized and received steroid therapy. Within the first week of tapering off, the scales disappeared but the pustules increased. After such clinical findings, the histopathological examination results were revisited and reassessed. Thus, we considered changing the diagnosis to Pustular Psoriasis, and the therapy was switched to Methotrexate. The patient had a better outcome, and the pustules slowly disappeared entirely. Discussion: It is often difficult to differentiate between the pustules in pustular psoriasis and AGEP unless by thorough history-taking and physical examinations. AGEP is characterized by a widespread of pustules with an acute febrile onset; while pustular psoriasis is an acute variant of psoriasis where pustules are spread over erythematous skin and accompanied by high fever and leukocytosis. Conclusion: Histopathological examination is the gold standard for the establishment of pustular psoriasis diagnosis. The histopathological characteristics of pustular psoriasis and AGEP are difficult to differentiate. Therefore, we need detailed history-taking and physical examination to establish the diagnosis.

Secukinumab Therapy in Psoriasis Management Ira Yunita; Sylvia Anggraeni
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 1 (2022): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.1.2022.59-65

Background : In recent years, use of biological therapy in psoriasis has increased as a result of advances in understanding the pathophysiology of psoriasis disease. Biological agents currently approved for the treatment of moderate to severe plaque psoriasis including inhibitor TNF-α (adalimumab, etanercept, infliximab), inhibitor IL-17 (ixekizumab, brodalumab, secukinumab), inhibitor IL-12/IL-23 (ustekinumab), and inhibitor IL-23 (guselkumab, tildrakizumab). Secukinumab is a human monoclonal antibody that selectively neutralizes IL-17A, a cytokine involved in the development of psoriasis. Review: Psoriasis is a chronic skin inflammation with the characteristic form of erythematous plaque firmly, thick scale, layered, and silvery-white. The trigger factors cause damage to the skin and produce cytokines IFN-γ, TNF-α, IL-17, and IL-22. This proinflammatory cytokine induces the proliferation of keratinocytes and subsequently causes skin inflammation, leading to plaque psoriasis formation. Biologic agents are utilized to block those cytokines. There are three main classes of biological agents in the treatment of psoriasis: inhibitor TNFα, inhibitor IL-17, and inhibitor IL-23. Secukinumab is a fully human antibody that selectively binds and neutralizes IL-17A. Conclusion: Biological agents targeting IL-17 receptors are more effective and safer than biological agents that target TNF-α and IL-23 receptors for moderate to severe plaque psoriasis treatment. Secukinumab has been approved for plaque psoriasis therapy in adults, psoriasis arthritis (PsA), and ankylosing spondylitis.

Contact Dermatitis Knowledge Level in Batik Workers of Desa Batik, Tanjung Bumi, Bangkalan, Madura Rahmadewi Rahmadewi; Trisniartami Setyaningrum; Damayanti Damayanti; Sylvia Anggraeni; Menul Ayu Umborowati
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 2 (2021): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.2.2021.93-95

Background: Batik has been declared as a humanitarian heritage for oral and non-cultural culture. The increasing demand for batik may have a negative impact as the industry utilizes chemical agents. Hazardous chemical exposure to the skin in the batik industry may result in a high risk of occupational contact dermatitis. This study was conducted to find out the social determinants of health. Purpose: This study aims to assess the level of knowledge of the batik workers before and after health education about occupational contact dermatitis. Methods: This was an observational interview study, and the data were collected using questionnaires. This study involved 30 batik workers. Â We assessed the level of knowledge before and after the health education about occupational contact dermatitis. Result: There were 4 (13.3%) male participants and 26 (86.7%) female participants. The mean score of the pre-test was 66.98Â±10.10, and the post-test was 77.77Â±13.53 (p<0.05). Conclusion: The result showed a significant difference between batik workers' knowledge before and after health education about contact dermatitis.

A Case Report of Tinea Capitis in Children: Utility of Trichoscopy Citra Dwi Harningtyas; Evy Ervianti; Linda Astari; Sylvia Anggraeni
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 1 (2022): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.1.2022.66-72

Background: Tinea capitis (TC) is the most prevalent pediatric superficial dermatophyte infection. Scalp dermoscopy or â€œtrichoscopyâ€ represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to TC. Purpose: To characterize trichoscopic findings in children with clinical findings suggestive of TC. Case: Â A 13-year-old boy was presented with a scaled plaque on his scalp that had appeared 1 month earlier. A physical examination revealed a scaly, nonerythematous, rounded lesion in the parietal area of the head. Woodâ€™s lamp yielded a blue fluorescence. Microscopic morphology from fungal culture found the typical spindle-shaped macroconidia of Microsporum canis. Trichoscopy showed mainly comma hair, corkscrew hair, morse code hair, bent hair, and zig zag hair. The patient was started on oral griseofulvin 20 mg/kg/day and antifungal shampoo for 8 weeks. The patient was cured after two months of treatment and trichoscopy returned to normal. Discussion: Fungal culture remains the gold standard in TC diagnosis, but it needs time. Trichoscopy can be an additional tool to help evaluate the diagnosis, aetiology, and follow up of this disorder. The presence of characteristic trichoscopic features (comma hairs, corkscrew hairs, Morse code-like hairs, zigzag hairs, bent hairs, block hairs, and i-hairs) is predictive of TC. The present analysis confirmed that trichoscopy is a useful method in differentiating between Microsporum and Trichophyton TC, which is important from the perspective of a different therapeutic approach. Conclusion: Trichoscopy is not only of value in the diagnosis of TC but also for the etiologic agent and follow-up after treatment in this case.

Co-Authors Afif Nurul Hidayati Aprilin Krista Devi Budi Utomo Cita Rosita Sigit Prakoeswa Cita Rosita SP Citra Dwi Harningtyas Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Desiana Widityaning Sari Dewi Puspitorini Evy Ervianti Hari Sukanto Hari Sukanto Indropo Agusni Ira Yunita Linda Astari M. Yulianto Listiawan Made Putri Hendaria Maria Ulfa Sheilaadji Marsudi Hutomo Marsudi Hutomo Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati Rahmadewi Rahmadewi Sunarso Suyoso Sunarso Suyoso Tjokorde Istri Nyndia Vaniari Trisniartami Setyaningrum Yuri Widia, Yuri Yuri Widya

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