Larisa Paramitha - Academia.edu (original) (raw)

Papers by Larisa Paramitha

Research paper thumbnail of Kriteria ABCDE untuk Deteksi Dini Keganasan Kulit

Cermin Dunia Kedokteran

Tingginya insiden keganasan kulit yang ditemukan pada stadium lanjut membutuhkan kemampuan lebih ... more Tingginya insiden keganasan kulit yang ditemukan pada stadium lanjut membutuhkan kemampuan lebih baik untuk mengenali tanda dan gejala awal. Pengenalan dini gejala klinis kanker kulit berpigmen, terutama melanoma maligna, dapat dengan pemeriksaan lesi menggunakan kriteria ABCDE. Kriteria ini sederhana dan mudah digunakan, baik oleh tenaga medis maupun masyarakat awam. Makin banyak kriteria ABCDE yang terpenuhi, makin tinggi kemungkinan suatu lesi adalah kanker kulit. High incidence of skin malignancy found in advanced stages calls for a better clinical judgment to detect early signs and symptoms. Screening for early clinical findings of pigmented skin cancer, especially malignant melanoma, can use ABCDE criteria. The criteria are simple and easy to apply, either by medical professionals or general public. The more ABCDE criteria were met, the higher chance that a lesion is a skin cancer.

Research paper thumbnail of Hypopigmented Mycosis Fungoides in Pediatric: A Case Report

Clinical Cases in Dermatology, 2022

Research paper thumbnail of Dermoscopy-guided carbon dioxide laser destruction for nevus sebaceous: two case reports

Journal of General - Procedural Dermatology & Venereology Indonesia, 2021

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinic... more Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO 2 ) laser therapy. Case Illustration: Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO­ 2 laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment. Discussion: The dermoscopy finding of NS were already reported as milia-like structure and multiple whitish structures (dots) varying in size, with orange background. The dermoscopy findings of these two cases were in accordance with previous reports. CO 2 laser destruction was reported to produce satisfying results, but with known recurrences. With the knowledge of dermoscopy appearance, we could determine the area and depth of the lesion to prevent reoccurrence. After two years of follow-up, the area where the deep ablation was performed had not reoccurred. Conclusion: Dermoscopy may aid the diagnosis and therapeutic confirmation of NS. Keywords : dermoscopy, sebaceous nevus, serial CO 2 laser

Research paper thumbnail of Correlation Between Psoriasis Severity and Nonalcoholic Fatty Liver Disease Degree Measured Using Controlled Attenuation Parameter

Psoriasis: Targets and Therapy, 2020

Background: A growing body of evidence links psoriasis to several metabolic disorders, but the ca... more Background: A growing body of evidence links psoriasis to several metabolic disorders, but the causal relationship between psoriasis and nonalcoholic fatty liver disease (NAFLD) remains understudied. Purpose: To measure the correlation between the severity of psoriasis and the degree of NAFLD. Patients and Methods: A cross-sectional study was conducted on adult patients with psoriasis in the Dermatovenereology Outpatient Clinic of Cipto Mangunkusumo Hospital from December 2017 through February 2018. Psoriasis severity (psoriasis area and severity index [PASI] and body surface area [BSA]) was recorded and compared with NAFLD degree measured by controlled attenuation parameter (CAP). Results: A total of 36 subjects were enrolled with an average age of 49.08 years (±15.52 years). The proportions of mild, moderate, and severe psoriasis were 50%, 27.8%, and 22.2%, respectively. Median of PASI was 6.1 (2-38.4) and BSA was 7.5 (2-93). The proportion of NAFLD was 77.8%. The mean of the CAP score was 250.03±45.64. There was no statistically significant correlation between psoriasis severity based on PASI and CAP score (r = 0.258; p = 0.128). However, if the degree of psoriasis was based on BSA, a significant correlation was found (r = 0.382; p = 0.021). The body mass index (BMI) and abdominal circumference were significantly correlated with CAP score (r = 0.448, p = 0.006 and r = 0.485, p = 0.003, respectively). Conclusion: Psoriasis extension correlates with NAFLD severity; further studies should assess in detail the effect of therapies on this pathophysiological link.

Research paper thumbnail of Efficacy and side effects of Blacksoap® as adjuvant therapy of scabies: a randomized control trial

Medical Journal of Indonesia

BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no signif... more BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy. METHODS This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-par...

