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All Journal Narra J Journal of General-Procedural Dermatology & Venereology Indonesia Indonesian Journal of Case Reports
Pradistha, Aldilla
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Chronic cutaneous chromoblastomycosis: A rare case Earlia, Nanda; Maulida, Mimi; Handriani, Risna; Kamarlis, Reno Keumalazia; Pradistha, Aldilla
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Chromoblastomycosis (CBM) is a rare, chronic granulomatous and suppurative skin infection classified as a subcutaneous mycosis. CBM has a poor prognosis with a low cure rate and a high recurrence rate. The lack of scientific data regarding the diagnosis and treatment of CBM also presents a challenge for clinicians in treating this disease. Appropriate therapy can increase the cure rate and prevent disease recurrence. Case Illustration: A 66-year-old woman presented with swelling in her left arm since the last 18 years due to wood-related injuries. There were multiple well-defined hyperkeratotic verrucous plaques, papules, and nodules, measuring 6-10 cm in diameter on the left antebrachial and hand regions. Some lesions were covered with erosion and crusts. The patient also had bone malformation. Histopathological examination showed typical characteristics of CBM. The patient was treated with 100 mg Itraconazole b.i.d. for 8 months. Discussion: Clinical manifestations and histopathological examination showed typical characteristics of CBM. Bone malformation occurred due to complications in chronic cases. Facility limitations led to the inability to perform direct microscopic examination using potassium hydroxide (KOH) and fungal culture on Sabouraud's dextrose agar. After 8 weeks of treatment, the patient's lesions were improved. The patient will be evaluated every month until treatment is complete to monitor the side effects of therapy. Conclusion: CBM lesions were improved after 8 weeks of treatment. Bone malformation could occur in chronic cases. It is important to diagnose CBM correctly and provide adequate therapy for a good outcome.
Systemic manifestation of necrotic erythema nodosum leprosum: A case report of a fatal leprosy Maulida, Mimi; Vella, Vella; Budini, Sulamsih S.; Kamarlis, Reno K.; Junaidi, Fachrul; Pradistha, Aldilla; Bulqiah, Mikyal
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.216

Abstract

Necrotic erythema nodosum leprosum (ENL) is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. Necrotic ENL is associated with the involvement of multiple organs, therefore delayed diagnosis and treatment will lead to complications and poor prognosis. The aim of this case report was to report a challenging case of necrotic ENL misdiagnosed with multiple cellulitis since there were no signs of prior leprosy nor had any antimycobacterial treatment. A 45-year-old man was presented to the surgery department of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, with complaints of fever, joint pain, and painful tender skin lesions with ulceration over the trunk, extremities, and ears for one month. The patient was diagnosed clinically with multiple cellulitis and underwent a debridement procedure. Clinical improvement was absent, the patient was then consulted to the dermatology department. Physical examination showed normal vital signs, madarosis, inguinal lymphadenopathy, thickening of nerves, and sensation of numbness in both hands and feet. Laboratory examinations on admission showed leucocytosis, anemia, thrombocytopenia, hypoalbuminemia, hypocalcemia, and elevated creatinine and ureum level. A slit skin smears examination yielded positive acid-fast bacilli (AFB) with a bacteriological index (BI) value of 3+ and morphological index (MI) of 72%. The patient was diagnosed with lepromatous leprosywith necrotic ENL reaction. Intravenous methylprednisolone and cefoperazone-sulbactam were given. Multidrug therapy mulitbacillary (MDT-MB) without dapsone, and ofloxacin 400 mg was initiated. On day 17, the patient had septic shock. The patient became unconscious and experienced death. This case highlights that medical professionals should be aware of the various manifestations of necrotic ENL to correctly diagnose and provide treatment as soon as possible to prevent mortality, especially in leprosy-endemic country, Indonesia.
An Intriguing Case of Erythroderma Possibly Related to Psoriasis Vulgaris Earlia, Nanda; Umborowati, Menul Ayu; Tasrif, Aqil Yuniawan; Pradistha, Aldilla; Liana, Mahda Rizki; Bulqiah, Mikyal
Indonesian Journal of Case Reports Vol. 1 No. 1 (2023): August 2023
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v1i1.56

