Herein, we present a case of Basal Cell Carcinoma (BCC) in a 59-year-old woman. It presented with painless itchy, black, gradually enlarged patches which were easily bled under her left eye since three years ago. Dermatological examination of the left medial canthus region obtained hyperpigmented plaques (2x0.8x0.1cm) with uneven skin texture, irregular borders, and erosion on the center of the lesion. We performed forehead flap technique surgery followed by eight-month monitoring, resulting in a satisfying outcome in both function and appearance. The thinning technique and adjusting the flap size from the forehead area to the medial canthus should be as thin as possible to avoid differences in skin thickness and post-reconstruction hypertrophic scars. A bulging appears on the surgical site a month after the procedure, known as Trap Door Phenomenon. But, on the 8th month of follow-up, the trap drop phenomenon disappeared.
<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>
Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae), which affects the skin and peripheral nerves. Lucio phenomenon is a rare leprosy reaction characterized by severe necrotizing skin lesions. This case report aims to provide clinicians with more information regarding the rare Lucio phenomenon.Case: A 53-year-old male patient presented with worsening lesions on both lower limbs. Physical examination revealed bilateral madarosis and saddle nose. Multiple erythematous lesions with deep ulceration, multiple necrotic tissues, and bilateral extremities deformities were found. There were amputations of the right hand’s digits III and V and left hand’s digits V. Decreased sensory function was found in the median, ulnar and posterior tibial nerves. Acid-fast bacilli (AFB) staining revealed bacterial index (BI) +3 and morphological index (MI) 10%. Histopathological examination showed foamy macrophages, leukocytoclastic vasculitis, lobular panniculitis, and diffuse multiple perivascular infiltrates. It also had extensive areas of necrosis with diffuse neutrophil infiltrate in the deep layer of the dermis and the globes in macrophages. The patient was diagnosed with the Lucio phenomenon and given treatment in the form of Multi-Drug Therapy (MDT) for its multibacillary leprosy, corticosteroids, antibiotics, and wound care. The patient died on the 18th day of treatment.Conclusion: Early detection is necessary to start the treatment immediately and prevent disease worsening. Although MDT and corticosteroid treatment effectively ameliorates the lesions of the Lucio phenomenon, this patient had extensive skin and nerve involvement, secondary infection, and anemia. These resulted in a poor prognosis and increased morbidity.
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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