Research paper thumbnail of Tata laksana komplikasi luka bakar di bidang dermatologi

Media Dermato Venereologica Indonesiana

Tata laksana komplikasi luka bakar di bidang dermatologi

Research paper thumbnail of The Dermoscopic Features of Photoaging and Its Association with Sun Index Score in the Coastal Population at Cilincing, Jakarta: A Cross-Sectional Study

Clinical, Cosmetic and Investigational Dermatology

Repeated exposure to ultraviolet light is the most significant factor that contributes to photoag... more Repeated exposure to ultraviolet light is the most significant factor that contributes to photoaging. Dermoscopy photoaging scale (DPAS) is a noninvasive examination utilized for the diagnosis of photoaging. However, there has been no study analyzing the correlation between DPAS and sun index. Hence, this study aims to find out the dermoscopic features of photoaging and its association with sun index score in the coastal population. Patients and Methods: This was a descriptive cross-sectional study on individuals living in Cilincing, a coastal area, at North Jakarta. Healthy male or female subjects aged over 18 years old with sun exposure equal or more than 2 hours daily were recruited consecutively. History taking was performed to document the sociodemographic characteristics (age, gender, skin type, smoking habit) and sun index score. Physical examination and dermoscopic examination were conducted to determine DPAS score. Associations of DPAS and photoaging profiles were analyzed with Chi-squared test while correlation between DPAS score and sun index was analyzed with Pearson correlation test. Results: A total of 100 subjects were included in this study. The median DPAS of the subjects was 9 (1-21). Right cheek had the highest median DPAS of 3 (0-6), followed by the left cheek with median DPAS of 3 (0-7). Men had a higher median DPAS score than women (9 vs 8). There was a significant difference between DPAS score and age (p<0.001). There was no significant correlation between DPAS score and sun index (r = −0.005; p = 0.957). Conclusion: Factors associated with high DPAS score were cheek predilection, male, actively smoking, Fitzpatrick skin type IV, and increasing age. DPAS score has no correlation with sun index.

Research paper thumbnail of An Unusual Coincidence of Alopecia Areata with Trichotillomania in a Child with Osteogenesis Imperfecta

Clinical Cases in Dermatology, 2022

Research paper thumbnail of Ultraviolet phototherapy for treatment of various dermatoses

Journal of the Medical Sciences (Berkala Ilmu Kedokteran), 2021

Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wav... more Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wavelength, UV radiation consists of three types, namely ultraviolet C (UVC), ultraviolet B (UVB), and ultraviolet A (UVA). The types of UV that are widely used in dermatology are narrowband ultraviolet B (NB-UVB), broadband ultraviolet B (BB-UVB), UVA1, and psoralen combined with UVA (PUVA). The interaction between UV and the skin determines the effectiveness of phototherapy. The biological effects of UV are used in the management of inflammatory skin diseases, malignancies, and various rare dermatoses. Apart from these benefits, UV increases the risk of photoaging and skin cancer. Therefore, further researches are necessary to enhance the effectiveness and safety of phototherapy. This literature review discusses the role of phototherapy in various dermatoses other than psoriasis and vitiligo. ABSTRAK Radiasi sinar ultraviolet (UV) telah digunakan untuk pengobatan penyakit kulit kronik. Berdasarkan panjang gelombangnya, radiasi UV dibedakan dalam tiga jenis yaitu ultraviolet C (UVC), ultraviolet B (UVB), dan ultraviolet A (UVA). Jenis UV yang digunanakan secara luas dalam dematologi adalah narrowband ultraviolet B (NB-UVB), broadbrand ultraviolet B (BB-UVB), UVA1, dan psoralen dikombinasikan dengan UVA (PUVA). Interaksi antara UV dan kulit menentukan efektivitas fototerapi. Efek biologi UV digunakan dalam pengelolaan penyakit kulit inflamasi, malignansi, dan berbagai penyakit kulit yang jarang. Terlepas dari manfaatnya, UV meningkatkan risiko fotoaging dan kanker kulit. Oleh karena itu, penelitian lanjut diperlukan untuk meningkatkan efektivitas dan keamanan fototerapi. Kajian pustaka ini membicarakan peran fototerapi dalam berbagai penyakit kulit selain psoriasis dan vitiligo.

