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All Journal Medicina E-Jurnal Medika Udayana Journal of Biomedicine and Translational Research Berkala Ilmu Kesehatan Kulit dan Kelamin ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of Global Pharma Technology

I Gusti Nyoman Darmaputra

Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Udayana/ RSUP Prof. Dr. I G. N. G. Ngoerah, Denpasar, Bali, Indonesia

Author-ID : 3287974

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

Published : 15 Documents Claim Missing Document

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LYMPHANGIOMA CIRCUMSCRIPTUM YANG DITERAPI DENGAN BEDAH LISTRIK Medikawati, IGAA Ratna; Wardhana, Made; Darmaputra, IGN
Medicina Vol 45 No 3 (2014): September 2014
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.784 KB)

Lymphangioma circumscriptum merupakan penyakit hamartoma, malformasi kongenital dari sistemlimfatik yang jarang dengan etiologi yang tidak diketahui, melibatkan saluran limfatik pada lapisandermis dalam dan subkutaneus, dapat terjadi pada saat lahir atau muncul pada masa bayi ataumasa kanak-kanak. Kasus adalah seorang perempuan berumur 13 tahun dengan keluhan munculbintik-bintik berair pada paha kanan sejak sepuluh tahun yang lalu. Pada pemeriksaan dermatologisditemukan vesikel multipel bergerombol dengan pola zosteriform pada paha kanan. Berdasarkananamnesis, pemeriksaan fisik dan pemeriksaan penunjang berupa dermoskopi dan histopatologismendukung diagnosis lymphangioma circumscriptum. Pada kasus dilakukan tindakan bedah listrikdan respon terapi baik. [MEDICINA 2014;45:176-181].

Distribution of CD4+RORg-T Th17 and CD25+ FOXP3+ Treg in Leprosy Patient with Reversal Reaction Renni Yuniati; Riawan W; Widasmara D; Darmaputra IGN; Arifin S
Journal of Biomedicine and Translational Research Vol 3, No 2 (2017): December 2017
Publisher : Faculty of Medicine, Diponegoro University

Background: One of the most common difficulties found in leprosy management is how to manage leprosy reaction, even though MDT has proven to be effective for the patients. Reversal reaction is associated with cell mediated immunity (CMI), consists of T-helper (Th) 1 and Th2 activities. Moreover, subset of CD4+ Th17 and CD25+ FOXP3 Treg were known to have an important role in leprosy’s natural history. Prior study showed a decreasing number of CD25+ FOXP3 Treg and increasing number of CD4+ Th17 in type II reversal reaction (ENL). However, the distribution of Th17 and Treg in type I reversal reaction (RR) has not yet been identified.Objective: To compare the distribution of CD4+ Th17 and CD25+ FOXP3 Treg between RR and ENL patient groups.Method: A total of 50 samples, consisted of 27 samples of reversal reaction (RR) and 23 samples of ENL, were collected. Observation of CD4+ RORg-T Th17 and CD25+ FOXP3 Treg were conducted with immunohistochemistry staining technique using anti FOX-P3 and anti RORg-T. Expression of CD4+ ROR-g Th17 and CD25+ FOXP3 Treg in percentage were analyzed using T-test.Result: There is a significant difference in mean CD4+ ROR-g Th17 and IL17 cell distribution for RR patient group (14.96% and 10.72%) compared with ENL (9.12% and 4.28%). No significant difference were found between mean CD25+ FOXP3 Treg and TGF-β cell distribution in RR patient group (6.12% and 5.44%) compared with ENL group (6.16% and 5.96%).Conclusion: There is a significant increment od CD+RORg-T Th17 and IL17 in RR patients group compared with ENL patients group. however, the distribution of CD25+ FOXP3+ Treg and TGF beta in RR has no significant difference campared with ENL.

