Introduction: Steven-Johnson syndrome (SJS) is an acute reaction to the skin and mucous membranes that is characterised by damage and flaking of the skin, accompanied by pain and can cause death. Treatment with anti-TB drugs sometimes results in side effects including SJS  as one of the skin rash reaction and liver dysfunction. Steven-Johnson syndrome incidence and mortality due to anti-TB is quite rate and here we present a case with SJS and some other drugs side effect symptoms who passed away on the ninth day of treatment. Case description: A 53-year-old woman admitted to our emergency department with dyspnea, fatigue, erosion on oral mucosa, and erythema appears in the whole body accompanied by itch since two weeks ago, she also has yellowish sclera. She is in ongoing therapy of anti-tuberculosis drugs. History of hepatitis B, on admission there was marked elevation of leukocyte and liver function test (AST and ALT). Systemic corticosteroid was given as characterised therapy with topical steroid and antibiotics regimen for maculopapular rash.Conclusion: SJS is an emergency requiring high attention and intensive care evaluation with administration of intravenous systemic steroids as primary immunosuppressive therapy.
Introduction: Seborrheic dermatitis is a chronic superficial skin disorder occurs in 2-5% of population with the symptom of erythematous plaque with slightly yellowish scaling and without clear border, it caused by multifactorial etiopathogenesis includes sebaceous gland secretion, Malassezia fungi colonization, and immune response. This disease is higher in rich sebaceous gland area, is mostly found in the face, upper trunk, and intertriginous (inguinal, inframammary, and axilla). Aim: This study aimed to know the profile of seborrheic dermatitis patients in dermatovenereology outpatient clinic of Wangaya General Hospital in October 2017-October 2018 period. Methods: This study is a retrospective study based on the number of cases, sex, age group, location of lesion, and type of treatment from Pendahuluan: Dermatitis seboroik merupakan penyakit kulit kronis superfisial yang menyerang 2-5% populasi dengan gejala berupa lesi berbentuk plak eritematosa dengan skuama berminyak kekuningan berbatas tidak tegas yang disebabkan oleh berbagai faktor termasuk berhubungan dengan sekresi kelenjar sebasea, kolonisasi jamur Malassezia, dan respon imun. Penyakit ini banyak didapati pada daerah yang kaya akan kelenjar sebasea yaitu daerah wajah, badan bagian atas, lipatan tubuh termasuk inguinal, inframama, dan aksila. Tujuan: Penelitian ini bertujuan untuk mengetahui profil pola penyakit dermatitis seboroik pada pasien di poliklinik Kulit dan kelamin RSUD Wangaya periode Oktober 2017-Oktober 2018. Metode: Penelitian dilakukan secara retrospektif pada pasien dermatitis seboroik berdasarkan jumlah kasus, jenis kelamin, kelompok umur, lokasi lesi, dan pilihan terapi dengan mengambil patient medical records of dermatovenereology outpatient clinic in Wangaya General Hospital in 2017-2018 period. Results: Seborrheic dermatitis mostly found in men (64,2%) with the adult age group is the highest number (77,6%). This disease often affected the face area in 36 patients (53,7%). The most frequent treatment used was anti-inflammation agent in 41 samples (61,2%). In this study, anti-inflammation used were topical corticosteroids (64,2%), there were betamethasone for adults and hydrocortisone for children. Conclusion: Seborrheic dermatitis were mostly found in male, occurred in the age group ≥35 years. The location of lesion is higher found in face area and mostly treated with corticosteroid. data catatan kunjungan pasien poliklinik Kulit dan Kelamin RSUD Wangaya tahun 2017-2018. Hasil: Jumlah pasien dermatitis seboroik tercatat sebanyak 67 pasien (2,3%). Dermatitis seboroik lebih sering ditemui pada laki-laki sebanyak 64,2% dengan usia terbanyak adalah dewasa ≥35 tahun sejumlah 52 pasien (77,6%). Penyakit ini seringkali menyerang daerah wajah sebanyak 36 pasien (53,7%). Terapi terbanyak yang diberikan yaitu anti inflamasi sebanyak 41 pasien (61,2%). Pada penelitian ini, anti inflamasi yang seringkali digunakan adalah kortikosteroid topikal (64,2%), yaitu betametason untuk dewasa dan hidrokortison untuk anak. Kesimpulan: Dermatitis seboroik...
Introduction: Vitiligo is an acquired pigmentation disorder of the skin with the manifestation of white macules due to the release of melanocytes. All therapies for vitiligo are limited and no treatment is known to consistently produce re-pigmentation in all patients. Case Presentation: A 43-year-old woman with this disease came with the chief complaint of white patches on the right forearm and back of the right and left hands. The white patches do not itch but make the patient feel uncomfortable and lower her self-confidence. Conclusion: Patients with vitiligo are characterized by white patches that develop and expand slowly over time, but each person is different. Topical corticosteroids still remain the gold standard in the treatment of small localized areas.