Research paper thumbnail of Numerous Basal Cell Carcinoma: A Case Report in a Suspected Nonsyndromic Patient

Research paper thumbnail of Perkembangan terbaru dan pendekatan tata laksana berbagai penyakit dermatologi dan venereologi / Sandra Widaty, dkk

Research paper thumbnail of The absence of prophylactic antibiotics administration and the surgical site infections rate in Mohs micrographic surgery

Journal of General - Procedural Dermatology & Venereology Indonesia, 2020

Background: The use of prophylactic antibiotics in dermatologic surgery, particularly in Mohs mic... more Background: The use of prophylactic antibiotics in dermatologic surgery, particularly in Mohs micrographic surgery (MMS), remains a gray area. Despite the low rate of surgical site infection (SSI), SSI can result in some significant morbidities. Thus, numerous dermatologists keep administering prophylactic antibiotics in MMS. Method: A search was conducted to identify clinically significant topics followed by literature review through the main available medical literature database. The three selected studies that met the inclusion and exclusion criteria were then critically assessed for their validity, importance, and applicability using the guidance from Centre for Evidence-Based Medicine for Critical Appraisal of Prognostic Studies. Results: Three articles showed a low SSI rate with a narrow confidence interval (CI): 0.91% (95% CI: 0.38%-1.45%), 0.7% (95% CI: 0.21%-1.19%), and 0.72% (95%CI: 0.5%-0.9%). Conclusion: Based on the available studies, we conclude that the absence of prophylactic antibiotics is not related to the SSI incidence.

Research paper thumbnail of Acquired vulvar lymphangioma: Report of two cases

Journal of General-Procedural Dermatology & Venereology Indonesia, 2016

Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired di... more Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired disorder manifests as dilatation of superficial lymph vessel due to obstruction. It is caused by urogenital infection and most often occurs following surgery and radiotherapy of cervical cancer. The diagnosis is established based on clinical and histopathological features. Treatment aimed to eliminate the cause of obstruction. This article reports two cases of vulvar lymphangioma found in our Hospital. Kelainan yang mendasari lesi kulit pada kedua kasus adalah dilatasi pembuluh limfe superfisial dermis vulva. Sumbatan pembuluh limfe akibat radiasi dan operasi kanker serviks pada kasus 1 dan sumbatan pada kelenjar getah bening inguinal pada kasus 2, menyebabkan peningkatan tekanan pembuluh limfatik dermis. Beberapa modalitas terapi untuk menghilangkan lesi diharapkan memberi hasil akhir yang baik secara kosmetis, mencegah kekambuhan, dan infeksi. Tatalaksana pada kedua kasus menggunakan bedah listrik memberikan respon baik, namun perlu waspada adanya kekambuhan.

Research paper thumbnail of Challenge in diagnosis and management of lentigo maligna and lentigo maligna melanoma

Journal of General-Procedural Dermatology & Venereology Indonesia, Aug 4, 2017

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna mela... more Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decade. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

Research paper thumbnail of Correlation Between Psoriasis Severity and Nonalcoholic Fatty Liver Disease Degree Measured Using Controlled Attenuation Parameter

Psoriasis: Targets and Therapy

Background: A growing body of evidence links psoriasis to several metabolic disorders, but the ca... more Background: A growing body of evidence links psoriasis to several metabolic disorders, but the causal relationship between psoriasis and nonalcoholic fatty liver disease (NAFLD) remains understudied. Purpose: To measure the correlation between the severity of psoriasis and the degree of NAFLD. Patients and Methods: A cross-sectional study was conducted on adult patients with psoriasis in the Dermatovenereology Outpatient Clinic of Cipto Mangunkusumo Hospital from December 2017 through February 2018. Psoriasis severity (psoriasis area and severity index [PASI] and body surface area [BSA]) was recorded and compared with NAFLD degree measured by controlled attenuation parameter (CAP). Results: A total of 36 subjects were enrolled with an average age of 49.08 years (±15.52 years). The proportions of mild, moderate, and severe psoriasis were 50%, 27.8%, and 22.2%, respectively. Median of PASI was 6.1 (2-38.4) and BSA was 7.5 (2-93). The proportion of NAFLD was 77.8%. The mean of the CAP score was 250.03±45.64. There was no statistically significant correlation between psoriasis severity based on PASI and CAP score (r = 0.258; p = 0.128). However, if the degree of psoriasis was based on BSA, a significant correlation was found (r = 0.382; p = 0.021). The body mass index (BMI) and abdominal circumference were significantly correlated with CAP score (r = 0.448, p = 0.006 and r = 0.485, p = 0.003, respectively). Conclusion: Psoriasis extension correlates with NAFLD severity; further studies should assess in detail the effect of therapies on this pathophysiological link.