Recurrent Verruca Vulgaris Treated with Combination of 80% Trichloroacetate and Electrosurgery: a Case Report Nyoman Yoga Maya Pramita; Ketut Kwartantaya Winaya; I Gusti Nyoman Darmaputra
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.V34.1.2022.73-76

Background: Verruca vulgaris is one of the most common benign skin tumor caused by human papillomavirus (HPV) type 1, 2, 3, 4, 27 and 57. HPV caused infection is often recurrent leading to frustration due to loss of time and medical expenses. Monotherapy gives a varied response, and in the case of recurrence, combination therapy can be an option. Purpose: To evaluate the cause and management of recurrent verruca vulgaris. Case: This is a case report of a 33 years-old man complaining of a recurrent wart with a rough surface on his right index finger in the past three months. Initially the patient was treated with electrosurgery, but the warts came back. The patient was a smoker. The warts disappeared after electrosurgery and two sessions of 80% trichloroacetate (TCA), and at the 4th week of observation no new lesion was reported. Discussion: Recurrence of verruca vulgaris often occurs using monotherapy, thus requires other modalities. The combination of electrocautery and 80% TCA provides good clearance with low recurrence. Conclusion: Combination treatment for recurrent warts is effective for clearing the lesion and prevent recurrence.

Peran sitokin dalam kerusakan saraf pada penyakit kusta: Tinjuan Pustaka I Gusti Nyoman Darmaputra; Putu Ayu Dewita Ganeswari
Intisari Sains Medis Vol. 9 No. 3 (2018): (Available online: 1 December 2018)
Publisher : DiscoverSys Inc.

Latar belakang: Kusta adalah penyakit infeksi yang menyebabkan masalah yang sangat kompleks baik dalam segi kesehatan, sosial, maupun ekonomi. Berdasarkan data WHO, jumlah kasus kusta baru pada tahun 2016 adalah sebesar 216.108 kasus (0,21 per 10.000 penduduk) dari 145 negara di dunia. Tujuan: Mengatahui peran sitokin dalam patogenesis kerusakan saraf pada penyakit kusta sehingga mempermudah proses klasifikasi kasus borderline dan memungkinkan pengobatan dini berdasarkan tipe kusta. Hasil: Â Kusta adalah penyakit yang disebabkan oleh bakteri Mycobacterium leprae dan terutama menyerang saraf perifer. Manifestasi kusta dipengaruhi oleh respon imun, terutama respon imun yang diperantarain sel. Terdapat keterlibatan sitokin yang berbeda dalam kerusakan saraf pada kusta tipe pausibasiler dan multibasiler. Simpulan: Manifestasi klinis kusta dipengaruhi oleh keseimbangan sitokin-sitokin dari Th1 dan Th2.

Karakteristik kanker kulit di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2015-2018 Made Wardhana; I Gusti Nyoman Darmaputra; I Gde Nengah Adhilaksman; Nyoman Yoga Maya Pramita; Ricky Fernando Maharis; Made Dwi Puspawati; I Gusti Ayu Agung Dwi Karmila; I Gusti Agung Ayu Praharsini; I Gusti Ayu Agung Elis Indira; Nyoman Suryawati
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Latar belakang: Prevalesi kanker kulit semakin meningkat di seluruh dunia. Walaupun insiden tertinggi pada kelompok berkulit putih, namun mengetahui epidemiologi dan tren penyakit dari kanker kulit diperlukan agar dapat menentukan pencegahan dan penanganan yang tepat.Tujuan: Untuk mengetahui karakteristik kanker kulit pada pasien yang telah dilakukan skin flap di Departemen Dermatologi dan Venereologi RSUP Sanglah.Metode: Penelitian ini merupakan studi deskriptif retrospektif dari catatan medis semua penderita kanker kulit yang memperoleh tindakan skin flap sejak Januari 2015 sampai dengan Desember 2019. Sampel diambil melalui total sampling. Karakteristik yang tercatat meliputi jenis kanker, jenis kelamin, umur, tipe kulit, pekerjaan, dan jenis flap yang dilakukan. Data yang terkumpul dianalisis secara deskriptif dengan program SPSS Ver21.Hasil: Terdapat 41 pasien kanker kulit yang memperoleh tindakan skin flap, terdiri dari 43,9% (n=16) BCC, 54,6% (n=10) melanoma, 21,9% (n=9) SCC, 9,8% (n=4) jenis kanker lain. Jenis flap yang umum digunakan yaitu simple advancement. Lokasi kanker paling umum ditemukan pada wajah dan kejadian kanker paling tinggi terjadi pada usia â‰¥50 tahun dan bekerja di luar ruangan.Simpulan: Kasus kanker tertinggi yaitu BCC dengan usia lebih dari 50 tahun dan bekerja di luar ruangan sebagai karakteristik paling umum pada semua kasus kanker.