Abstract

Erythroderma or generalized exfoliating dermatitis is an inflammatory disease characterized by erythema and thickened scales. A woman, 34 years old, was consulted with complaints of red spots accompanied by blisters and peeling skin almost all over her body for 4 days. Complaints are accompanied by itching and burning sensations. The patient had experienced complaints like this 5 months ago and had been treated at three different hospitals. Physical examination found in the facial region, thorax, superior and inferior right and left extremities, erythematous patches with diffuse borders, thick scales, erosions, and a generalized distribution. The patient's fingernails were found to have a change in shape (pitting nails). Examination of the ANA profile was negative, IgE atopy did not show an allergic reaction to a specific allergen, and histopathological examination was within normal limits. The patient was diagnosed with erythroderma based on psoriasis vulgaris. Treatment includes injection of methylprednisolone, cetirizine 10 mg tablets, and wound care with wet gauze and topical cream. After giving therapy, the patient's clinical improvement. Erythroderma occurs because of an underlying condition and cannot be prevented by itself. Erythroderma because of an underlying inflammatory skin condition usually resolves with treatment but can recur at any time. Overall, the prognosis for erythroderma depends on the underlying cause and is generally good if the underlying disease can be treated effectively.
Comprehensive Treatment Approaches in a Unique Case of Generalized Pustular Psoriasis Earlia, Nanda; Maulida, Mimi; Badiri, Istanul; Pradistha, Aldilla; Bulqiah, Mikyal; Fajrina, Nur
Indonesian Journal of Case Reports Vol. 1 No. 2 (2023): December 2023
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v1i2.113

Abstract

Psoriasis is an immunological inflammatory disease characterized by skin inflammation and epidermal hyperplasia. One type of psoriasis is Generalized Pustular Psoriasis (GPP), which is usually preceded by other diseases. A 56-year-old woman presented to the Department of Dermatology and Venereology with a recent onset of red spots accompanied by pustules distributed across her body. The initial manifestation of these symptoms occurred approximately one month prior, and the condition has progressively worsened over the past three days. Physical examination of dermatological status showed erythematous plaques with smooth, well-defined scales with irregular, round edges, lenticular size, multiple, discrete, and confluent distribution, generalized distribution in the pedis dextra et sinistra, manus dextra et sinistra, and femoral regions. Skin biopsy examination results showed skin tissue with hyperkeratosis, acanthosis, and parakeratosis, with PMN inflammatory cells (Munro's micro abscess). The conclusion of the skin biopsy is pustular psoriasis. The patient was diagnosed with GPP. Patients were given Methotrexate, calcitriol tablets 0.25 mcg twice a day, cetirizine tablets 10 mg twice a day, and topical cream. After one week of treatment, the patient's lesions improved. Treatment continues, and patients are given education to avoid trigger factors such as stress, excessive activity, extreme temperature changes, and focal infections. The management must consider various influencing factors, including genetic factors, skin barriers, predisposing factors, and trigger factors. Prevention is also important. The patient needs to be educated about the details of the disease, how to prevent a recurrence, and treatment when the disease recurs.
Clinical Insights and Diagnostic Dilemmas: Two Cases of Livedoid Vasculitis Earlia, Nanda; Budini, Sulamsih Sri; Lestari, Wahyu; Handriani, Risna; Ismida, Fitri Dewi; Pradistha, Aldilla; Dinillah, Teuku Muhammad Muizzy; Vemulen, Dara Avinda; Athira, Athira
Indonesian Journal of Case Reports Vol. 2 No. 1 (2024): June 2024
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v2i1.183