Research paper thumbnail of Vaginal microbiota in menopause

Journal of General-Procedural Dermatology & Venereology Indonesia, Dec 31, 2016

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal mic... more The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman's lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp, and Streptococcus sp. The normal vaginal microbiota's imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H2O2-producing Lactobacillus. They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp.

Research paper thumbnail of The epidemiology of skin cancer at Dr. Cipto Mangunkusumo National Central General Hospital from 2014 to 2017

Background: The incidence of skin cancer has been increasing over the past decades globally. At p... more Background: The incidence of skin cancer has been increasing over the past decades globally. At present, there is no valid national cancer data in Indonesia. The purpose of this study is to evaluate the increment of skin cancer cases at Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Methods: In this retrospective descriptive study, we evaluated all pigmented skin tumor cases from June 2014 to June 2017. Data were obtained from the Department of Anatomical Pathology and medical records at Dr. Cipto Mangunkusumo National General Hospital. Data were compared with previous reports. Results: From 263 skin cancer cases, the most frequent skin cancer was basal cell carcinoma (BCC; 66.9%), followed by squamous cell carcinoma (SCC; 27.4%), and malignant melanoma (MM; 5.7%). Most of the skin cancer w ere predominantly in the female population. In BCC and SCC, most of the patients were within the age group above 60 years (n = 106 and 18, respectively). In MM, the incidence is great...

Research paper thumbnail of The role of oral vitamin D in several skin diseases

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune syste... more Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with indication of oral vitamin D use is important to be understood, especially in association with some chronic diseases requiring long-term therapy. The effects of using oral vitamin D analogues are minimal, but hypervitaminosis D might cause uncomfortable symptoms for patients. Therefore, it is important to understand and regulate the amount of doses of oral vitamin D supplements presc...

Research paper thumbnail of Dermoscopy-guided carbon dioxide laser destruction for nevus sebaceous: two case reports

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinic... more Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO 2 ) laser therapy. Case Illustration: Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO­ 2 laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment. Discussion: The dermoscopy finding of NS were already reported as milia-like structure and multiple whitish structures (dots) varying in size, with orange background. The dermoscopy findings of these two cases were in accordance with previous reports. CO 2 laser destruction was reported to produce satisfying results, but with known recurrences. ...

Research paper thumbnail of Tes Tzanck DI Bidang Dermatologi Dan Venereologi

Media Dermato Venereologica Indonesiana, Jul 23, 2019

Tes Tzanck merupakan prosedur sitologi sederhana yang praktis, mudah dilakukan, ekonomis, kurang ... more Tes Tzanck merupakan prosedur sitologi sederhana yang praktis, mudah dilakukan, ekonomis, kurang traumatik dan hasil cepat. Arnault Tzanck pada tahun 1947 pertama kali melakukan metode ini untuk menemukan sel akantolitik pada lesi kulit vesikobulosa, kemudian berkembang dan terbukti bermanfaat membantu diagnosis untuk menegakkan atau menyingkirkan berbagai penyakit kulit, antara lain penyakit infeksi (herpes simpleks dan varisela zoster), autoimun bulosa (terutama Pemfigus vulgaris), dermatitis spongiosis (dermatitis kontak iritan dan dermatitis kontak alergi), tumor kulit (karsinoma sel basal, karsinoma sel skuamosa dan penyakit paget) serta genodermatosis. Sebagian besar sensitivitas dan spesifisitas baik dan dipengaruhi oleh jenis penyakit dan awitan lesi kulit. Prosedur pengambilan spesimen berbeda-beda bergantung pada jenis lesi. Bahan apusan difiksasi dan diwarnai, paling sering dengan pewarnaan Giemsa. Tinjauan pustaka ini membahas peran pemeriksaan sitologi tes Tzanck, berbagai pola karakteristik sitologi pada penyakit yang sering dijumpai, serta beberapa petunjuk teknis pengambilan sampel pada setiap jenis lesi dan fiksasi serta pewarnaan secara benar.

