Background: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that affects peripheral nerves and skin. The interaction between M. leprae and Schwann cells causes irreversible damage to peripheral nervous tissue afterward disability occurs. Involvement of the major nervous trunks of the extremities can produce sensory-motor deficits. The risk factors are delay in diagnosis, gender, age, type of leprosy, duration of disease, number of affected nerves, leprosy reaction, type of treatment, socioeconomic factors, education, ethnicity, and occupation. Purpose: The aim was to study the profile of leprosy patients with disability who seek treatment in Leprosy Division Dermatovenerology Outpatient Clinic RSUD Dr. Soetomo Surabaya. Methods: This was a descriptive retrospective study of leprosy patients with disability from January 2017 to December 2019. Result: The results of this study obtained a total of 275 leprosy patients with disabilities, which consisted of 76 patients (27.6%) with grade-1 disability and 199 patients (72.4%) with grade-2 disability. The majority were male (73.4%) and aged 25-44 years old (42.2%). Other dominant risk factors were MB type leprosy (92%), duration of disease more than 12 months (52.3%), no leprosy reaction (68%), and had received multidrug therapy (45.5%). Conclusion: Knowledge of disability risk factors can assist in improving management and education to prevent disability in leprosy patients.

Background: Oral candidiasis is an infection due to the activity of Candida albicans in the oral cavity. Oral candidiasis is one of the most common opportunistic infections occuring among Human Immunodeficiency Virus (HIV)/Acquired immune deficiency syndrome (AIDS) patients. Due to increasing resistance and adverse effects to commonly used antifun¬gal drugs, many recent studies have examined the use of herbal essential oils as antifungal agents. In this study, essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin were examined for in vitro antifungal activ¬ity against Candida species. Aim: To evaluate antifungal activity of essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin by comparing inhibition zone diameters. Methods: This study was an experimental laboratory study with a posttest only design conducted in Dr. Soetomo General Academic Hospital, Surabaya. Forty isolates consisted of 20 isolates of Candida albicans and Candida non-albicans were subjected to test for antifungal activity using the diffusion disk method using paper discs or blank discs and inhibitory zones were recorded. Results: Diffusion test results revealed stronger antifungal effect of nystatin against all analyzed Candida strains. This study showed the mean diameter of the inhibitory zone for Candida albicans formed by rosemary essential oil is 2.25 mm and the average inhibition zone formed by rosemary essential oil for Candida non-albicans is 1.5 mm. Conclusion: The antifungal activity of nystatin is stronger when compared to rosemary essential oil as seen from a greater inhibition zone than rosemary essential oil in the diffusion method.

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Type 1 leprosy reaction is a delayed hypersensitivity reaction caused by the increased response of cellular-mediated immunity to the Mycobacterium leprae antigen on the skin and nerves with a reversal result. The clinical manifestation includes inflammation which can cause skin and nerve lesions, swell, to permanent disabilities. Purpose: To describe the demographic and clinical profile of type 1 leprosy reaction at the Leprosy Division of the Dermatology and Venerology Outpatient Clinic of Dr. Soetomo General Academic Hospital in 2017–2019. Methods: This was a descriptive study. We used secondary data from the medical records of leprosy patients at the Leprosy Division of Dermatology and Venereology outpatient clinic, Dr. Soetomo General Academic Hospital Surabaya, from January 2017 to December 2019. Result: Out of 364 patients, 65 (17.9%) had type 1 reactions. They were mostly in productive age at 35–55 years old (56.9%). The patients were predominantly male (75.4%), with normal nutritional status (98.5%) and negative bacterial index (72.3%). The most common types of leprosy were BB (Borderline) with 61.6% and BL (Borderline Lepromatous) with 20.8%. All patients took WHO (World Health Organization) MDT (Multi Drug Therapy) MB (Multi-Bacillary). Conclusion: The profile of type 1 leprosy reaction at the Leprosy Division of Dermatology and Venerology Outpatient Clinic of Dr. Soetomo General Academic Hospital in 2017–2019 shows an average data as follows: age 35–55 years, male, normal nutritional status, negative bacterial index, leprosy type BB.

BACKGROUND: Type 1 leprosy reaction is a delayed hypersensitivity reaction caused by increased response of cellular-mediated immunity to Mycobacterium leprae. Manifestations include skin and nerve lesions, edema, and permanent disabilities. There are several risk factors that should be recognized to prevent disabilities. AIM: The aim of this study was to analyze the relationship of risk factors to the occurrence of type 1 leprosy reaction in leprosy patients treated at the Outpatient Clinic of Dr. Soetomo General Hospital. METHODS: This study was an analytical study with retrospective observational study design. Data were secondary from the medical records of leprosy patients at the Outpatient Clinic of Dr. Soetomo General Hospital from January 2017 to December 2019. RESULTS: Out of 364 patients in the Outpatient Clinic, 190 (52.2%) had leprosy without a reaction and 65 (17.9%) had type 1 reaction. Analysis showed that age, leprosy type, and treatment regimen were significantly associated with the incidence of type 1 reaction (p = 0.023; 0.003 and 0.004, respectively), with the leprosy type as the most dominant risk factor. Age 15–34 years old; leprosy types BB, BL, and BT; and the MB MDTL therapeutic regimen are risk factors for the occurrence of type I leprosy reaction. CONCLUSION: There is a statistically significant correlation between the risk factor and the occurrence of type 1 leprosy reaction in leprosy patient. The risk factor that has significant correlation is age 15–34 years; leprosy types BB, BL, and BT; and the MB MDTL therapeutic regimen. The most significant risk factor for the occurrence of type 1 leprosy reaction from our study is the type of leprosy (BB, BL, and BT).

