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All Journal Journal of General Procedural Dermatology and Venereology Indonesia
Rahadi Rihatmadja
Universitas Indonesia
Medicine & Pharmacology

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Atypical mycobacterial infection resembles sporotrichosis in elderly patient Siti Nurani Fauziah; Lili Legiawati; Sri Adi Sularsito; Shannaz Nadia Yusharyahya; Rahadi Rihatmadja; Sondang P Sirait; Fifi Mifta Huda; Indah Widyasari
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis. An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no fungal element nor acid-fast bacilli (AFB). Culture and polymerase chain reaction (PCR)of M. tuberculosis were negative. The working diagnosis was atypical mycobacterial infection and treatment with 450 mg rifampicin and 100 mg minocycline daily were administered accordingly. In two months observation following the treatment, the pain was no longer exist, the ulcers were completely healed, and some nodules were in the process of healing Among other Mycobacterium spp, M.marinum is the most common cause of AM infrections. Clinical manifestation of M. marinum infection may present as solitary or multiple nodules on the hands, feet, elbows and knees with sporotrichoid spreading patern. The diagnosis of AM was established based on clinical and laboratory examination. The diagnosis was also confirmed by good clinical response to minocycline and rifampicin. Keywords: atypical, mycobacterium, minocycline, rifampicin
The role of dermoscopy in non-pigmented skin disorders Hafiza Fathan; Wresti Indriatmi; Rahadi Rihatmadja; Inge Ade Krisanti
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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The use of dermoscopy in non-pigmented skin disorders includes dermoscopy as a diagnostic tool for non-pigmented skin tumors, inflammatory diseases (inflammoscopy) and/or infectious disease (entomodermoscopy), lesions on nail fold and as a tool to monitor skin reaction as a response to treatment and/or side effect. The diagnosis becomes easier, faster and less expensive with dermoscopy without the need for invasive procedures. Knowledge on vascular pattern and its architectural arrangement; which is coupled with additional dermoscopic features, can aid clinicians to the diagnosis. Dermatoscopy can also predict, monitor and evaluate therapeutical response and/or side effect of skin disorders. Nonetheless, dermoscopy has its limitations. Many of various non-pigmented disorders have more specific clinical features than dermoscopic ones, for clinicians to rely on to establish a diagnosis. Keywords: dermoscopy, non-pigmented disorders, diagnosis
Atopic dermatitis in the elderly Yudo Irawan; Rahadi Rihatmadja; Lili Legiawati; Shannaz Nadia Yusharyahya; Sri Adi Sularsito
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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Atopic dermatitis (AD) is a recurrent skin inflammation accompanied by itching. The incidence of AD is increasing worldwide. AD, which persists until elderly or with an onset during elderly, is known as senile AD. It has different prevalence and clinical features from other AD stages. Senile atopic dermatitis affects males more than females, which is different from other stages of AD. Skin manifestation of senile AD is similar with the adult stage of Hanifin-Rajka criteria, but can be atypical. The typical feature of senile AD is eczematous dermatitis around a free-lesion fossa. Other common clinical manifestations are erythroderma and non-specific chronic dermatitis. In the management of senile AD, changes related to aging process should be considered. Management of senile AD is complex, involves combined pharmacological treatment consists of topical and systemic agents, and nonpharmacological aspects. Appropriate treatment considering effectiveness and safety will improve the quality of life of patients with senile AD. Keywords: atopic dermatitis, elderly, clinical feature, senilis, atypical
Co-Authors Fifi Mifta Huda Hafiza Fathan Indah Widyasari Inge Ade Krisanti Lili Legiawati Shannaz Nadia Yusharyahya Siti Nurani Fauziah Sondang P Sirait Sri Adi Sularsito Wresti Indriatmi B. Makes Yudo Irawan