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Syphilis serological tests are crucial for diagnosing and evaluating syphilis therapy. Human immunodeficiency virus (HIV) infection can alter syphilis serologies, making manifestations more atypical and increasing complications. This study aims to compare treponemal and nontreponemal titers before and after therapy between HIV-positive and negative patients. From January 2018 to December 2021, we retrospectively evaluated patients diagnosed with early and latent syphilis using quantitative nontreponemal and treponemal serologies (VDRL and TPHA) and categorized them as HIV-positive or negative. Baseline and post-therapy (1 month and last follow-up within 2 years) VDRL and TPHA titers were recorded. Twenty-nine HIV-negative and 28 HIV-positive patients met the inclusion criteria. Baseline VDRL and TPHA titers differed significantly between both groups, particularly in early syphilis, with the median baseline VDRL titer higher in the HIV-positive group. At 1-month and the last follow-up after therapy, VDRL titers continued to differ significantly, underscoring the impact of HIV coinfection on treatment response. Notably, TPHA titers exhibited significant differences between the two groups only at the last follow-up in overall syphilis. The HIV-positive group showed a higher percentage of patients failing to achieve a serological cure (60.7% vs. 58.6%). HIV coinfection in syphilis patients affects both nontreponemal and treponemal titers and elevates the treatment failure risk. This study highlights the importance of periodic syphilis serology tests in coinfected individuals to ensure treatment effectiveness, detect reinfection promptly, and prevent complications. [ J Adv Biotechnol Exp Ther 2024; 7(2.000): 442-450]

Background: One of the most prevalent skin conditions worldwide is acne vulgaris (AV). Even mild forms of AV could have an adverse impact on psychological wellbeing. Purpose: To explore the profile of mild AV patients in a tertiary care facility in Surabaya, Indonesia. Method: This was a descriptive study conducted for eight weeks. Data regarding the patient's identity, history, skin type, and complaints related to AV or other complaints that arose were noted on the sample’s medical record and collected for analysis. The Lehmann classification was used to assess the AV degree. Result: A total of 34 patients were included. Gender equality was similar in our study, and late adolescence (17-25 years) is the most dominant age group (73.5%). Genetics plays the biggest precipitating factor (73.5%), followed by stress (70.6%). Most patients had an oily skin type (91.2%) with Fitzpatrick’s phototype 4 (85.3%). Comedone is the most prevalent lesion in our study (median = 10, range = 4-20). Conclusion: Most patients with mild AV had an oily skin type, and late adolescent is most dominant age group.

Background: Adamantiades–Behçet is a genetically determined disorder with a probable environmental triggering factor and is an inflammatory disease representing vasculitis. Chronic relapsing progressive course, Dapson prevents problems in other organs. Case Report: A 31-year-old woman with chief complaints of a progressive painful ulcer on her genitalia in the last month, covered by pus and with a bad odor, and also recurrent tongue sores that healed spontaneously. Multiple partner sexual intercourse, joint pain, and an eye complaint were denied. Her husband has no history of previous sexually transmitted diseases. The labia majora region showed a solitary ulcer, sharply marginated, and covered with pus. The Haemophilus ducreyi, pathergy, VDRL, TPHA, and rapid test HIV all came back negative. Enterococcus faecalis, found in bacterial culture, is sensitive to Penicillin and glycopeptide. Histopathologically recited vasculitis with thrombus in the blood vessel marks Behcet disease. The patient was given Mefenamic Acid (3x500mg), doxycicline (2x100 mg), and a wet dressing. The ulcer decreased in size after 3 weeks of treatment. Discussion: Adamantiades-Behçett disease is characterized by chronic, recurrent oral aphthous ulcers, genital ulcers, skin lesions, ocular lesions, and arthritis or arthropathy. Viral and bacterial infections have been implicated in initiating immunopathologic pathways. The pathergy test is pathognomonic, but it is not specific and often gives a negative result. Histopathological examination is still the best option to establish the diagnosis.

Background: Acne vulgaris (AV) often occurs at the age of puberty, most people with AV feel ashamed of their appearance. It has been believed that green tea contains high level antioxidant, such as Epigallocatechin-3-gallate (EGCG). Purpose: This study is to compare quality of life from the patient of acne vulgaris before and after using 3% Epigallocatechin-3-Gallate (EGCG) cream as adjuvant therapy of 0,025% tretinoin cream with 0,025% tretinoin cream alone in the treatment of AV. Methods: This study is a quasi-experimental study with a pre-test and post-test design, and a control group design aiming to know the difference in quality of life of 46 samples after administration of EGCG cream combined with tretinoin cream compared to the group that was given tretinoin cream alone in patients with AV for 12 weeks, and then evaluate patients satisfaction and change in quality of life after treatment using the Dermatology Life Quality Index (DLQI). Result: Statistical analysis found that there was a significant difference (p-value

