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Journal of General-Procedural Dermatology & Venereology Indonesia
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  This is an Open Access Journal Open Access journal
ISSN (Online) 2460-7991
Published by Universitas Indonesia Homepage  [20 journals]
  • Elevated homeostatic model assessment of insulin resistance level
           increases the risk of acne

    • Authors: Stefani Nurhadi; IGAA Praharsini, A. A. Gde Putra Wiraguna
      Abstract: Insulin resistance and carbohydrate diets are currently considered to be influential in acne aetiology. Insulin is a hormone that does not only regulate the concentration of blood glucose but also affects the production of sebum and through the Insulin Growth Factor-1 (IGF-1) receptor stimulates androgen synthesis which will increase the proliferation of keratinocytes of the pilosebaceous duct and the production of sebum in acne.   This is a cross sectional observational analytic study involving 38 acne patient and 38 non acne patients. This study aims to determine whether the increase in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value is a risk factor for acne. HOMA-IR formula was used to determine insulin activity in basal state. High HOMA-IR values ​​are expressed from cut-off point ≥2. Sampling by consecutive sampling that meets inclusion and exclusion criteria. Fasting insulin and glucose levels is derived from venous blood examination.   The average age of acne subjects was 23.71 years (10 men and 28 women). The mean value of HOMA-IR in the acne group was higher (2.63 ± 0.29) than those in the non acne group (1.71 ± 0.26) and statistically significant (p value <0.001). The prevalence ratio was 31.58, meaning that patients with high HOMA-IR were 31.6 times more likely to have acne than patients with normal HOMA-IR values. These results were statistically significant with p value <0.001. The conclusion was elevated HOMA-IR is one of the factors that increase the risk of someone developing acne.
      PubDate: Tue, 08 Jan 2019 15:08:24 +080
  • Efficacy of low level laser therapy in the treatment of postherpetic

    • Authors: Lili Legiawati; Marsha Bianti
      Abstract: Background: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and defined as pain that persists for more than 90 days after the onset of HZ rash. The chronic pain of PHN is debilitating and often associated with significant morbidity. It is a neuropathic pain and manifests as allodynia, hyperalgesia, or spontaneous pain. Although it is not considered to be life-threatening, sometime HZ is inadequately treated and may result in more severe PHN. Various treatment protocols for PHN are available; however, the result remains unsatisfactorily. The use of low level laser therapy (LLLT) in pain management is relatively new and is used with increasing frequency in the management of chronic pain.Aim: To assess the efficacy of low level laser therapy in the treatment of postherpetic neuralgia.Methods: Articles were searched through Pubmed/ MEDLINE, Cochrane, and Google scholar. Two randomized-controlled trials by Kemmotsu et al. and Moore et al. were obtained and critically appraised.Results: Based on the appraisal, studies by Kemmotsu et al. and Moore et al. are considered valid, important, and applicable. The results demonstrated a significant reduction in PHN intensity following a course of LLLT (p< 0.05).Conclusion: There is a statistically significant difference between the involvement of LLLT in PHN patients and without involvement of LLLT. LLLT is a noninvasive, painless, and safe method of treatment and may be recommended as an early intervention for pain therapy of PHN.  Keywords: low level laser therapy, herpes zoster, pain, postherpetic neuralgia, treatment
      PubDate: Mon, 31 Dec 2018 15:14:03 +080
  • Cumulative exposure to solar ultraviolet A & B increases apoptosis of
           peripheral blood cutaneous lymphocyte antigen (CLA)+ T-Lymphocytes in
           outdoor workers

    • Authors: Afif Nurul Hidayati; Saut Sahat Pohan, Widodo J. Pudjirahardjo, Isaak Effendy
      Abstract:   Background: Exposure to ultraviolet A & B (UVA-UVB) plays a role in the survival of human life, but it may cause negative effects, such as immunosuppression and skin cancer. The effect of solar UVA-UVB exposure on apoptosis (Bax/Bcl-2 ratio) of peripheral blood cutaneous lymphocyte antigen (CLA)+ T-lymphocyte; the immune competent cells in the skin, has not been investigated. Apoptosis of peripheral blood CLA+ Tlymphocyte affects its function; which serves as the skin's resistance and is involved in infectious diseases, skin inflammation, and malignancies. This study observed the effect of solar UVA-UVB to apoptosis (Bax/Bcl2 ratio) of peripheral blood CLA+ T-lymphocytes. Methods: An observational cohort study of 37 male outdoor workers (caddies on the golf course) and 33 indoor workers in Surabaya, aged 20-45 years, with skin phototype IV/V. Measurement of solar UVA-UVB doses received by the subjects was conducted for 2, 4, and 8 weeks. Examination of Bax and Bcl-2 of peripheral blood CLA+ T-lymphocyte was conducted at the beginning of the study, after 4 and 8 weeks. Results: The average dose of solar UVA-UVB for 8 weeks received by outdoor workers was 12450.51±3948.81 (J/m2 ) and that by indoor workers was 1793.97±1518.46 (J/m2 ). Exposure to solar UVAUVB leads to the increase of apoptosis (Bax/Bcl-2 ratio) of peripheral blood CLA+ T-lymphocytes (p=0.003). Conclusion: Cumulative exposure to solar UVA-UVB radiation in high-dose or received within 8 weeks resulted in the increase in apoptosis of peripheral blood CLA+ T-lymphocytes.
      Keywords: solar UVA-UVB, CLA+ T Lymphocyte, Bax, Bcl-2, apoptotic.  
      PubDate: Mon, 31 Dec 2018 14:03:08 +080
  • Profile of vitiligo patients and distribution of narrowband-UVB therapy at
           dr. Cipto Mangunkusumo General Hospital