Research paper thumbnail of Kriteria ABCDE untuk Deteksi Dini Keganasan Kulit

Cermin Dunia Kedokteran

Tingginya insiden keganasan kulit yang ditemukan pada stadium lanjut membutuhkan kemampuan lebih ... more Tingginya insiden keganasan kulit yang ditemukan pada stadium lanjut membutuhkan kemampuan lebih baik untuk mengenali tanda dan gejala awal. Pengenalan dini gejala klinis kanker kulit berpigmen, terutama melanoma maligna, dapat dengan pemeriksaan lesi menggunakan kriteria ABCDE. Kriteria ini sederhana dan mudah digunakan, baik oleh tenaga medis maupun masyarakat awam. Makin banyak kriteria ABCDE yang terpenuhi, makin tinggi kemungkinan suatu lesi adalah kanker kulit. High incidence of skin malignancy found in advanced stages calls for a better clinical judgment to detect early signs and symptoms. Screening for early clinical findings of pigmented skin cancer, especially malignant melanoma, can use ABCDE criteria. The criteria are simple and easy to apply, either by medical professionals or general public. The more ABCDE criteria were met, the higher chance that a lesion is a skin cancer.

Research paper thumbnail of Hypopigmented Mycosis Fungoides in Pediatric: A Case Report

Clinical Cases in Dermatology, 2022

Research paper thumbnail of Dermoscopy-guided carbon dioxide laser destruction for nevus sebaceous: two case reports

Journal of General - Procedural Dermatology & Venereology Indonesia, 2021

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinic... more Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO 2 ) laser therapy. Case Illustration: Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO­ 2 laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment. Discussion: The dermoscopy finding of NS were already reported as milia-like structure and multiple whitish structures (dots) varying in size, with orange background. The dermoscopy findings of these two cases were in accordance with previous reports. CO 2 laser destruction was reported to produce satisfying results, but with known recurrences. With the knowledge of dermoscopy appearance, we could determine the area and depth of the lesion to prevent reoccurrence. After two years of follow-up, the area where the deep ablation was performed had not reoccurred. Conclusion: Dermoscopy may aid the diagnosis and therapeutic confirmation of NS. Keywords : dermoscopy, sebaceous nevus, serial CO 2 laser

Research paper thumbnail of Correlation Between Psoriasis Severity and Nonalcoholic Fatty Liver Disease Degree Measured Using Controlled Attenuation Parameter

Psoriasis: Targets and Therapy, 2020

Background: A growing body of evidence links psoriasis to several metabolic disorders, but the ca... more Background: A growing body of evidence links psoriasis to several metabolic disorders, but the causal relationship between psoriasis and nonalcoholic fatty liver disease (NAFLD) remains understudied. Purpose: To measure the correlation between the severity of psoriasis and the degree of NAFLD. Patients and Methods: A cross-sectional study was conducted on adult patients with psoriasis in the Dermatovenereology Outpatient Clinic of Cipto Mangunkusumo Hospital from December 2017 through February 2018. Psoriasis severity (psoriasis area and severity index [PASI] and body surface area [BSA]) was recorded and compared with NAFLD degree measured by controlled attenuation parameter (CAP). Results: A total of 36 subjects were enrolled with an average age of 49.08 years (±15.52 years). The proportions of mild, moderate, and severe psoriasis were 50%, 27.8%, and 22.2%, respectively. Median of PASI was 6.1 (2-38.4) and BSA was 7.5 (2-93). The proportion of NAFLD was 77.8%. The mean of the CAP score was 250.03±45.64. There was no statistically significant correlation between psoriasis severity based on PASI and CAP score (r = 0.258; p = 0.128). However, if the degree of psoriasis was based on BSA, a significant correlation was found (r = 0.382; p = 0.021). The body mass index (BMI) and abdominal circumference were significantly correlated with CAP score (r = 0.448, p = 0.006 and r = 0.485, p = 0.003, respectively). Conclusion: Psoriasis extension correlates with NAFLD severity; further studies should assess in detail the effect of therapies on this pathophysiological link.

Research paper thumbnail of Efficacy and side effects of Blacksoap® as adjuvant therapy of scabies: a randomized control trial

Medical Journal of Indonesia

BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no signif... more BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy. METHODS This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-par...

