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<![CDATA[Severe Cutaneous Adverse Drug Reaction ]]>
<![CDATA[Damayanti Damayanti]]>;
<![CDATA[Sylvia Anggraeni]]>;
<![CDATA[Cita Rosita SP]]>;
<![CDATA[Marsudi Hutomo]]>;
<![CDATA[Hari Sukanto]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.151-157
<![CDATA[Background: Cutaneous adverse drug eruption (CADR) are frequently found. A systematic review showed, the incidence of severe CADR (SCADR) ranging from 0-8%. Few studies have assessed the severe form of CADR, which has high mortality rate. The epidemiological study was needed to show the profile of SCADR, especially in the setting of general hospital. Purpose: To evaluate clinical and epidemiological profile of SCADR in Dermatology and Venereology Ward Dr. Soetomo Hospital Surabaya. Methods: All SCADR patients in the period of January 2015–January 2016 was evaluated clinically and epidemiologically. Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic reaction (DRESS) cases were included in the study. Results: There were 14 patients in this study, consist of 10 SJS cases (71.4%), 2 TEN patients, and 2 AGEP patients. The highest frequency of age group was 25-29 years old (57.1%). Man to woman ratio was 3:4. The most common offending drug was paracetamol (50%), followed by amoxicillin (28.6%). Antibiotic was the highest frequent offending drug-group (64.3%), followed by antipiretics (50%). In this study, all patients got systemic corticosteroid and the mortality was 0%. Conclusion: The most common type of SCADR was SJS. The most common offending drug was paracetamol, and antibiotic was the highest frequent offending drug-group. Systemic corticosteroid therapy showed good result in severe CADR management.]]>
<![CDATA[Compatibility of Clinical Manifestation with Skin Prick Test Result and Food Provocation Test in Food Cross Reaction ]]>
<![CDATA[Azwin Lubis]]>;
<![CDATA[Wisnu Barlianto]]>;
<![CDATA[Anang Endaryanto]]>;
<![CDATA[Ariyanto Harsono]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.106-116
<![CDATA[Background: Subjective diagnostic test of food allergy is hugely biased, resulting in irrational diet avoidance. Additional objective tools by skin prick test following food provocation test resulting more accurate cause and prevalence on population. Purpose: To evaluate the compatibility of clinical symptoms with skin prick test and provocation test for imunoglobulin E (IgE) mediated food allergy in Dr. Soetomo Hospital Surabaya. Methods: Cross sectional observational analytic study. Patient with allergy symptoms, diagnosed with food skin prick test followed by food provocation test. McNemar test and Kappa were used to analyze compatibility of skin prick test with food provocation test. Sensitivity and spesificity test of skin prick test toward food provocation test were done. Results: McNemar test between skin prick test and food provocation test are valued p<0.05 in all food allergen, except fruit p=0.607, but all Kappa test are low p<0.6. Fruit and chocolate showed low sensitivity (0.307;0.409) but with high spesificity (0.823;0.8333); egg and shrimp showed high sensitivity (0.777;1.000) but low spesificity (0.548;0.352); cow’s milk, seafish, and chicken meat showed sensitivity (0.636;1.000;0.785) and high specifity (0.607;0.625;0.631); fresh water fish showed low sensitivity and spesificity (0.500;0.583). IgE mediated symptoms profile is dominated by cough except for shrimp, and non-IgE mediated also is dominated by cough except seafish and shrimp. Conclusion: There is incompatibilty between result of skin prick test and food provocation test in IgE mediated food allergy. IgE mediated and non-mediated food allergy symptoms are dominated by airway, gastrointestinal tract, and skin symptoms. Food allergy symptoms are more related to IgE mediated than non-IgE mediated.]]>
<![CDATA[A Diagnostic Test of Tinea Cruris Using Polymerase Chain Reaction Restriction Fragmented Length Polymorphism ]]>
<![CDATA[Cut Putri Hazlianda]]>;
<![CDATA[Kamaliah Muis]]>;
<![CDATA[Isma Aprita Lubis]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.158-163
