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All Journal Bali Dermatology and Venereology Journal Bali Dermatology Venereology and Aesthetic Journal
Herman Saputra
Department of Pathological Anatomy, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Bali
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Bali Dermatology and Venereology Journal

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Generalized pustular psoriasis with nail psoriasis in children: a case report Dewi Gotama; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra
Bali Dermatology and Venereology Journal Vol. 2 No. 2 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v2i2.28

Abstract

Background: Pustular psoriasis in children is one of the clinical variants of psoriasis. It is classified into generalized pustular psoriasis (GPP) and localized pustular psoriasis. The aetiology of psoriasis in children has not been known but is believed to be multifactorial. Nail psoriasis rarely occurs in children who suffer from skin psoriasis, with an incidence lower than that reported in adults. The diagnosis is generally made from the clinical and histological examination. The choice of therapy depends on the severity of the disease. Until now, there have been no specific guidelines for the management of psoriasis in children.Case report: A-15-years-old Balinese girl presenting with erythema, confluent scaly plaques over the trunk and extremities with pustules localized on the lower extremity. She had a history of fever before the lesions appear. Right third digital nails examination showed subungual hyperkeratosis and onycholysis. Positive auspitz sign and karsvlek phenomena were found. Biopsy result suitable for psoriasis. The patient got improvement after treated with methotrexate tablet orally and desoximetasone cream topically within four weeks without any side effect.Conclusion: Combination therapy with methotrexate tablet and desoximetasone cream give an effective result. However, the safety and side effects of methotrexate in children still need further monitoring. 
Lichen amyloidosis with combined topical therapy: a case report Made Sanitca Indah; Ni Made Dwi Puspawati; Herman Saputra
Bali Dermatology and Venereology Journal Vol. 2 No. 2 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bdv.v2i2.29

Abstract

circumscribed, highly pruritic, hyperkeratotic, and hyperpigmented papules occurring typically over the shins, outer aspects of upper arms, and on the upper back with amyloid deposits in the papillary dermis. Several therapeutic strategies, including topical steroids, oral antihistamines, cyclosporine, retinoids, laser, phototherapy, cryosurgery, and surgical interventions, have been reported as treatment options for patients with LA, but no standardized treatment has been established.Case report: A 58-year-old man came to the Dermatovenereology Outpatient Department complaints of itchy blackish-brown papules on the shins. Dermatology examination found discrete multiple hyperpigmentation papules and plaque covered with white scale. A scar-like center surrounded by brownish circles or white edges was found from the dermoscopic examination. The histopathological examination found thickened keratin with compact orthokeratosis and hyaline materials in the papillary dermis with dendritic melanophages. The patient diagnosed with LA and treated by combining desoximetasone cream 0.25% with 3% salicylic acid. The papules on the legs had flattened in the patient, with a significant improvement in the severe itching after three weeks.Conclusion: Combination therapy of potent corticosteroids and keratolytic seems to be an appropriate modality and well-tolerated by LA patients. Skin lesion becomes thinner, and pruritus is reduced.
Co-Authors Dewi Gotama Made Sanitca Indah Ni Made Dwi Puspawati Prima Sanjiwani Saraswati Sudarsa Prima Saraswati Sanjiwani Sudarsa