Abstract

Livedoid Vasculitis (LV) is a thrombo-occlusive vasculopathy involving dermal vessels, especially in the lower extremities. Clinical symptoms of LV are chronic, recurrent, scarring, and painful purpuric ulcers. Diagnosing and providing therapy for LV is a challenge because there are no standard guidelines. We present clinical insights and diagnostic approaches on two cases of LV to improve early diagnosis and prevent misdiagnosis, which were confirmed based on history, dermatological examination, and skin biopsy. In the first case, it was a woman, 23 years old, who came with complaints of a blackish-red rash appearing on both legs. There were scars on several parts of the patient's legs, which felt painful, and the legs looked swollen. On histopathological examination, fibrin deposition in the vessel walls, endothelial proliferation, and intraluminal hyaline thrombin were found. In the second case, it was a man, 19 years old, who came with complaints of pain when walking accompanied by wounds on both lower legs. On histopathological examination, fibrin deposition in the vessel walls, endothelial proliferation, and intraluminal hyaline thrombin were found. The conclusion from the histopathology results was LV. After receiving therapy, both cases showed improvement: swelling in the legs was reduced, red and black rashes began to disappear, ulcers improved, pain decreased, and scars became blurred. These two cases provide examples of success in diagnosing LV. Being able to diagnose LV early and correctly is very important so that adequate therapy can be given and good outcomes can be achieved.
Dermatological Presentations in Systemic Lupus Erythematosus: A Comprehensive Case Study Earlia, Nanda; Salim, Fitria; Hidayati, Arie; Pradistha, Aldilla; Ibrahim, Teuku Maulana Malik; Azzahra, Shelda Syifa; Maulidina, Rizka Yuliani
Indonesian Journal of Case Reports Vol. 2 No. 2 (2024): December 2024 (In Press)
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v2i2.188

Abstract

Lupus erythematosus (LE) is an inflammatory autoimmune disease with a broad clinical spectrum of multi-organ inflammation and can be life-threatening. Manifestations of LE can occur confined to the skin (cutaneous lupus erythematosus, CLE) or systemic involving several organs such as the kidneys, heart, and lungs (systemic lupus erythematosus, SLE). We report a female, 27-year-old with complaints of black spots on her back, stomach area, hands, and feet. The patient feels that the spots increase when doing activities outside the home. Patients also complain of fever, pain when swallowing, joint pain, fatigue, and hair loss. Dermatological status in the abdominal, posterior thoracic, and extremities regions shows the presence of macules accompanied by hyperpigmented patches with unclear borders, irregular edges, gutta-plaque size, multiple numbers, and atypical arrangement and configuration. In the ANA profile examination, the native SS-A antigen (60 kDa) +++ results were strongly positive. The examination results concluded CLE type Subacute CLE (SCLE). The patient was given Calcium Carbonate capsules, Folic Acid tablets, and Methylprednisolone tablets. Topical medications include tretinoin 0.25% cream, momethasone 0.1% cream, Desoximethasone 0.25% cream, clobetasol propional 0.05% cream, and must use Sunscreen morning and evening. After 2 weeks, the patient showed good results. The black spots are starting to fade. Other complaints, such as fever, fatigue, and pain when swallowing, have decreased. Cutaneous lupus can be a challenge to treat because the symptoms are varied and complex. Management of CLE aims to eliminate symptoms and signs of the disease, prevent damage from occurring, minimize side effects of drugs, and improve quality of life.
Co-Authors Athira, Athira Azzahra, Shelda Syifa Badiri, Istanul Budini, Sulamsih S. Dinillah, Teuku Muhammad Muizzy Earlia, Nanda Handriani, Risna hidayati, Arie Ibrahim, Teuku Maulana Malik Ismida, Fitri Dewi Junaidi, Fachrul Kamarlis, Reno K. Liana, Mahda Rizki Maulida, Mimi Maulidina, Rizka Yuliani Menul Ayu Umborowati, Menul Ayu Mikyal Bulqiah, Mikyal NUR FAJRINA Reno Keumalazia Kamarlis Salim, Fitria Sulamsih Sri Budini, Sulamsih Sri Tasrif, Aqil Yuniawan Vella, Vella Vemulen, Dara Avinda Wahyu Lestari