<![CDATA[Background: Tinea cruris is the second most common dermatophytosis in the world and the most common in Indonesia. The conventional diagnostic method fungal culture is slow and less specific, therefore requiring a more rapid and exact diagnostic methods. Polymerase chain reaction (PCR) is a very sensitive and specific test to diagnose various microorganisms including pathogenic fungi. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) is a PCR method with the addition of enzyme after amplification, therefore enabling for more specific results. Purpose: To determine the diagnostic value of PCR-RFLP in the diagnosis of tinea cruris. Methods: This study is a diagnostic test tinea cruris with PCR-RFLP by using culture as the gold standard. The specimens were skin scrapings from thirty-one patients suspected of having tinea cruris from history taking and dermatological examination. The tools and materials that were used in this study were Sabaroud’s dextrose agar media, Internal Transcribe Sequences (ITS) 1 and ITS 4 primer, and MvaI. Results: The values of the diagnostic test yielded in this study are: the sensitivity value was 75%, the specificity was 66.7%, the positive predictive value was 70.6%, the negative predictive value was 71.4%, the positive likelihood ratio was 2.25, the negative likelihood ratio was 0.38, the accuracy value was 70.9%. Conclusion: PCR-RFLP can be used as an alternative tool for the diagnosis of tinea cruris.]]>
<![CDATA[Superficial Mycoses ]]>
<![CDATA[Fatma Rosida]]>;
<![CDATA[Evy Ervianti]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.117-125
<![CDATA[Background: Superficial mycoses were superficial fungal infections caused by fungal or yeast colonization. The prevalence of fungal infection is estimated 20-25% of the world’s population and one of the most common infection in humans. Purpose: To evaluate the profile of superficial mycoses patients. Method: A retrospective study of all new cases of superficial mycoses who visited the Mycology Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya from January 2011 until December 2013 (3 years). Results: The total new patients in 2011-2013 was 1.136 with the percentage 5,47% in 2011, 4,91% in 2012, and 5,90% in 2013. Men were more affected than women, and it was more common in the age group 15-24 and 25-44. Most patients complaint were itchy and most commonly used therapies were ketoconazole 200 mg and griseofulvin 125 mg orally. Conclusion: Superficial mycoses is still a common issue in Indonesia, especially in Surabaya.]]>
<![CDATA[The Pathogenesis of Atopic Dermatitis: The Role of Filaggrin ]]>
<![CDATA[Tamarachiara Kuntjoro]]>;
<![CDATA[Erna Harijati]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.164-167
<![CDATA[Background: Atopic dermatitis (AD) is a multifactorial skin disease with waxing and waning inflammatory process. In recent years, genetic mutations namely the null mutations of the filaggrin gene (FLG) has been the focus in AD risk factors investigations. Purpose: To highlight the emerging topic on the role of filaggrin as an important element in the pathogenesis of AD. Reviews: Filaggrin binds to cytoskeleton keratin to bring the physical strength to corneocytes. Filaggrin will be degraded to amino acids that conserve acidic pH and condensation of the skin. Patients with FLG null mutations are more likely to experience early-onset, severe and persistent AD. AD patients with FLG R501X null mutations are reported to be the least responsive to therapy. Conclusion: A filaggrin deficit is the main culprit in AD development that eventually leads to the defective skin barriers, reduction in natural moisturizing factors (NMF), infections and inflammation. FLG mutations associates with the phenotypes and course of AD which could be examined using Raman-determined NMF.]]>
<![CDATA[Evidence Based Treatment of Alopecia Areata ]]>
<![CDATA[Eva Hariani]]>;
<![CDATA[Nelva K. Jusuf]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.126-134