Research paper thumbnail of Tata laksana komplikasi luka bakar di bidang dermatologi

Media Dermato Venereologica Indonesiana

Tata laksana komplikasi luka bakar di bidang dermatologi

Research paper thumbnail of The Dermoscopic Features of Photoaging and Its Association with Sun Index Score in the Coastal Population at Cilincing, Jakarta: A Cross-Sectional Study

Clinical, Cosmetic and Investigational Dermatology

Repeated exposure to ultraviolet light is the most significant factor that contributes to photoag... more Repeated exposure to ultraviolet light is the most significant factor that contributes to photoaging. Dermoscopy photoaging scale (DPAS) is a noninvasive examination utilized for the diagnosis of photoaging. However, there has been no study analyzing the correlation between DPAS and sun index. Hence, this study aims to find out the dermoscopic features of photoaging and its association with sun index score in the coastal population. Patients and Methods: This was a descriptive cross-sectional study on individuals living in Cilincing, a coastal area, at North Jakarta. Healthy male or female subjects aged over 18 years old with sun exposure equal or more than 2 hours daily were recruited consecutively. History taking was performed to document the sociodemographic characteristics (age, gender, skin type, smoking habit) and sun index score. Physical examination and dermoscopic examination were conducted to determine DPAS score. Associations of DPAS and photoaging profiles were analyzed with Chi-squared test while correlation between DPAS score and sun index was analyzed with Pearson correlation test. Results: A total of 100 subjects were included in this study. The median DPAS of the subjects was 9 (1-21). Right cheek had the highest median DPAS of 3 (0-6), followed by the left cheek with median DPAS of 3 (0-7). Men had a higher median DPAS score than women (9 vs 8). There was a significant difference between DPAS score and age (p<0.001). There was no significant correlation between DPAS score and sun index (r = −0.005; p = 0.957). Conclusion: Factors associated with high DPAS score were cheek predilection, male, actively smoking, Fitzpatrick skin type IV, and increasing age. DPAS score has no correlation with sun index.

Research paper thumbnail of An Unusual Coincidence of Alopecia Areata with Trichotillomania in a Child with Osteogenesis Imperfecta

Clinical Cases in Dermatology, 2022

Research paper thumbnail of Ultraviolet phototherapy for treatment of various dermatoses

Journal of the Medical Sciences (Berkala Ilmu Kedokteran), 2021

Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wav... more Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wavelength, UV radiation consists of three types, namely ultraviolet C (UVC), ultraviolet B (UVB), and ultraviolet A (UVA). The types of UV that are widely used in dermatology are narrowband ultraviolet B (NB-UVB), broadband ultraviolet B (BB-UVB), UVA1, and psoralen combined with UVA (PUVA). The interaction between UV and the skin determines the effectiveness of phototherapy. The biological effects of UV are used in the management of inflammatory skin diseases, malignancies, and various rare dermatoses. Apart from these benefits, UV increases the risk of photoaging and skin cancer. Therefore, further researches are necessary to enhance the effectiveness and safety of phototherapy. This literature review discusses the role of phototherapy in various dermatoses other than psoriasis and vitiligo. ABSTRAK Radiasi sinar ultraviolet (UV) telah digunakan untuk pengobatan penyakit kulit kronik. Berdasarkan panjang gelombangnya, radiasi UV dibedakan dalam tiga jenis yaitu ultraviolet C (UVC), ultraviolet B (UVB), dan ultraviolet A (UVA). Jenis UV yang digunanakan secara luas dalam dematologi adalah narrowband ultraviolet B (NB-UVB), broadbrand ultraviolet B (BB-UVB), UVA1, dan psoralen dikombinasikan dengan UVA (PUVA). Interaksi antara UV dan kulit menentukan efektivitas fototerapi. Efek biologi UV digunakan dalam pengelolaan penyakit kulit inflamasi, malignansi, dan berbagai penyakit kulit yang jarang. Terlepas dari manfaatnya, UV meningkatkan risiko fotoaging dan kanker kulit. Oleh karena itu, penelitian lanjut diperlukan untuk meningkatkan efektivitas dan keamanan fototerapi. Kajian pustaka ini membicarakan peran fototerapi dalam berbagai penyakit kulit selain psoriasis dan vitiligo.