Karsinoma sel basal tipe nodular yang diterapi dengan bedah eksisi elips dan anastesi tumesen I Gusti Nyoman Darmaputra; Made Wardhana; I Gde Nengah Adhilaksman; I Gusti Ayu Agung Elis Indira; Nyoman Suryawati
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Basal cell carcinoma (BCC) has a very slow-growing and rarely metastatic nature but tends to be locally invasive and relapse after therapy. Elliptical excision is one of the surgical procedures in the field of dermatology which is most often used with the application of tumescent techniques.Case Description: A woman, 64 years old, no. CM. 18.03.11.71, Balinese tribe, on July 30, 2018, came to the Dermatology and Venerology Polyclinic at Sanglah General Hospital with a frequent symptom of arising from wounds on the forehead. The lession began one year ago. Initially, it was a small reddish lump which was then felt more and more dilated as well as became blackish and accompanied by itching. Dermatology examination revealed hyperpigmentation, solitary, oval, 3x2cm, multiple erosion, firm boundary, round shape, 0.3-0.4 cm in diameter, covered in black crusting on top.Conclusion: The diagnosis of BCC determined on anamnesis, physical examination, dermoscopy, and histopathology regard with standard ellipse excision surgery.

Disregulasi IL-17, CD4 neutrofil, IL-10, PGE-2, iNOS, dan MMP-9 di jaringan kulit terhadap kerusakan saraf dermal pada pasien erythema nodusum leprosum I Gusti Nyoman Darmaputra; Cita Rosita Sigit Prakoeswa; Anang Endaryanto; IGAA Elis Indira; Nyoman Suryawati; Evy Ervianti; Linda Astari; Bagus Bagus
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Introduction: The mechanism of nerve damage in ENL patients is important to be revealed because the problem of nerve damage is not getting enough attention in handling ENL patients. Some pro-inflammatory mediators that have been studied are risk factors for nerve damage in ENL.Aim: This study aim in knowing the mechanism of nerve damage in the relation with its risk factors, which are CD64 neutrophil, IL-17, MMP-9, and iNOS with PGE-2 and IL-10 protective factor and IL-10 in ENL patients.Method: This is an analytic cross-sectional design study with tissue samples from 30 leprosy patients with ENL in Dr. Soetomo General Hospital Surabaya. Samples from biopsy examined using IHC method to evaluate S-100, IL-10, IL-17, PGE-2, iNOS, MMP-9, and CD64 neutrophil expressions. The result calculated within 20 view field with 1000 times magnification.Result: CD64 neutrophil (p=0.022, r=-0.417), IL-17 (p=0.001, r=-0.560), iNOS (p=0.005, r=-0.502) and MMP-9 (p=0.025, r=-0.409) has significant correlation with S-100. There is no significant correlation between IL-10 (p=0.061) and PGE-2 (p=0.407) with S-100.Conclusion: Expressions of IL-17, CD64 neutrophil, MMP-9, and iNOS in tissue correlate with nerve damage in ENL patients.

