Cutaneous tuberculosis (TB) has several clinical manifestations. The most common forms include cervical scrofuloderma and plaque type of lupus vulgaris (LV), otherwise the rare cases including inguinal scrofuloderma, ulcerative LV, and acute miliary TB. The highlight of this case series was to report various rare clinical manifestations of cutaneous TB.

Bone and joint involvements are the most common manifestation in leprosy, after cutaneous and neurological manifestations, yet are underdiagnosed and rarely reported. We report a case of lepromatous leprosy in a 41-year-old male with bone and joint changes. Physical examination revealed a leonine face, madarosis, hypesthetic hypopigmented macules on the back, and swelling of fingers and toes. Acid-fast bacilli from slit-skin smear and synovial fluid in an interphalangeal joint of the hand were found. Radiographic features showed osteolysis and destruction of some phalanges of the hands, bone erosion and destruction of some phalanges of the feet, as well as destruction and subluxation of some hand joints. The patient was given multidrug therapy for multibacillary leprosy, resulting in the reduction of swelling in fingers and toes. In conclusion, the examination of bone and joint changes in leprosy patients is important for early detection and management of musculoskeletal complications, to prevent future deformities and disabilities.

Angka kejadian kutil kelamin (KK) di seluruh dunia terus meningkat. Sampai saat ini belum terdapat terapi yang lebih unggul dibanding dengan terapi lainnya. Krim 5-fluorourasil (5-FU) 5% merupakan salah satu terapi untuk KK pada meatus uretra dan uretra. Krim 5-FU 5% adalah antimetabolit pirimidin fluorinated yang memiliki fungsi sebagai agen antineoplastik dengan menghambat sintesis DNA. Seorang pasien laki-laki berusia 27 tahun dengan KK tipe kondiloma akuminta (KA) di  meatus uretra dan uretra. Pada meatus uretra dan uretra tampak lesi papula ukuran 0,3x0,5x0,2 cm, sewarna kulit dan mukosa dengan permukaan yang tidak rata, pemeriksaan acetowhite positif, dan pemeriksaan polymerase chain reaction (PCR) positif untuk HPV tipe 6. Pasien diterapi  dengan krim 5-FU 5% yang diaplikasikan 3 hari berturut-turut setiap minggu per siklus. Setelah mengaplikasikan krim 5-FU 5% selama 3 siklus, didapatkan lesi pada meatus uretra dan uretra menghilang pada pengamatan hari ke-29 serta tidak timbul lesi baru hingga hari ke-180. Hasil, krim 5-FU 5% untuk KK pada meatus uretra dan uretra memiliki efektivitas yang bervariasi, berkisar 25-95%, dan  rekurensi sebesar 50%. Penggunaan krim 5-FU 5% efektif untuk lesi KK berukuran kecil pada meatus uretra dan uretra, dapat diaplikasikan sendiri oleh pasien, mudah digunakan, dan murah. Simpulan, krim 5-FU 5% merupakan terapi yang efektif untuk KK di meatus uretra dan uretra.

The aim of this study was to assess the frequency of testicular atrophy and its consequences through the examination of clinical manifestations, hormonal profile, and semen analysis in leprosy patients. Methods: A descriptive observational study using a cross-sectional design and consecutive sampling method was conducted from May to July 2018. The study was conducted in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia and included 32 men affected by leprosy and five healthy men as a control group. All patients were subjected to history-taking, dermatological and genital examinations, assessment of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, and testicular ultrasonography examination. Semen analysis was performed for the 10 patients who consented. Results: Testicular atrophy was observed in 93.75% of patients. Clinical manifestations of testicular atrophy were loss of libido (21.87%), female pubic hair pattern (9.38%), gynecomastia (6.25%), and secondary infertility (6.25%). Hormonal imbalance was seen in 16 patients, and all 10 patients who underwent semen analysis showed an abnormality. Conclusions: This study showed a high frequency of testicular atrophy, but the symptoms were only present in a few of patients. The assessment of testicular function should be recommended as a routine work-up for leprosy patients.

Background Molluscum contagiosum (MC) is a benign disease of the skin and mucous membrane caused by a poxvirus. To date, there is no standard therapy used for the treatment of MC. Using 10% of potassium hydroxide (KOH) once or twice a day and 20% KOH once a day are often applicable to MC lesions both in children and adults. Nevertheless, the usage of 20% KOH twice a day still has not been reported. Purpose This case series aimed to show the efficacy and side effects of once- or twice-daily application of 20% KOH solution for MC lesions due to sexually transmitted infections (STIs) in adults. Patients and Methods Three cases of MC on the genital were applied once or twice daily and one case of MC on the face was applied twice daily using 20% KOH solution. Results As a result, the application of 20% KOH twice daily showed the improvement of MC lesions on the face on day 7 and MC lesions on the genital on day 20. Meanwhile, once-daily application of 20% KOH showed diminished MC lesions on genital on day 25–31 after treatment. There were tolerable side effects that occurred in this treatment, such as stinging and burning sensation several minutes after application, erosions, and post-inflammatory hypo- and hyper-pigmentation. Conclusion The 20% KOH solution twice daily on MC lesions in adults is effective, practical, and inexpensive.

