Although historically known as a genetic disorder, epidermodysplasia verruciformis (EV) might be acquired in patients with a noninherited defective cell-mediated immunity. This article reports a case of EV in a patient with systemic lupus erythematosus and a history of 3 years immunosuppressive methylprednisolone treatment. The microscopic features of the skin biopsy showed morphologic changes of the keratinocytes characteristic of human papilloma virus (HPV) infections and immunoreactivity to p16. HPV genotyping demonstrated the presence of HPV 6 which belongs to a low-risk mucosal HPV group and has not been reported in EV previously. The clinical recognition of EV in immunocompromised patients and subsequent HPV typing is important because some patients will develop squamous cell carcinoma.
Oxidative stress in obesity leads to insulin resistance in type 2 diabetes. Some selenoproteins possess antioxidant properties, suggesting that selenium (Se) may protect against type 2 diabetes; however, evidence from epidemiological studies is contradictory. We hypothesized that Se status before supplementation (baseline) contributes to the supplementation outcome. This study aimed to clarify the influence of baseline Se status on the effect of Se supplementation on the diabetic condition. Six-week-old KKAy mice were fed a diet without supplemental Se or with 0.1 ppm Se in the form of L-selenomethionine (SeM) for 2 weeks to create low-Se and sufficient-Se baseline statuses, respectively. For the next 4 weeks, low-Se mice were given a SeM (0.5 ppm Se)-supplemented diet, and sufficient-Se mice were given either a SeM (0.5 ppm Se)- or sodium selenite (0.5 ppm Se)-supplemented diet; control groups continued on baseline diets. Serum Se concentrations, glutathione peroxidase (GPx) activities, adiponectin levels, glucose tolerance, and insulin sensitivity were analyzed. All mice became diabetic during the 2-week baseline induction period. At the end of the supplementation period, Se-receiving groups demonstrated significantly higher Se concentrations and GPx activities than their respective controls. Sufficient-Se mice receiving SeM had lower blood glucose levels and better insulin sensitivity than control and sodium selenite-receiving mice, whereas low-Se mice receiving SeM showed no such improvements compared with their controls. Our results suggest that Se supplementation in the form of SeM may help prevent type 2 diabetes aggravation in people taking the 55 μg/day Se recommended dietary allowance.
Psoriasis pustulosa generalisata (PPG) adalah penyakit multisistem yang cukup sulit diterapi. Sejauh ini masih sedikit penilaian keberhasilan terapi PPG menggunakan alat uji yang objektif. Penelitian ini menilai evaluasi terapi PPG menggunakan pustular symptom score (PSS). Rancangan penelitian ini adalah deskriptif retrospektif. Subjek penelitian yaitu semua penderita PPG derajat berat yang berobat di poliklinik dermatologi dan venereologi RSUP dr. Sardjito tahun 2017-2019. Pustular symptom score dievaluasi selama 4 bulan berupa penurunan skor ke derajat ringan, remisi, PSS 50, PSS 75, dan PSS 100. Terdapat 37 subjek PPG derajat berat selama 2017-2019. Perbaikan derajat keparahan menjadi ringan pada subjek yang mendapat metotreksat, metilprednisolon (MP), kombinasi metotreksat dan MP, dan kombinasi narrow-band ultraviolet B (NBUVB) dan MP adalah sebesar 100%; sedangkan perbaikan pada kombinasi siklosporin dan MP sebesar 90%. Metotreksat dan kombinasi metotreksat dan MP memberikan remisi dan pencapaian PSS 75 tertinggi di antara terapi lainnya. Rerata skor PSS terendah di akhir pengamatan juga didapatkan pada kedua kelompok tersebut. Pemberian metotreksat, MP, kombinasi metotreksat dan MP, kombinasi siklosporin dan MP, serta kombinasi NBUVB dan MP mampu memperbaiki derajat keparahan menjadi ringan. Metotreksat, baik tunggal maupun dikombinasi dengan MP, memberikan hasil lebih baik pada penurunan skor PSS dibandingkan modalitas terapi lain.Kata kunci :Â Psoriasis, PPG, PSS, metotreksat, siklosporin
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