Research paper thumbnail of Numerous Basal Cell Carcinoma: A Case Report in a Suspected Nonsyndromic Patient

Research paper thumbnail of Perkembangan terbaru dan pendekatan tata laksana berbagai penyakit dermatologi dan venereologi / Sandra Widaty, dkk

Research paper thumbnail of The absence of prophylactic antibiotics administration and the surgical site infections rate in Mohs micrographic surgery

Journal of General - Procedural Dermatology & Venereology Indonesia, 2020

Background: The use of prophylactic antibiotics in dermatologic surgery, particularly in Mohs mic... more Background: The use of prophylactic antibiotics in dermatologic surgery, particularly in Mohs micrographic surgery (MMS), remains a gray area. Despite the low rate of surgical site infection (SSI), SSI can result in some significant morbidities. Thus, numerous dermatologists keep administering prophylactic antibiotics in MMS. Method: A search was conducted to identify clinically significant topics followed by literature review through the main available medical literature database. The three selected studies that met the inclusion and exclusion criteria were then critically assessed for their validity, importance, and applicability using the guidance from Centre for Evidence-Based Medicine for Critical Appraisal of Prognostic Studies. Results: Three articles showed a low SSI rate with a narrow confidence interval (CI): 0.91% (95% CI: 0.38%-1.45%), 0.7% (95% CI: 0.21%-1.19%), and 0.72% (95%CI: 0.5%-0.9%). Conclusion: Based on the available studies, we conclude that the absence of prophylactic antibiotics is not related to the SSI incidence.

Research paper thumbnail of Acquired vulvar lymphangioma: Report of two cases

Journal of General-Procedural Dermatology & Venereology Indonesia, 2016

Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired di... more Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired disorder manifests as dilatation of superficial lymph vessel due to obstruction. It is caused by urogenital infection and most often occurs following surgery and radiotherapy of cervical cancer. The diagnosis is established based on clinical and histopathological features. Treatment aimed to eliminate the cause of obstruction. This article reports two cases of vulvar lymphangioma found in our Hospital. Kelainan yang mendasari lesi kulit pada kedua kasus adalah dilatasi pembuluh limfe superfisial dermis vulva. Sumbatan pembuluh limfe akibat radiasi dan operasi kanker serviks pada kasus 1 dan sumbatan pada kelenjar getah bening inguinal pada kasus 2, menyebabkan peningkatan tekanan pembuluh limfatik dermis. Beberapa modalitas terapi untuk menghilangkan lesi diharapkan memberi hasil akhir yang baik secara kosmetis, mencegah kekambuhan, dan infeksi. Tatalaksana pada kedua kasus menggunakan bedah listrik memberikan respon baik, namun perlu waspada adanya kekambuhan.

Research paper thumbnail of Challenge in diagnosis and management of lentigo maligna and lentigo maligna melanoma

Journal of General-Procedural Dermatology & Venereology Indonesia, Aug 4, 2017

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna mela... more Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decade. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

Research paper thumbnail of Correlation Between Psoriasis Severity and Nonalcoholic Fatty Liver Disease Degree Measured Using Controlled Attenuation Parameter

Psoriasis: Targets and Therapy

Background: A growing body of evidence links psoriasis to several metabolic disorders, but the ca... more Background: A growing body of evidence links psoriasis to several metabolic disorders, but the causal relationship between psoriasis and nonalcoholic fatty liver disease (NAFLD) remains understudied. Purpose: To measure the correlation between the severity of psoriasis and the degree of NAFLD. Patients and Methods: A cross-sectional study was conducted on adult patients with psoriasis in the Dermatovenereology Outpatient Clinic of Cipto Mangunkusumo Hospital from December 2017 through February 2018. Psoriasis severity (psoriasis area and severity index [PASI] and body surface area [BSA]) was recorded and compared with NAFLD degree measured by controlled attenuation parameter (CAP). Results: A total of 36 subjects were enrolled with an average age of 49.08 years (±15.52 years). The proportions of mild, moderate, and severe psoriasis were 50%, 27.8%, and 22.2%, respectively. Median of PASI was 6.1 (2-38.4) and BSA was 7.5 (2-93). The proportion of NAFLD was 77.8%. The mean of the CAP score was 250.03±45.64. There was no statistically significant correlation between psoriasis severity based on PASI and CAP score (r = 0.258; p = 0.128). However, if the degree of psoriasis was based on BSA, a significant correlation was found (r = 0.382; p = 0.021). The body mass index (BMI) and abdominal circumference were significantly correlated with CAP score (r = 0.448, p = 0.006 and r = 0.485, p = 0.003, respectively). Conclusion: Psoriasis extension correlates with NAFLD severity; further studies should assess in detail the effect of therapies on this pathophysiological link.

