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All Journal Bali Dermatology Venereology and Aesthetic Journal
Prima Sanjiwani Saraswati Sudarsa
Department of Dermatovenereology, 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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Generalized pustular psoriasis with nail psoriasis in children: a case report Dewi Gotama; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/gm279n15

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.
Focus on the dabrafenib, vemurafenib, and trametinib in the clinical outcome of melanoma: A systematic review and meta-analysis Ida Ayu Widya Anjani; Anak Agung Bagus Putra Indrakusuma; I Gede Krisna Arim Sadeva; Putri Ayu Wulandari; Luh Made Mas Rusyanti; Prima Sanjiwani Saraswati Sudarsa; I Gede Putu Supadmanaba; Desak Made Wihandani
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 3 No. 2 (December 2020)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/myphje28

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Background: Melanoma is the most severe lethal skin cancer, affecting melanin producer cells (melanocytes). Surgery is the most common treatment, whereas, for the advanced stage, the development of treatment is recommended. BRAF (Dabrafenib and Vemurafenib) inhibitor or MEK inhibitor (Trametinib) is the most frequently targeted melanoma therapy due to more than 80% of patients with positive BRAF mutation. In this review, those treatments will be investigated systematically to identify their clinical outcome. Method: This systematic literature review (SLR) was performed from Cochrane, Science Direct, Google Scholar, and Pubmed. Cochrane Risk-of-Bias Tool RoB2 is used to assess RCT studies and New-castle Ottawa Scale Assessment to assess cohort studies by three different assessors. Data analysis was carried out by using Review Manager (RevMan 5.4). Heterogenicity test was assessed by I2 and Chi2 statistic Result: There are 20 studies used in this article (13 RCT and seven cohorts). The overall survival (OS) and progression-free survival (PFS) of the survey that using targeted therapy (vemurafenib, trametinib, or dabrafenib) compare other treatments (chemotherapy, immunotherapy, etc.) showed risk ratio (RR) was 1.12 (95%CI 1.07,1.17; I2=100%; p<0,00001). The OS and PFS with monotherapy compare of vemurafenib, trametinib, or dabrafenib with combination therapy showed RR was 1.09 (95%CI.06,1.13; I2=99%; p<0,00001). Conclusion: BRAF and MEK targeted therapy has a good prognosis for a patient with a positive BRAF gene mutation and could be combined with other treatments for better clinical outcomes rather than monotherapy.
Co-Authors Anak Agung Bagus Putra Indrakusuma Desak Made Wihandani Dewi Gotama Herman Saputra I Gede Krisna Arim Sadeva I Gede Putu Supadmanaba Ida Ayu Widya Anjani Luh Made Mas Rusyanti Putri Ayu Wulandari