<p>Latar belakang :Sindrom Steven Johnson (SSJ) dan nekrolisis epidermal toksik (NET) adalah manifestasi reaksi alergi obat paling berat dan mengancam jiwa yang dimediasi sel T. Salah satu terapi SSJ-NET yaitu kortikosteroid sistemik. Tujuan : Mengetahui pola terapi kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Metode : Penelitian deskriptif retrospektif atas data rekam medis pasien SJS-NET di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Hasil : Didapatkan 80 pasien SJS-NET, usia terbanyak 46-65 tahun (39%), lebih banyak laki-laki (52%). Diagnosis SSJ paling banyak (61%) dibandingkan SSJ overlap NET (24%) maupun NET (15%) dengan keterlibatan mukosa mulut terbanyak (64%). Penyakit penyerta terbanyak adalah diabetes melitus (18 %). Penyebab SSJ-NET terbanyak diduga lebih dari satu obat (44%). Terapi kortikosteroid sistemik berupa injeksi metilprednisolon dengan rata-rata dosis 65 mg/hari dan lama perawatan 10 hari. Simpulan :Kortikosteroid sistemik merupakan terapi semua kasus SSJ-NET di RSUD dr. Moewardi Surakarta.</p><p>Background: Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the severest primarily T-cell mediated manifestation and life threatening drug reaction. Systemic corticosteroid is used for SJS-TEN management. Objective: To study the pattern of systemic corticosteroid therapy for SJS-TEN in Dr.Moewardi General Hospital Surakarta Januari 2014-December 2018. Method: A descriptive retrospective study on medical record data of SJS-TEN patients hospitalized at Dr.Moewardi General Hospital Surakarta between January 2014 and December 2018. Results: From a total 80 SJS–TEN patients in this study, 39% was 46-65 year-old, male (52%). The most frequent diagnosis was SJS (61%) followed by SJS overlap TEN (24%) and TEN (15%), mostly with mucosal mouth involvement (64%). The most frequent comorbidities was DM (18%). More than one drug were related to SJS-TEN (44%). Therapy for all cases was systemic corticosteroids with an average dose of methylprednisolone 65 mg per day in 10 days. Conclusion :Systemic corticosteroids was used in all cases of SSJ-NET in Dr.Moewardi General Hospital Surakarta.</p><p> </p><p> </p>
Background: The COVID-19 pandemic causes health workers to use level 2 and level 3 personal protective equipment. Hand washing and the use of latex gloves are important in limiting the spread of COVID-19, but they can potentially induce hand eczema and skin pH disturbance if used too frequently. Purpose: Determine the correlation between the frequency of handwashing and duration of using hand sanitizer and moisturizer as well as skin pH level on the incidence of hand eczema in nurses in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta. Methods: This cross-sectional study was conducted in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta with 90 nurses as subjects. A validated questionnaire carried out the frequency of handwashing, hand sanitizer, moisturizer, duration of using latex gloves, and hand eczema complaints. The subject’s pH assessment was conducted after 4-5 hours in the COVID-19 treatment room. Data were analyzed bivariately with a Spearman rank correlation test. Result: There was a significant correlation with the incidence of hand eczema with the frequency of handwashing with soap (r=0.305 and p=0.003) and the duration of using latex gloves (r=0.328 and p=0.002) with a weak category correlation (r=0.200-0.399). The frequency of using hand sanitizer, moisturizer, and skin pH did not correlate with the incidence of hand eczema. Conclusion: Frequency of handwashing and the duration of using latex gloves correlated with the incidence of hand eczema, meanwhile frequency of using hand sanitizer, using moisturizer, and skin pH didn’t correlate with the incidence of hand eczema.