Infeksi menular seksual (IMS) adalah infeksi yang penularannya terutama melalui hubungan seksual. World Health Organization (WHO) pada tahun 2016 menyatakan terdapat lebih dari 1 juta orang menderita IMS setiap hari. IMS memiliki pengaruh yang sangat besar pada kesehatan seksual dan reproduktif di seluruh dunia. Komplikasi dari IMS dapat menyebabkan kemandulan, gangguan kehamilan, gangguan pertumbuhan, kanker, dan memudahkan seseorang terkena infeksi human immunodeficiency diseases (HIV). Tingkat pengetahuan masyarakat diketahui berkorelasi dengan tingginya kejadian IMS di masyarakat khususnya remaja. Peningkatan pengetahuan dengan penyebaran informasi seperti kegiatan penyuluhan tentang IMS dan komplikasinya merupakan salah satu upaya penting yang harus dilakukan untuk mengurangi angka kejadian IMS di masyarakat. Kegiatan pengabdian kepada masyarakat (PPM) berupa penyuluhan ini dilakukan di SMA Negeri Jatinangor, Kecamatan Jatinangor, Kabupaten Sumedang. Peserta penyuluhan yaitu siswa dengan total peserta 50 orang. Pengumpulan data dilakukan dengan menggunakan kuesioner. Setiap lembar kuesioner terdiri dari 10 pertanyaan, yang meliputi definisi, jenis-jenis penyakit, cara penularan, tanda dan gejala, komplikasi, dan pencegahan IMS. Tingkat pengetahuan seluruh siswa SMA tentang IMS dan komplikasinya sebelum dilakukan penyuluhan masih cukup, yaitu 38,2% pertanyaan yang dapat dijawab dengan benar oleh peserta penyuluhan. Penyuluhan dapat meningkatkan pengetahuan siswa tentang jenis-jenis penyakit IMS dan komplikasinya. Siswa SMA diharapkan dapat menjadi ujung tombak dalam penyebaran informasi penyuluhan pada keluarga dan masyarakat, sehingga dapat menurunkan angka kejadian dan penularan IMS pada masyarakat.

AbstractsClinical manifestations of leprosy are various and may resemble other skin diseases. Skin lesions of leprosy mimicking psoriasis and mycosis fungoides (MF) that simultaneously occurs in one patient are rare. We reported a unique case of borderline lepromatous (BL) leprosy with severe reversal reaction manifested as psoriasis-like lesions and MF-like lesions in a 43-year-old-man. Psoriasis-like lesions all over the body accompanied by plaques and tumor-like lesions mimicking MF on the face could be found in this patient. Histopathological examination on an MF-like lesion from the face and psoriasis-like lesions from the posterior trunk and lower extremities revealed granulomatous reaction with epithelioid cells, Langhans giant cells, and foam cells which supported the diagnosis of BL leprosy. The patient was treated with multidrug therapy multibacillary (MDT-MB) regimen and 40 mg prednisone daily which was tapered off. Clinical improvement was observed on the 32nd day of observation as psoriasis-like and MF-like lesions became hyperpigmented macules and plaques, respectively. Due to the rarity of the multitype skin lesions of leprosy in one patient, a diagnosis of leprosy should be suspected by the clinicians in any patients with previously described skin disorders, especially in an endemic area.

An abundance of endocrine receptors is expressed on the skin and becomes the target of many hormones. This was associated with various skin diseases that might occur in some endocrine diseases eg, lichen amyloidosis (LA) and acquired reactive perforating collagenosis (ARPC). Here, we report a coexistent LA and ARPC in a 55-year-old woman, characterized with multiple pruritic hyperkeratotic papules and plaques on both arms accompanied by pruritic hyperkeratotic papules and nodules on both legs. She had a history of type 2 diabetes mellitus (DM) and post-thyroidectomy hypothyroidism due to papillary thyroid carcinoma. Histopathological examination revealed amyloid deposition in the papillary dermis corresponding with LA and cup-shaped epidermal depression filled with collagen corresponding with ARPC. The hyperkeratotic papules and nodules flattened in one month after application of 0.05% clobetasol propionate ointment with occlusion on both arms and 0.05% retinoic acid gel on both legs. Hyperkeratotic papules, nodules, and plaques in a patient with a history of endocrine diseases, such as type 2 DM and thyroid disorders should undergo histopathological examination to confirm the diagnosis of skin diseases eg, LA or ARPC.