<![CDATA[Background: Alopecia areata is a chronic autoimmune disease, involving non-scarring hair loss, which affects hair follicles and sometimes nails. Hair loss pattern presents as patchy alopecia, ophiasis, ophiasis inversa (sisapho), reticularis or diffuse. Alopecia areata is common disorder and can impact on patient’s quality of life. Purpose: To review commonly used evidence based treatments of alopecia areata. Review: A number of treatments for alopecia areata have been showed to stimulate hair growth but there is no universally proven therapy that sustains remission. There is high rate of spontaneous remission in alopecia areata makes difficult to assess effectiveness of treatment (spontaneous remission occurs in up to 80% of patients). Numerous of topical and systemic treatment for alopecia areata have been assessed by randomized controlled trials. However management of patients with alopecia areata is still challenging. Conclusion: A number of treatments were found to be effective for alopecia areata. Based on randomized controlled trials, contact immunotherapy has the highest therapeutic evidence based level. Potent topical corticosteroid and intralessional corticosteroids are recommended for limited patchy hair loss and contact immunotherapy for extensive patchy hair loss and alopecia areata totalis/universalis.]]>
<![CDATA[Chromomycosis Treatment With Combination Of Itraconazole And Terbinafine ]]>
<![CDATA[Amalia Rositawati]]>;
<![CDATA[Sunarso Suyoso]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.168-174
<![CDATA[Introduction: Chromomycosis is a localized chronic mycosis of skin and subcutaneous tissue caused by pigmented fungi. It is most common in tropical regions. Lesion usually presented with trauma history, and characterized by nodular verrucous that grow slowly on the lower extremities. The disease is difficult to treat. Case Report: A 33-year-old male garderner came with the main complaint multiple bumps accompanied with itchy and pain sensation on left leg that has became wider since 15 years before. There was a history of a thorn trauma in his left lower extrimity and he used to contact with soil and plants. The patient was diagnosed as chromomycosis based on history, clinical features, and confirmed with potassium hydroxide 10% that showed muriform cell, and fungal culture revealed the species Fonsacaea pedrosoi. The patient has not improved significantly treated with ketoconazole 200 mg 2 times daily for 9 months. The treatment was replaced into itrakonazole 100 mg 2 x 2 tablets combined with terbinafine 250 mg 2 x 1 tablets for 7 months and it gave a good result. Discussion: Predisposing factors in this case were a history of thorn trauma and contact with soil and plants continously. The lesions improved after 7 months treated with itraconazole and terbinafine. Chromomycosis is very difficult to treat and until now the gold standard treatment is not available yet. Combination therapy, itraconazole and terbinafine, could be considered for the therapy of chromomycosis with good result. Combination therapy can be continued until 2-4 weeks after no palpable nodules anymore.]]>
<![CDATA[Profile and Evaluation of Dermatophytosis ]]>
<![CDATA[Ardhiah Iswanda Putri]]>;
<![CDATA[Linda Astari]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.135-141
<![CDATA[Background: Dermatophytosis is an infection of the tissues, for example, the stratum corneum of the epidermis, hair, and nails, which is caused by dermatophyte fungi group. This retrospective study has never been done before and the 2011-2013 election was conducted due to changes in the health insurance system at RSUD Dr. Soetomo. Purpose: To evaluated patient management of dermatophytosis in Mycology Division Outpatient Clinic Dr. Soetomo General Hospital 2011-2013. Methods: A descriptive retrospective study the aim to evaluated general description, epidemiology, clinical manifestation, establisment diagnosis, management and repeated control new patient dermatophytosis. Results: Percentage new case dermatophytes infection increased, but the number of visits to URJ for 3 years decreased. The most diagnosis is tinea corporis. Most cases come from Surabaya. The most patient complaints are itching. The most efflorescence is polycyclic. Griseofulvin is the most therapeutic choice given in the case of tinea corporis. Conclusions: In this study most cases of dermatophytosis is tinea korporis. The diagnosis approach of dermatophytosis diagnosis was obtained by anamnesis, physical examination, and additional examination. Most of dermatophytosis treated with antifungal griseofulvin.]]>