Research paper thumbnail of Vaginal microbiota in menopause

Journal of General-Procedural Dermatology & Venereology Indonesia, Dec 31, 2016

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal mic... more The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman's lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp, and Streptococcus sp. The normal vaginal microbiota's imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H2O2-producing Lactobacillus. They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp.

Research paper thumbnail of The epidemiology of skin cancer at Dr. Cipto Mangunkusumo National Central General Hospital from 2014 to 2017

Background: The incidence of skin cancer has been increasing over the past decades globally. At p... more Background: The incidence of skin cancer has been increasing over the past decades globally. At present, there is no valid national cancer data in Indonesia. The purpose of this study is to evaluate the increment of skin cancer cases at Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Methods: In this retrospective descriptive study, we evaluated all pigmented skin tumor cases from June 2014 to June 2017. Data were obtained from the Department of Anatomical Pathology and medical records at Dr. Cipto Mangunkusumo National General Hospital. Data were compared with previous reports. Results: From 263 skin cancer cases, the most frequent skin cancer was basal cell carcinoma (BCC; 66.9%), followed by squamous cell carcinoma (SCC; 27.4%), and malignant melanoma (MM; 5.7%). Most of the skin cancer w ere predominantly in the female population. In BCC and SCC, most of the patients were within the age group above 60 years (n = 106 and 18, respectively). In MM, the incidence is great...

Research paper thumbnail of The role of oral vitamin D in several skin diseases

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune syste... more Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with indication of oral vitamin D use is important to be understood, especially in association with some chronic diseases requiring long-term therapy. The effects of using oral vitamin D analogues are minimal, but hypervitaminosis D might cause uncomfortable symptoms for patients. Therefore, it is important to understand and regulate the amount of doses of oral vitamin D supplements presc...

Research paper thumbnail of Dermoscopy-guided carbon dioxide laser destruction for nevus sebaceous: two case reports

Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinic... more Background: Nevus sebaceous (NS) is a common hamartoma of the cutaneous adnexal structure, clinically appear as a well demarcated yellow-orange plaque, sometimes with verrucous surface. Dermoscopy may aid the diagnosis of NS and also guide carbon dioxide (CO 2 ) laser therapy. Case Illustration: Two cases of brown and yellowish plaque on the face, with clinical appearance, dermoscopic, and histopathological findings consistent with NS. The patients consented to undergo serial CO­ 2 laser destruction, aimed to reduce recurrences and shorten the duration of the downtime. Dermoscopy aided in locating the area and the depth of each treatment. Discussion: The dermoscopy finding of NS were already reported as milia-like structure and multiple whitish structures (dots) varying in size, with orange background. The dermoscopy findings of these two cases were in accordance with previous reports. CO 2 laser destruction was reported to produce satisfying results, but with known recurrences. ...

Research paper thumbnail of Tes Tzanck DI Bidang Dermatologi Dan Venereologi

Media Dermato Venereologica Indonesiana, Jul 23, 2019

Tes Tzanck merupakan prosedur sitologi sederhana yang praktis, mudah dilakukan, ekonomis, kurang ... more Tes Tzanck merupakan prosedur sitologi sederhana yang praktis, mudah dilakukan, ekonomis, kurang traumatik dan hasil cepat. Arnault Tzanck pada tahun 1947 pertama kali melakukan metode ini untuk menemukan sel akantolitik pada lesi kulit vesikobulosa, kemudian berkembang dan terbukti bermanfaat membantu diagnosis untuk menegakkan atau menyingkirkan berbagai penyakit kulit, antara lain penyakit infeksi (herpes simpleks dan varisela zoster), autoimun bulosa (terutama Pemfigus vulgaris), dermatitis spongiosis (dermatitis kontak iritan dan dermatitis kontak alergi), tumor kulit (karsinoma sel basal, karsinoma sel skuamosa dan penyakit paget) serta genodermatosis. Sebagian besar sensitivitas dan spesifisitas baik dan dipengaruhi oleh jenis penyakit dan awitan lesi kulit. Prosedur pengambilan spesimen berbeda-beda bergantung pada jenis lesi. Bahan apusan difiksasi dan diwarnai, paling sering dengan pewarnaan Giemsa. Tinjauan pustaka ini membahas peran pemeriksaan sitologi tes Tzanck, berbagai pola karakteristik sitologi pada penyakit yang sering dijumpai, serta beberapa petunjuk teknis pengambilan sampel pada setiap jenis lesi dan fiksasi serta pewarnaan secara benar.