Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.

CiteScoreCiteScore rank & trend Scopus content coverage i Improved CiteScore methodologyCiteScore ���� counts the citations received in ����-���� to articles, reviews, conference papers, book chapters and data papers published in ����-����, and divides this by the number of publications published in ����-����.

Introduction: Pyogenic granuloma (PG) is a benign vascular tumor of skin and mucous membranes which more commonly develops following trauma, laser treatment, or pregnancy. Although infrequently, PG may arise spontaneously in richly vascularized area due to arteriovenous anastomoses found in Port Wine Stain (PWS).Case Presentation: A 44-year old woman presented with a solitary, dome-shaped, 7x7 mm nodule covered with crusts and scales emerging on sharply demarcated erythematous macule extending from temporal to maxillary part of the left side of her face. The distribution was aligned with the innervation of the second branch of trigeminal nerve. We performed shave biopsy for treatment and followed with 30% TCA to treat the bleeding. The obtained specimen reveled acanthosis, rete ridges lengthening, and capillary proliferation under histopathology examination, confirming the diagnosis of PG. However, the specimen was not enough to confirm the diagnosis of PWS histologically.Discussion: The congenital defect in PWS may have increased number arteriovenous anastomoses that lacks capillary bed to deliver blood to surrounding tissue. The decrease in oxygen delivery may induce angiogenesis that may contribute to the development of PG.

No abstract

Background: Leprosy is a neglected tropical disease caused by chronic granulomatous infection of Mycobacterium leprae. Indonesia ranks third in new case findings, with 84% of the case being multibacillary (MB) leprosy. MB leprosy cases have a higher risk of leprosy reactions and physical disabilities that decrease quality of life. Purpose: To determine the demographic, clinical characteristics, and white blood analysis of newly diagnosed MB leprosy patients, especially concerning leprosy reactions. Methods: This is a descriptive retrospective study with a cross-sectional design that describe the following data: domicile, gender, age, treatment status, disabilities, body mass index (BMI); bacterial index (BI), morphological index (MI), white blood cell (WBC) and differential counts, and thrombocyte count. Result: This study included 176 adult MB cases, predominantly male aged 20–39 years old with average BMI, lived in Surabaya with negative history of multi-drug therapy, disability, BI, nor MI. The grade 2 disability (G2D) percentage in this study setting than in Indonesia (10.7% vs. 6.43%). The WBCs, especially neutrophil count, was higher in T2R group. Monocyte and lymphocyte counts were relatively similar. There was an increase in thrombocyte count in leprosy reaction groups. Conclusion: MB leprosy in the endemic area, which is more commonly found in productive-aged male, displayed higher G2D than global Indonesia population. Thus denotes the importance of active case findings. The difference in blood analysis characteristics between MB leprosy with and without reactions may serve as the foundation for future study.

Latar Belakang: Kusta merupakan penyakit tropis terabaikan. Pada perjalan penyakit kusta yang kronis, sering terjadi reaksi kusta dengan episode subakut akibat respon imunologis terhadap antigen Mycobacterium. leprae . Pada kusta, penting diketahui  berbagai faktor pemicu yang mungkin akan mencetuskan reaksi kusta,  karena memiliki efek signifikan terhadap kualitas hidup. Metode: Studi ini merupakan studi retrospektif analitik dengan data yang diambil dari rekam medis seluruh pasien kusta baru dari tahun 2015-2020. Seluruh varian data dianalisis dengan Pearson’s Chi Square dan Kruskal Wallis test. Analisis regresi  logistik multivariat digunakan untuk mengkalkulasi risiko reaksi kusta.Hasil & Diskusi: Reaksi tipe 1 lebih sering terjadi pada kusta borderline dengan indeks bakteri (IB) dan indeks morfologi (IM) negatif. Reaksi tipe 2 umum terjadi pada kusta tipe lepromatosa dengan IB  ≥3 + (p=0.001) dan IM  1-5%. Pada analisis multivariat, hanya IB 3+ atau lebih yang memiliki korelasi positif dengan kemunculan reaksi kusta.Kesimpulan:  Klinisi perlu menggunakan klasifikasi Ridley and Jopling  dan pemeriksaan IB  serta IM untuk mengetahui risiko terjadinya reaksi kusta. Kata Kunci: penyakit tropis, faktor risiko, reaksi kusta