<p class="abstract">Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with a high misdiagnosis rate. Here, we present the case of NF with hypoesthesia due to prior leprosy in a limited resource area. Laboratory risk indicator for NF (LRINEC) score was used to determine the diagnosis of NF. Resuscitation and broad-spectrum antibiotic were initiated, followed by surgical debridement due to lack of wound improvement and skin graft to cover the wound was done. This case report highlights the usage of LRINEC score to reduce misdiagnosis, ensure early diagnosis, and improve patient management in NF with masking effect.</p>
The STI-control programme was effective in reducing infection prevalence and increasing condom use among sex workers. This intervention has been scaled up and may decrease national STI levels and reduce HIV transmission.
Introduction: Since the emerging Delta variant of COVID-19 in 2021, the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) have encouraged world citizens to get booster vaccination. Booster vaccination has been used worldwide to prevent severe COVID-19. Healthcare providers were given the priority to be vaccinated, and the Moderna vaccine was given as chosen booster vaccination. Cutaneous side effect related to the Moderna vaccine has been reported in Public Secondary Hospital in both two cities in Indonesia, Jakarta and Tangerang. Material & Methods: The observation for this report took place from August until September 2021. All the patients gave their informed consent to participate in this case report and explicit consent to use their clinical photos. We collected data on 357 cases for 2 months in Dr. Suyoto Hospital (Jakarta) dan Dr. Sitanala Hospital (Tangerang). Results: The total number of healthcare workers who got the booster vaccine was 1370, and the number of experienced Moderna Arm was 350 cases: 321 cases with edema, urtica, and erythematous rash, and 29 cases with ecchymosis in Suyoto Hospital while in Sitanala Hospital 7 cases of urtica & erythematous rash. Conclusion: There were side effects after the Moderna injection, and it was important to inform the recipient about those effects.
Hingga tahun 2013, Indonesia berada di urutan ketiga dunia untuk penyakit kusta. Angka kejadian reaksi eritema nodosum leprosum (ENL) di RS Kusta Dr. Sitanala tahun 2015 adalah sebesar 17,22%. Reaksi ENL berat dapat disertai vaskulonekrotik.Laporan kasus ini bertujuan mengulas penggunaan pentoksifilin pada reaksi ENL serta melaporkan penggunaannya pada kasus ENL berat dengan lesi vaskulonekrotik pada pasien kusta lelaki, 29 tahun, dengan gizi kurang dan pengobatan tidak adekuat di RSK Dr. Sitanala. Penelusuran kepustakaan secara online menggunakan database elektronik, dan kata kunci erythema nodosum leprosum and pentoxifylline. Empat artikel terpilih ditelaah untuk menentukan apakah sahih dan dapat diterapkan pada pasien.Pentoksifilin memiliki efektivitas tidak hanya pada perbaikan klinis namun juga penurunan kadar TNF-α yang merupakan mediator inflamasi utama reaksi ENL. Pada reaksi ENL berat dengan vaskulonekrotik, efektivitas talidomid lebih unggul dibandingkan dengan pentoksifilin, namun pentoksifilin dapat menjadi obat alternatif yang baik dengan angka perbaikan hampir sama.Kata kunci: Eritema nodosum leprosum (ENL), pentoksifilin, kusta , vaskulonekrotik
<p>The human skin possesses a microenvironment conducive to the growth of the skin microbiome, which plays in many physiological functions in cutaneous immunity homeostasis and maturation. The microbiome composition depends on many variables, such as endogenous (host condition) or exogenous (environmental) factors and topographic location. Host-skin microbes’ interaction can be mutualism or pathogenicity. Dysbiosis or alteration in skin microbiota is associated with various dermatological diseases, including leprosy. Dysbiosis is driven by the alteration of the microbial communities themselves or due to the intrinsic features of the host. Leprosy is a chronic granulomatous disease caused by <em>Mycobacterium leprae</em> targeting the nerves and skin, leading to loss of sensation on the skin, with or without dermatologic lesions, and correlated with long term consequences, such as deformities or disability. Microvascular dysfunction and significant alterations in capillary structure due to invasion of <em>M. leprae</em> lead to altered hydration levels of the skin caused by disruption of blood flow; which changes the resident microbial community structure. The skin microbiome composition differences in leprosy patient’s skin lesions were observed; skin microbial diversity in the leprosy patients was lower than in healthy individuals. The diversity reduction was observed in freshly diagnosis leprosy patients, those at various stages of MDT, and post-MDT; indicated that both the interaction between skin microbial community and<strong> </strong><em>M. leprae</em> or the ongoing therapeutic regimen impacted the skin microbiome variation. </p><p> </p>
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