<![CDATA[Effect of Lactobacillus plantarum on Total Immunoglobulin E Serum and Scoring Atopic Dermatitis (SCORAD) Index in Children With Atopic Dermatitis ]]>
<![CDATA[Renata Prameswari]]>;
<![CDATA[Linda Astari]]>;
<![CDATA[Afif Nurul Hidayati]]>;
<![CDATA[Cita Rosita Sigit Prakoeswa]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.91-97
<![CDATA[Background: The prevalence of atopic dermatitis (AD) has been increased for several decades. T-helper cell (Th)1 and Th2 disregulation influence the level of immunoglobulin (Ig)E and interfere Scoring Atopic Dermatitis (SCORAD) index. Management approachment only relieved the symptoms, therapy with probiotic are potentially improve this disregulation. Lactobacillus plantarum (LP) has been fullfilled as probiotic criteria and it’s safely used in human. Methods: In a randomized, double-blind, placebo-controlled trial, twenty (22) patients were randomized to take LP or placebo for 12 weeks with 2 weeks wash-out period in Pediatric Division, Dermatology and Venereology Outpatient Clinic. Total IgE serum level and SCORING indeks were evaluted before and after intervention. Results: Twelve (12) patients in probiotic group and 10 patient in placebo group completed the study. Our findings revealed that there is no significant different in total IgE serum between LP (504.533 IU/ml ± 415.686 IU/ml) and placebo (909.580 ± 885.051 IU/ml) respectively (p=0.117). Mean decreased difference of SCORAD index in LP group (36.784 ± 8.705) significant greater than placebo (26.860 ± 5.021) respectively (p= 0.000). Conclusion: Total IgE serum in both group not significantly different. However, SCORAD indeks in LP group showed a significantly greater reduction. LP is beneficial in the treatment of children with AD.]]>
<![CDATA[Condylomata Acuminata in Children: Report of Two Rare Cases ]]>
<![CDATA[Yuri Widia]]>;
<![CDATA[Shinta Dewi Rahmadhani]]>;
<![CDATA[Sawitri Sawitri]]>;
<![CDATA[Afif Nurul Hidayati]]>
<![CDATA[ Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 29 No. 2 (2017): AGUSTUS ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Airlangga ]]>
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DOI: 10.20473/bikk.V29.2.2017.175-181
<![CDATA[Background: Condylomata acuminata are mostly found in adult patients through sexual contact. Non-sexual transmission should be considered in children with condylomata acuminata. There are no Food Drug Administration (FDA) guidelines approved for condyloma acuminata in children less than 12 years old. Purpose: To report two rare cases of condylomata acuminata in children. Cases: Two girls, aged 1 and 2 years old came at different times to Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital with perianal tumors. Both were born by vaginal delivery. There was no history of the same disease on the genital or the skin of both parents. Physical examinations on the perianal area were multiple flesh-colored papules with ‘cauliflower’ appearance. There was no sign or symptom of sexual abuse. Histopathological examinations in both patient show epidermis with hyperkeratosis, acanthosis, papilomatosis, some epithelial cell show koilocytosis. On the dermis layer there were proliferation from capillary blood vessel, infiltration mononuclear, intact membrane basale and no sign of malignancy. Human papillomavirus (HPV) subtypes examination results were type 11. Discussion: Trichloroacetic acid (TCA) was giving different results on both cases. The patient who did not show improvement with TCA was consulted to pediatric surgery to get electrodessication therapy by hefrycauter. Conclusion: Accurate history and physical examination isneeded to determine the mode transmissions of condylomata acuminata in children. Human papillomavirus (HPV) subtypes examination is not routinely performed and has limitation to determine the mode of transmission, especially in children. Perinatal transmission should be considered in children up to 2 years old. Multiple modalities are available for the treatment of warts in children.]]>
