Introduction: Lucio's phenomenon (LP) is a rare leprosy reaction characterized by severe necrosis of the skin. LP is a variant of type II leprosy reaction by the involvement of immune complexes. LP is usually found in Mexico and Central America. This reaction is especially found in diffuse non-nodular lepromatous leprosy who have not received or completed leprosy treatment. Case: A 36 years woman with newly diagnosed Lucio's phenomenon after initially being misdiagnosed with fungal infection for several months. Discussion: In clinically, LP may mimic other diseases such as mycosis and allergic reaction. Until now there is no consensus regarding LP treatment and combination MDT-MB and systemic corticosteroids are the options in this case. Conclusion: A proper history, physical examination, and histopathology are important diagnostic approaches to avoid misdiagnosis or underdiagnosis in LP cases especially in leprosy endemic regions. The combination of MDT-MB and systemic corticosteroids in FL gives a good response.
Introduction: Epidermolysis Bullosa Simplex (EBS) is one of the major forms of rare genodermatosis EB characterized by non-scarring bulla on the skin or mucosa induced by minor trauma. The worldwide prevalence of EBS is estimated 1 in 50,000 births. The most common etiology of EBS is mutations gene KRT5 and KRT14 who were genetically inherited or de novo in sporadic case. Case: A newborn from the Sasak tribe without a family history of blistering disease was referred to emergency room with generalized multiple blisters with exfoliate skin at birth. Discussion: The accurate diagnosis of EB types and subtypes is important for the management and prognosis of the disease. Many developing countries have difficulty access for advanced laboratory facilities to support the diagnosis of EB while clinically diagnoses are often inaccurate. Clinical Diagnostic Matrix (CDM) is a simple clinical diagnostic tool that can used by the clinical practitioner in limited resource conditions to diagnose type and subtype EB. Conclusion: EBS is the most common type of EB with a generalized form in most sporadic cases. CDM can be used as a diagnostic tool for diagnosis EB more accurately in developing countries such as Indonesia.
<p class="abstract">Gianotti-Crosti syndrome (GCS) is a benign skin disorder characterized by self-limiting acute exanthema. Commonly preceding with the infection of viruses or bacteria and vaccinations. Usually affects children aged 1-6 years and is associated with atopic disease. The exact of GCS incidence is unknown, although several countries in the world have been reported GCS cases. Vaccine-induced GCS cases are infrequently reported. The diagnosis can be made clinically based on clinical features and vaccination history. Treatment is generally symptomatic. Education about GCS is important to prevent over-treatment and avoidance of vaccination in the future. We reported a 9-month-old baby with symmetrical bilateral monomorphic multiple dome-shaped papules lesions on the extremities two days following vaccination.</p>
<p class="abstract">Scabies is an infection caused by infestation and sensitization to the parasitic mite <em>Sarcoptes</em> <em>scabiei</em> <em>var</em>. <em>hominis</em>. World Health Organization (WHO) in 2017 declared that scabies was included as Neglected Tropical Diseases (NTD) and become a significant health concern in many developing countries. According to the Global Burden of Disease Study in 2015, Indonesia was the first place among 195 countries with the greatest scabies burden. Nodular scabies is an uncommon clinical variant in classical scabies cases, characterized by persistent pruritic nodules due to immune response against the mites and their products (eggs and scybala). This variant was occurring in about 7% of scabies patients. The incidence and prevalence of nodular scabies are still unknown. Nodular scabies is usually found in young children and affect the male genitalia, especially in the scrotum. The diagnosis of nodular scabies generally can be made clinically and supported by a history of receiving adequate anti-scabies treatment. Active infestation form or atypical manifestations of nodular scabies might be confused the diagnosis. Diagnostic tools such as dermoscopic and skin biopsy may aid in differentiating them. Histopathology features also can rule out the differential diagnosis. Corticosteroid (topical or injection) and topical inhibitor calcineurin (tacrolimus) was reported effective in treating nodular scabies. We reported an Indonesian adolescent boy who has been diagnosed with scabies complained of persistent pruritic nodules on his genital for several months despite adequate anti scabies therapy being given. Intralesional corticosteroid injection was the options treatment of this case due to the nodular lesion being resistant with topical corticosteroids, while topical tacrolimus is difficult to obtain in our region.</p>
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