Background: Incontinentia pigmenti (IP) is a rare X-linked dominant inherited genodermatosis that occurs almost in females and is usually accompanied by other ectodermal tissue diseases such as the central nervous system, eyes, hair, nails, teeth and skeletal system. This case report aims to enhance understanding of incontinentia pigmenti and provide appropriate treatment to patients and proper education to families. Case report: A 3-days-od baby girl was consulted by the Pediatric department with complaints of blisters and erythematous rashes on almost her entire body with the Blaschko line distribution. The nails on the right and left big toes appeared inward. No history of fever and seizure. No family had similar complaints. There were no eye and nerve abnormalities involved. She treated with hydrocortisone 1% cream every 12 hours on erythematous papules and vesicles, open compresses with 0.9% NaCl every 8 hours for 10-15 minutes on lesions with yellowish crusts. Thus, the patient diagnosed with incontinentia pigmenti. Conclusion: The diagnosis of incontinentia pigmenti is based on history and physical examination. This case is very rare, so the family needs to understand the course of this disease. Appropriate management and education can prevent secondary infection.
Introduction: Scleroderma is a rare autoimmune disease of connective tissue characterized by extensive fibrosis, inflammation, and vasculopathy. It classified as limited cutaneous and diffuse based on the degree of skin involvement. The management is still a challenge since it has a high morbidity and mortality rate. This case report aims to understand scleroderma and provide appropriate treatment that can improve the patient's prognosis.Case report: A 55-year-old female came with complaints of stiff skin on the forearms, lower legs and face since approximately eight months ago, initially on the right and left forearms, then to face, right and left lower legs. On physical examination, there was sclerosis of the skin on the face, forearms and lower legs, and salt and pepper appearance with Rodnan score were 26. The result from histopathological examination were sceleroderma. The patient was diagnosed with limited cutaneous scleroderma. The management consisted of methotrexate, folic acid, sulpha ferrous, vitamins B1, B6, B12 intraorally and 10% urea cream topically. She also was informed to practice moving the hands and fingers slowly.Conclusion: The diagnosis of limited cutaneous scleroderma is based on history, physical examination and investigations. It is still a life-threatening disease, however multidisciplinary management with early detection and treatment of complications can improve the prognosis.
Background: Keloids are soft solid tumors with a smooth surface that extend beyond the wound margins and invade adjacent normal tissue. Appears at the age of 10-30 years, occurs as a result of an imbalance between increased collagen synthesis and extracellular matrix. There are several types of therapeutic modalities such as intralesional or topical corticosteroids, surgical excision, electrosurgery, frozen surgery, radiotherapy and laser therapy. Combination therapy of surgical excision and intralesional corticosteroids used for this case. Case Description: A woman, 43 years old, complained since 3 years ago, in the lower left abdomen there is a lump, which has been getting bigger over the past 1 year, sometimes feels pain and itching. In the left inferior abdominal region, multiple tumors were found to be erythematous to hyperpigmented, with firm boundaries, oval in shape, 0.2 cm to 0.5 cm in diameter, with a length and width of 0.3 cm and 0.5 cm, respectively. 1 cm and 1.5 cm, the surface feels smooth and shiny. On palpation, the tumor was fixed and firm in consistency. Surgical excision was performed and continued with intralesional injection of triamcinolone acetonide once a week on keloid and post-excision lesions. There was clinical improvement of keloids, on the 21st day of observation. Conclusion: Surgical excision is minimally invasive and can be combined with weekly intrakeloid triamcinolone acetonide injection therapy for keloid lesions and post-excision area to reduce the risk of new keloids appearing. On follow-up observation of keloids in the left inferior abdominal region, the lesion was getting smaller and softened and there was no new keloid growth in the post-excision area. Latar belakang: Keloid adalah tumor yang padat lunak, dengan permukaan licin berkembang melebihi batas luka dan menginvasi jaringan normal yang berdekatan. Muncul pada usia 10-30 tahun, terjadi akibat dari ketidakseimbangan antara peningkatan sintesis kolagen dan matriks ekstraseluler. Terdapat beberapa macam modalitas terapi seperti kortikosteroid intralesi atau topikal, bedah eksisi, bedah listrik, bedah beku, radioterapi dan terapi laser. Kasus ini membahas terapi kombinasi bedah eksisi dan kortikosteroid intralesi. Kasus: Seorang wanita, berusia 43 tahun, mengeluh sejak 3 tahun yang lalu, pada perut kiri bawah terdapat benjolan, yang semakin lama semakin membesar selama 1 tahun terakhir, rasa nyeri dan gatal terkadang dirasakan. Pada regio abdominalis inferior sinistra ditemukan tumor multipel berwarna eritema sampai hiperpigmentasi, dengan batas yang tegas, berbentul bulat oval, berdiameter 0,2 cm sampai 0,5 cm, dengan panjang dan lebar masing-masing 0,3 cm dan 0,5 cm serta 1 cm dan 1,5 cm, permukaan teraba licin dan mengkilat. Pemeriksaan palpasi ditemukan tumor terfiksir dan konsistensinya keras. Dilakukan tindakan bedah eksisi dan dilanjutkan dengan injeksi triamsinolon asetonid intralesi seminggu sekali pada lesi keloid dan lesi paska eksisi. Terdapat perbaikan klinis keloid, pada pengamatan hari ke-21. Simpulan: Tindakan invasif minimal seperti bedah eksisi dapat dikombinasi dengan injeksi triamsinolon asetonid intrakeloid seminggu sekali pada lesi keloid dan daerah paska eksisi untuk mengurangi risiko munculnya keloid baru. Pada pengamatan lanjutan keloid pada regio abdominalis inferior sinistra, didapatkan lesi semakin mengecil dan melunak dan tidak terdapat pertumbuhan keloid baru pada daerah paska tindakan eksisi.
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