    • Authors: Lis Surachmiati Suseno; Putu Martha Gerynda Sukma, Rahadi Rihatmadja, Triana Agustin, Githa Rahmayunita, Endi Novianto
      Abstract: Background: Vitiligo is a disease marked by depigmented macules. Prevalence of vitiligo varies between 0.1- 2.3% worldwide. The objectives of this study are to identify the socio-demographic profile of vitiligo patients and distribution of narrowband-UVB given as a treatment modality. However, in Indonesia, including at dr. Cipto Mangunkusumo General Hospital, there has not been any study on the profile of vitiligo patients. Therefore, a preliminary study on the patients’ profile would be very useful for healthcare providers in calculating the need for narrowband-UVB equipment and evaluation of its current use. Method: A retrospective descriptive study, using secondary data obtained from dr. Cipto Mangunkusumo General Hospital medical records during the period of 2015-2017. Result: There were 255 vitiligo patients enrolled. Females were greater in number (55.3%). Most patients were distributed evenly in all age groups, highest number of patients were the 21-30 years age group (18.8%). Most patients received elementary school–high school education (56.9%), worked as private employees (36.9%), resided in Jakarta (47.8%). The common diagnosis were unspecified vitiligo (53.3%). Onset of symptoms were mostly around 2 months prior to diagnosis (38.8%) and most of the patients received other treatments other than narrowband-UVB (N=180, 70.6%). Conclusion: The number of vitiligo cases decreased each year with the average vitiligo cases of 85 cases per year and mostly women whereas the number of unspecified vitiligo were quite high. Therefore, more attention is needed from the physicians to treat the patient starting from the establishment of vitiligo to the decision treating with narrowband-UVB Keywords: patient profile, prevalence, vitiligo
      PubDate: Mon, 31 Dec 2018 14:00:09 +080
  • Diagnostic procedures in pediatric dermatology

    • Authors: Arini Astasari Widodo; Githa Rahmayunitha, Triana Agustin, Rinadewi Astriningrum
      Abstract: Diagnostic procedures in pediatric dermatology are different and significantly more challenging than those in adult patients, especially on how to approach the patients. We need to acknowledge that pediatric patients have unique anatomical, physiological, and psychological aspects. Compared to adults, children have smaller procedure area, are less cooperative, and more difficult to understand. For these reasons, we should perform diagnostic procedures on children cautiously. Having extensive knowledge in this field can facilitate us to carry out an ethical, efficient, targeted procedure with less risk. This article reviewed the most appropriate, most comfortable, and least invasive diagnostic procedures for children. Some of the most commonly performed pediatric dermatology procedures highlighted in this article are potassium hydroxide examination, Gram staining examination, acid fast bacilli examination, skin test for allergies, and skin biopsy for children. We also discuss the process of obtaining a written informed consent from the parents who were involved in decision making process and play a crucial role in assisting physicians to calm their children during the diagnostic procedures.  Keywords: children, dermatology, diagnostic procedures
      PubDate: Thu, 27 Dec 2018 14:56:18 +080
  • Eccrine poroma: The prominent mimicker

    • Authors: Nahla Shihab; Larisa Paramitha, Adhimukti T. Sampurna, Inge Ade Krisanti
      Abstract: Background: Eccrine poroma (EP) is an adnexal benign tumor arising from the eccrine duct epithelium. The appearance of EP can mimic benign and malignant skin tumors, thus often making the diagnosis delayed or inaccurate.Case Illustration: We report two cases of EP, with clinical and dermoscopic features mimicking Bowen’s disease, verruca vulgaris, pyogenic granuloma, skin metastases of breast cancer, and amelanotic melanoma. Both patients were surgically excised and biopsied. Histopathology examination of both cases revealed eccrine poroma.Discussion: Both cases showed similarity with the theories, that EP is most found in middle age population and its predilection on extremities. The dermoscopy appearance of the first patient showed two major components, multiple red dots and lacunae mimicking glomerular vessels, and multiple whitish halos-likekeratosis. Red dots with whitish halos can be seen in dermoscopy of verruca vulgaris, while glomerular vessels and keratosis is usually found in Bowen’s disease. The dermoscopy examination of our second patient only showed some loop hemorrhagic and thrombosed vessels, which are quite inconclusive. Diagnoses were made with histopathology examination which revealed similar pattern of eccrine poroma in both cases. Conclusion: EP is a prominent mimicker, often misdiagnosed because it is uncommon in clinical practice, has variable clinical presentations and dermoscopic appearances. Hence, recognizing and diagnosing this disease becomes a challenge for dermatologist. Keywords: adnexal tumor, dermoscopy, eccrine poroma
      PubDate: Wed, 19 Dec 2018 14:01:58 +080
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