Scabies is difficult to treat in some settings. By observation, it is highly prevalent among students of religion-affiliated boarding schools in Indonesia. Treatment often results in temporary relief. It is known that treatment alone will fail if personal hygiene and environment problems are not addressed. The aforementioned boarding schools have certain challenging characteristics, and several studies have found they might influence those problems. Our study aimed to specify and describe the characteristics to prepare future mass treatment in tackling with the problems. The study recruited and interviewed 105 students of a boarding school located in West Java region. The problems identified were sharing clothes/prayer attire among students, infrequent washing of clothes, availability of hot water, sharing beds, lack of bed sheet, and the presence of scabies among friends and siblings at home. A successful treatment plan must provide means to improve these habits.

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Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.

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Riehl melanosis (RM) is a form of pigmented contact dermatitis that often poses a diagnostic challenge due to overlaps in its clinical, dermoscopic, and histopathological features with other pigmentary disorders. This report highlights significant findings and the proper approach for diagnosis. We present the case of a 47-year-old female with progressive facial hyperpigmentation (irregular, blotchy, grayish patches on the forehead, cheeks, and around the mouth) that acknowledged applying a lightening product before her complaint. Dermoscopy revealed brownish-gray dots and pseudonetwork pigmentation. The histopathological findings were comprised of hypergranulosis, interface dermatitis, and pigment incontinence. The patient's history and clinical, dermoscopic, and histopathological examination results showed features consistent with-but not exclusive to-RM, such that it was not possible to rule out lichen planus pigmentosus (LPP) and ashy dermatosis (AD). We finally diagnosed the patient with RM and treated her with medications consisting of alpha hydroxy acid, tretinoin, hydroquinone, and sunscreen. Patch testing might help because higher positivity rates were found in RM patients compared to LPP and AD. However, positive patch testing favors RM, and, regardless of diagnosis, provides a basis for substance avoidance in the treatment plan.

Scabies is one of the most prevalent infectious skin diseases in Indonesia, especially in boarding schools. Diagnosis of scabies can be made using the four cardinal signs through anamnesis and simple physical examination. The high incidence of scabies requires collaboration between various parties to diagnose and treat scabies. “DeSkab” (scabies detection form) is a form containing questions for non-medical personnel to detect scabies before being confirmed by trained medical personnel. Face and content validity of “DeSkab” is first established by boarding school’s supervisors, experts in community medicine, and dermatovenereologists. To establish reliability, study is conducted in Al-Hidayah Islamic Boarding School, Indonesia. Six non-medical personnel were chosen to examine 81 students of the boarding school using “DeSkab”. Each student is examined by three non-medical personnel, then confirmed through an examination by dermatovenereologists. Result of McNemar test shows that scabies detection by five nonmedical personnel have no statistically significant difference compared to the dermatovenereologist (McNemar test value of P>0.05). Based on this result, “DeSkab” proves to be an option for non-medical personnel to use as an instrument for detecting scabies in Indonesia.

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