Skin flap pattern in skin cancer at Sanglah General Hospital Denpasar, Bali-Indonesia Made Wardhana; IGN Darmaputra; I Gde Nengah Adhilaksman Sunyamurti Wirawan; Nyoman Yoga Maya Pramita; Rikcy Fernando Maharis; Ni Made Dwi Puspawati; IGAA Dwi Karmila; IGAA Praharsini
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: The prevalence of skin cancer is consistently increasing recently, an hence a more comprehensive management is necessary for patientsâ€™ satisfaction. Generally, skin cancer is categorized into several histological types, including melanoma, basalioma, squamous cell carcinoma (SCC), and several other less common types such as keratoacanthoma, pyogenic granuloma, and Bechet disease. In dermatology, the intervention is limited which only consists of infiltrative anesthesia, no involvement of other organs, and no attachment to the underlying tissue. Therefore, random skin flap frequently becomes the preferred option that involves advancement, rotation, transposition, and interpolation flap. This study aims to investigate the profile of skin cancer and flap pattern among patients undergoing skin flaps procedure at Dermatology and Venereology Department of Sanglah General Hospital, Denpasar.Â Method: This study included all skin cancer patients who underwent skin flap surgery. Samples collection was performed retrospectively using patientsâ€™ medical records from January 2015 - December 2018.Â Results: Over the study period, there were a total of 41 skin cancer patients who underwent skin flap surgery of whom 10 (54.6%) patients were diagnosed with melanoma, 16 patients with basalioma, 9 patients with SCC and the remaining included 3 cases of acanthoma and 1 Bechet disease. Regarding the flap types, simple advancement and its variances were performed in 6 melanoma, 11 basaliomas, 5 SCC and 4 keratoacanthoma cases. Transposition flap was performed in 2 melanoma, 3 basalioma, and 3 SCC cases; whereas rotation flap was performed in 2 melanoma and 2 basaliomas and SCC cases.Conclusion: From 41 skin cancer patients discovered, basalioma was the most frequent cases and advancement techniques were the most frequently performed flap surgery. Only 1 post-surgical infection was found after rotational flap procedure.Â Â Â

Terapi non bedah pada karsinoma sel basal Adeline Santoso; I Gusti Ngurah Darmaputra; Dewi Gotama; Sissy Sissy
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Basal cell carcinoma accounts for approximately 75% of non-melanoma skin cancer and 25% of all diagnosed skin cancer in the United States. Epidemiological data show the incidence is increasing significantly by 3% -10% per year worldwide. Changes in life expectancy patterns are associated with an increase in this skin cancer, and the incidence is predicted to increase until 2040. Many factors must be considered in the choice of therapy for a patient, including the patient's general condition, the presence or absence of serious medical problems, the use of antiplatelet or anticoagulant medication. Conservative treatment of asymptomatic and low-risk lesions is recommended, as overly aggressive therapy may have a greater effect than the lesions themselves. Topical therapy and non-surgical therapy are currently quite effective as therapeutic options for low-risk basal cell carcinoma and high-risk basal cell carcinoma. They can be an option in conditions that are contraindicated for surgery. Kasus keganasan karsinoma sel basal (KSB) mencakup sekitar 75% dari kasus kanker kulit non melanoma dan mencakup 25% dari semua kasus kanker yang didiagnosa di Amerika Serikat.Data epidemiologi menunjukkan insiden meningkat signifikan sebanyak 3%-10% per tahun di seluruh dunia. Perubahan pola usia harapan hidup berhubungan dengan peningkatan kanker kulit ini, dan di prediksi insiden akan terus meningkat sampai tahun 2040. Terdapat banyak faktor yang harus dipikirkan dalam pemilihan terapi pada pasien, antara lain keadaan umum pasien, ada atau tidaknya masalah medis serius, penggunaan obat anti platelet atau anti koagulan. Perawatan konservatif pada lesi asimptomatik dan beresiko rendah dianjurkan, dikarenakan terapi yang terlalu agresif mungkin akan memberikan efek yang lebih besar dibandingkan dengan lesi itu sendiri. Saat ini terapi topikal dan terapi non-bedah dikatakan cukup efektif sebagai pilihan terapi untuk KSB resiko rendah dan KSB resiko tinggi serta dapat menjadi pilihan pada kondisi kontraindikasi terhadap tindakan pembedahan.