Leprosy is a skin disease caused by Mycobacterium leprae. Leprosy is still a problem in the world. Based from WHO, the defined age for a child is from the womb until the age of 19 years. The risk factors of leprosy in children are host, agent, and environment. Nutritional is one of the risk factors in child leprosy. This study is an analytical study with a cross-sectional study design to evaluate the correlation of nutritional status of child leprosy patients based from WHO and CDC growth charts. The 10-14 years age group was the largest age group with male patients the most affected. The evaluation of the nutritional status of new child leprosy patients at the first visit were found, 8 child leprosy patients with short stature (30%). There were 5 child leprosy patients (19.2%) with an overweight nutritional status, and obesity in 1 child leprosy patient (3.8%). However, there is no correlation between nutritional risk factor and child with leprosy (p-value : 0,79).

Background: The long term use of antifungals for oral candidiasis (OC) in patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) causes some strains to be resistant to certain antifungals. HIV/AIDS are currently most common in men. Aim: To evaluate ketoconazole sensitivity on Candida species in male HIV/AIDS patients with OC. Method: This is an observational descriptive study at the Outpatient Unit and Inpatient Installation of the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo, Surabaya. Samples were taken from HIV/AIDS male patients with OC using sterile swabs. The smear was cultured in CHROMagar Candida incubated at 37°C for 48-72 hours, and Sabouraud Dextrose Agar media for 48 hours at 28°C. Species identification were done using carbohydrate and Cornmeal test. Resistance test was done by disk diffusion method. Results: There were 23 research subjects with 40 isolates of Candida species growing in culture. The most common species was C. albicans in 23(57.5%) isolates, while Candida non-albicans were found in 17(42.5%) isolates. The sensitivity test results showed that 34 (85%) isolates were sensitive, while 2(5%) isolates were resistant to ketoconazole. All C. albicans (23 [100%]) and most Candida non-albicans species (11 [64%]) were sensitive to ketoconazole. Conclusion: Ketoconazole can be recommended as a treatment option for OC patients with HIV/AIDS due to the high sensitivity of both C. albicans and non-albicans to this drug.

Occupational skin disease due to intensified infection prevention procedures among healthcare workers has been reported since the outbreak of coronavirus disease-2019 (COVID-19). This study was to determine the cause of Occupational Contact Dermatitis (OCD) among healthcare workers in the COVID-19 isolation ward using a skin patch test to prevent the recurrence of the disease. The allergens for the patch test included thiuram-mix 1%, 2-mercaptobenzothiazole 2%, and tetramethyl thiuram disulfide 1% which were contained in gloves, cobalt chloride 1%, and colophony 20% which were contained in adhesives, as well as irigasan 2% and lanolin 100% which were contained in hand hygiene products. Thirty healthcare workers who were diagnosed with OCD were included and underwent patch tests. The participants were dominated by females (90%) and nurses (66.67%). Six participants got weak positive (+) results from thiuram-mix 1%. Meanwhile 1 weak positive (+), 6 strong positive (++) and 1 extreme positive (+++) were found in lanolin 100% patch test. There was clinical relevance to these results. The infection prevention measures among healthcare workers in the COVID-19 isolation ward increased the risk of OCD, including the use of PPE and hand hygiene products.

Background: Syphilis is one of the most serious sexually transmitted diseases worldwide, and has tremendous consequences for the mother and her developing fetus if left untreated. The burden of morbidity and mortality due to congenital syphilis is high. Purpose: Screening and prompt to know the importance of treatment of syphilis during pregnancy. Case: A 32-year-old multigravida in 5 months of pregnancy presented with multiple raised lesions over her labia. It was accompanied by fluor and smelly fishy odor. There was no history of genital ulcers in either spouse and no history of sexual promiscuity. History of antenatal care in public health showed non-reactive status of HIV, syphilis and hepatitis B. Clinical examination revealed multiple flat, moist warts over her labia mayora and minora, and multiple roseola syphilitica on the plantar pedis sinistra. Darkfield microscopic examination presence spirochete, venereal disease research laboratory (VDRL) titer was 1:16 and T. pallidum particle agglutination assay (TPHA) titer was 1:2560. Obstetric ultrasonography examination was suggestive no mayor congenital abnormalities. Both of serology VDRL and TPHA were non-reactive in her husband. Significant of lesion improvement and decrease a fourfold titer serologic in VDRL (1:4) and TPHA (1:320) as follow-up 3 months after being treated with single intra-muscular injections of benzathine penicillin 2.4 million units. Discussion: Coordinated prenatal care and treatment are vital. It’s implemented before the fourth month of pregnancy to reduce vertical transmission and all associated side effects of congenital syphilis. Penicillin is highly efficacious in maternal syphilis and prevention of congenital syphilis. Conclusion: Universal screening and adequate pregnancy care must be a priority.