Herpes Zoster (HZ) or shingles is a clinical manifestation caused by the reactivation of varicella-zoster virus (VZV). HZ is rarely happening in children, and its incidence increases with age. We report a 9-month-old baby boy with disseminated HZ. There were grouped vesicles on an erythematous base scattered in several dermatomes with dominant lesions in C5-C7 dermatomes. Complete blood count were within the normal limits. Human immunodeficiency virus (HIV) serology was negative both in mother and baby. Patient was treated with 150 mg oral acyclovir 4 times a day for 5 days. The infant experienced significant improvement and recovered completely without sequelae.
Background: Under-five populations are at higher risk of Staphylococcal Scalded Skin Syndrome (SSSS). The incidence of SSSS in developing countries is still a concern because the staphylococcal infection rate is high. This report aims to describe the clinical profiles of SSSS in infants below 1-year-old. Case: 7 month-old baby boy came with a chief complaint of skin blister for 7 days. It had been preceded by erythema on the right axilla, which turned into blisters on both axilla, perioral, trunk region, and both extremities the following day. The complaint was accompanied by fever. Five days before, he had experienced the common cold. On examinations, he was alert, weighed 9.1 kg, with a heart rate of 134 beats/minute, respiratory rate 40 times/minute, SpO2 98%, and axillary temperature 37.8oC. There were crusts and blisters on the face and trunk with positive Nikolsky’s sign. Genital and lower extremities looked erythematous. Laboratory results showed leukocytes 19,240/uL, neutrophil 50.7%, lymphocytes 35.2%, hemoglobin 9.9 g/dL, hematocrit 30.2%, and platelet 679,000 /uL. He was diagnosed with SSSS and was suggested for hospitalization. He received maintenance fluid therapy with D5%:¼NS 100 ml/kg/day, Cefotaxime injection 3 x 35 mg/kg, Paracetamol syrup 3 x 10 mg/kg, Fusidic Acid 2% cream twice a day, Gentamicin eye ointment 0.3% twice a day, and non-adherent dressing twice a day. He was discharged in good condition after 5 days of hospitalization. Conclusion: The knowledge about the clinical profiles of SSSS is important in order to give rapid management and reduce mortality. Latar Belakang: Populasi di bawah usia 5 tahun rentan mengalami Staphylococcal scalded skin syndrome (SSSS). Di negara-negara berkembang, insidens SSSS masih tinggi karena infeksi staphylococcus masih banyak terjadi. Laporan kasus ini ditulis untuk memberi gambaran mengenai SSSS pada bayi berusia di bawah 1 tahun. Kasus: Bayi laki-laki berusia 7 bulan dibawa dengan keluhan utama kulit melepuh sejak 7 hari sebelumnya. Keluhan didahului kemerahan di ketiak kanan dan keesokan harinya, kulit di ketiak kanan, kiri, dan daerah sekitar bibir, dada, perut, kemaluan, serta kedua tungkai melepuh. Dua hari kemudian, kulit di seluruh tubuh mengelupas. Keluhan disertai dengan demam. Lima hari sebelumnya, pasien mengalami pilek. Pada pemeriksaan, pasien sadar dengan berat badan 9,1 kg, denyut nadi 134 kali/menit, laju pernafasan 40 kali/menit, SpO2 98%, dan suhu aksila 37,8oC. Kulit tampak melepuh disertai krusta pada wajah, dada, abdomen,dan punggung. Tanda Nikolsky positif. Daerah ekstremitas bawah dan genital tampak kemerahan. Pemeriksaan darah menunjukkan leukosit 19.240/uL, neutrofil 50,7%, limfosit 35,2%, hemoglobin 9,9 g/dL, hematokrit 30,2%, dan trombosit 679.000 /uL. Dokter mendiagnosis pasien mengalami SSSS dan menyarankan rawat inap. Pasien menerima terapi cairan rumatan dengan D5%:¼NS 100 ml/kg/hari, Cefotaxime injeksi 3 x 35 mg/kg, Parasetamol sirup 3 x 10 mg/kg, krim Asam Fusidat 2% 2 kali/hari, salep mata Gentamisin 0,3% 2 kali/hari, dan perawatan luka 2 kali/hari. Setelah dirawat selama 5 hari, pasien sembuh dan diizinkan pulang. Simpulan: Pengetahuan mengenai gambaran klinis SSSS penting untuk memberi tatalaksana yang cepat dan tepat sehingga mortalitas dapat ditekan.
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