Karsinoma sel basal tipe campuran yang diterapi dengan eksisi dan island pedicle flap: laporan kasus I Dewa Made Rendy Sanjaya; I Gusti Nyoman Darmaputra; Ketut Kwartantaya Winaya; I Gusti Ayu Agung Elis Indira; Herman Saputra
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Introduction: Basal cell carcinoma (BCC) is a malignant neoplasm originating from non-keratinized cells. The incidence increases worldwide and one of the triggering factors is excessive exposure to ultraviolet (UV) rays. The therapy aims to eradicate the tumor and maintain optimal organ function and cosmetic results after the procedure, one of which is the excision technique accompanied by an island pedicle flap. Case Description: A man, 67 years old, came with a complaint of a black lump on the left cheek accompanied by a wound that did not heal. Based on the history, physical examination, and investigations, the patient was diagnosed with mixed type BCC. Excision and wound closure were performed with the island pedicle flap technique. Conclusion: The treatment chosen in this case is surgical excision and island pedicle flap. Although the wound healing is classified as good, the prognosis of the patient is dubius. Considering the location of the lesion and the histopathological results showing an aggressive tumor with a tendency to metastasize, the patient is advised to take precautions. Pendahuluan: Karsinoma sel basal (KSB) adalah neoplasma ganas yang berasal dari sel non keratin. Terjadi peningkatan insiden KSB di seluruh dunia dan salah satu faktor pencetusnya adalah paparan sinar ultraviolet (UV) berlebih. Terapi yang dilakukan bertujuan untuk mengeradikasi tumor serta tetap mempertahankan fungsi organ dan hasil kosmetik yang optimal paska tindakan, salah satunya dalah dengan teknik eksisi yang disertai island pedicle flap. Deskripsi kasus: Seorang laki-laki, usia 67 tahun, datang dengan keluhan benjolan kehitaman pada pipi kiri yang disertai luka yang tidak kunjung sembuh di atas benjolan. Berdasarkan anamnesis, pemeriksaan fisik dan penunjang, pasien terdiagnosis KSB tipe campuran. Dilakukan tindakan eksisi dan penutupan luka dengan teknik island pedicle flap. Simpulan: Tatalaksana yang dipilih pada kasus ini adalah pembedahan eksisi serta island pedicle flap. Meskipun penyembuhan luka tergolong baik, namun prognosis pasien dubius. Mengingat lokasi lesi dan hasil histopatologi yang menunjukkan tumor agresif yang memiliki kecenderungan metastase, pasien disarankan untuk melakukan pencegahan.

Co-Authors Adelia Suryani Adeline Santoso Anang Endaryanto Arifin S Bagus Bagus Cita Rosita Sigit Prakoeswa Dewi Gotama Evy Ervianti Gusti Ayu Anggawati Herman Saputra I Dewa Made Rendy Sanjaya I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman Sunyamurti Wirawan I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini IGAA Ratna Medikawati, IGAA Ratna Ketut Kwartantaya Winaya Ketut Kwartantaya Winaya Linda Astari Made Wardhana Ni Made Dwi Puspawati Nila Puspasari Nyoman Suryawati Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Prima Sanjiwani Putu Ayu Dewita Ganeswari Putu Ayuni Yayas Ramaswari Putu Shinta Widari Tirka Renni Yuniati Riawan W Richard Richard Ricky Fernando Maharis Rikcy Fernando Maharis Sissy Sissy Widasmara D

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