Introduction : Furunculosis is a skin inflammation of hair follicle which may become chronic and recurrence. Plasmacytosis is a rare lymphoproliferative disorder involving skin and systemic organs. Here in we report a case of reccurent furunculosis with plasmacytosis treated with surgical excision. Case : A 57-years-old woman presented to our outpatient clinic with a recurrent lumps filled with pus on her left cheek since 2 years ago. Dermatological examination obtained a solitary nodule on the erythematous base skin filled with pus. Laboratory findings did not indicate the monoclonality of electrophoretic serum protein. Histopathological features of skin biopsy showed inflammatory cells aggregate in the perifollicular area consisting neutrophils, lymphocytes, monocytes, eosinophils, and plasma cells mainly in the dermal layer. The CD 138 immunostaining was positive, hence we diagnosed the patient with recurrent furunculosis with plasmacytosis. Surgical excision was conducted and no recurrence has been reported since then. Discussion : Chronic and recurrent furunculosis leads to plasma reactivity against inflammation, promoting plasma cell deposition as the risk of cutaneous plasmacytosis. Histopathological examination and immunostaining may helpful to establish the diagnosis of plasmacytosis occuring in chronic skin infections. Surgical intervention can be performed on furunculosis cases with fluctuated and solitary lesion resulting in less recurrence.
Background: Scabies is caused by parasite, called Sarcoptes scabiei, infestation into the skin. Scabies is generally found in children who live in crowded environments and poor hygiene.Methods: This is a retrospective descriptive study with secondary data collection from medical record data in the Outpatient Installation of RSDM for the period January 2015-December 2019. The subjects were infants to children aged 14 years with a diagnosis of scabies. Data variables used included age, gender, family history of scabies, diagnosis, comorbidities, supporting examinations and, therapy in scabies patients.Results: There were 88 pediatric patients with scabies. The most age group that experienced child scabies was 11-14 years (33%) with the most sex being male (55%). The largest source of scabies transmission was from the family (39%). The most common lesion morphology was papules and excoriations (49%). The lesion location was found mostly between the fingers (24%). Examination of skin scrapings using NaCl 0.9% was positive only in 5 patients (6%) with the most diagnosis was scabies (77%) Conclusion:This study shows that most of pediatric patients with scabies in the 11-14 years range are dominated by males. The most common sources of infection were families with papule morphology and excoriation, whereas the most lesions were found between the fingers. Skin scrapings are only positive 6% of cases. The most commonly used topical therapies are 5% permethrin and 2% ointment mupirocin while the systemic therapies are cetirizine and cefadroxil.
Latar belakang: Pemphigus vulgaris adalah penyakit vesikobulosa autoimun yang mengancam jiwa, yang disebabkan oleh adanya akantolisis sel keratinosit akibat gangguan adhesi pada desmoglein 1 (Dsg1) dan desmoglein 3 (Dsg3). Gambaran klinis pada pemphigus vulgaris berupa lepuhan (bullae) kendur yang dapat mengenai seluruh bagian tubuh disertai keterlibatan mukosa. Penelitian ini bertujuan untuk mengetahui profil kasus pemphigus vulgaris di Instalasi Rawat Inap Rumah Sakit Dr. Moewardi Surakarta periode Januari 2014-Desember 2019. Metode: Penelitian dilakukan secara deskriptif retrospektif dengan melihat data rekam medis pasien pemphigus vulgaris di Instalasi Rawat Inap Rumah Sakit Dr. Moewardi Surakarta periode Januari 2014-Desember 2019. Hasil: Didapatkan 25 orang pasien pemphigus vulgaris dalam kurun waktu 6 tahun, dengan kelompok usia terbanyak adalah 51-60 tahun (36%) dan jenis kelamin terbanyak pada wanita (80%). Pemphigus vulgaris melibatkan mukokutan mulut pada 60% pasien dengan komorbiditas terbanyak adalah hiperglikemia (20%) dan kelainan laboratorium tersering adalah hipoalbuminemia (32%). Terapi yang diberikan pada 52% pasien berupa corticosteroid sistemik, sedangkan sisanya (48%) diberikan terapi kombinasi dengan immunosuppressant, antara lain mycophenolate mofetil (20%), cyclosporine (16%) dan azathioprine (12%). Kesimpulan: Pemphigus vulgaris sering dijumpai pada wanita rentang usia 51-60 tahun. Tata laksana kasus pemphigus vulgaris dilakukan dengan menggunakan terapi tunggal corticosteroid sistemik (52%) atau terapi kombinasi menggunakan agen immunosuppressant.
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