Background: Vitiligo is a long-term autoimmune disorder marked by the loss of melanocytes and the formation of white macules. Vitiligo can have an impact on the patient's look and quality of life. The Dermatology Life Quality Index (DLQI) is a questionnaire that analyzes the quality of life of skin patients in general, but it is not disease-specific. To assess the quality of life of vitiligo patients in Indonesia, a disease-specific instrument is required. Purpose: This study aims to analyze the validity and reliability of the Vitiligo Quality of Life (VitiQol) questionnaire in Indonesia and translate the VitiQol questionnaire into Indonesian. Methods: Using cross-sectional analytic observation, this study was performed on 39 participants with vitiligo at Dr. Soetomo Surabaya between December 2021 and January 2022. The investigation consisted of three phases: the Indonesian translation of VitiQol, testing for validity, and assessing reliability. Result: The VitiQol questionnaire is a valid and reliable questionnaire. Valid with a correlation coefficient between 0.40 and 0.80 and reliability close to perfection. There was a significant correlation between VitiQol and DLQI (r=0.511, p=0.001). Conclusion: According to the findings of this study, the Indonesian VitiQol is a valid and reliable instrument for measuring the life quality of vitiligo patients in Indonesia.

Background: Oral candidiasis (OC), frequently caused by Candida albicans, is the most common opportunistic infection in HIV/AIDS patients. Topical treatment for OC is limited. In vitro study revealed rosemary (Rosmarinus officinalis L.) essential oil has an antifungal effect. However, the essential oil is volatile and is not recommended to be applied to the skin and mucosa; therefore, emulsion gel (emulgel) is made. Purpose: This study was conducted to evaluate the antifungal activity of rosemary emulgel 6.25%, 25%, 37.5%, and 50% compared to nystatin. Methods: This study is an in vitro test using the disk diffusion method to d etermine the antifungal activity shown by the inhibitory zones of rosemary emulgel at 6.25%, 25%, 37.5%, and 50% compared to nystatin to stored isolates of C. albicans from HIV/AIDS patients with OC. Result: Rosemary emulgel 6.25% dan 25% did not show antifungal activity because no inhibitory zone was shown. The inhibitory zone diameter provided by rosemary emulgel 37.5%; 50%; and nystatin against C. albicans isolates were 3.17±3.763 mm; 7.00±4.107 mm; and 30.13±5.319 mm respectively. Significant differences in antifungal activity were shown by the inhibitory zone diameter provided between rosemary emulgel 37.5%, 50%, and nystatin (p

Background: Psoriasis vulgaris can be diagnosed clinically. A biopsy is usually used to confirm non-classic cases. The findings of the histopathology feature are not usually present, thus clinical relevance is needed to confirm the diagnosis. Purpose: To describe the histopathology findings from tissue samples of histopathologically confirmed psoriasis vulgaris reported in the Department of Pathology and Anatomy of Dr. Soetomo General Hospital. Methods: A descriptive-retrospective study of pathology-ascertained tissue samples of histopathologically confirmed psoriasis vulgaris was reported in the Department of Pathology and Anatomy from patients who were also previously diagnosed clinically with psoriasis vulgaris in the Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Academic Hospital over a period of 2 years. Morphological parameters were observed after histopathology sections were stained with hematoxylin and eosin. Result: Thirty-three tissue samples were examined. Parakeratosis (86%) and hypogranulosis (70.3%) were the most observed findings. Club-shaped rete ridges, suprapapillary plate thinning, and spongiform pustules of Kogoj were the least observed findings (each by 2.7%). Three tissue samples (8.1%) showed only parakeratosis. Only 1 tissue sample (2.7%) showed 4 features (absence of the granular layer, parakeratosis, microabscess of Munro, and spongiform pustules of Kogoj). No tissue sample showed every histopathology finding of psoriasis vulgaris. Conclusion: All of the histopathology features of psoriasis vulgaris are rarely found in one tissue section. Albeit histopathology is believed to be the gold standard diagnosis of psoriasis vulgaris, relevance with clinical findings is still mandatory to support the diagnosis.

Background: In 2007, skin cancers were third most common malignancies in Indonesia. However, profile of cutaneous tumors in our institution has not been studied. Purpose: To evaluate profile of cutaneous tumors in Dermatology and Venerology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: This is a descriptive retrospective study. Inclusion criteria was new cutaneous tumor patients. Exclusion criteria was incomplete data. Medical record and photograph database from 2019-2020 were assessed for demography, clinical features, histopathological examination and final diagnosis. Results: There were 379 (5,5%) cutaneous tumors among 6896 new patients at Dermatology and Venereology Outpatient Clinic. Overall, there were more female patients (53.7%) and age group of 0-45 years old (70.4%). Cutaneous tumors more commonly presented as papular (50.4%), multiple (56.5%), nonpigmented (58.3%), asymptomatic lesions (62.5%), with time from onset 0-24 months (66.2%) and location on head and face (61.2%). Benign cutaneous tumors showed similar findings. Malignant cutaneous tumors showed differences including predominantly male sex, age above 45 years old, nodular, solitary, pigmented and easily bleeding lesions. Malignant tumors were less common (6.9%). Most common malignant tumor was BCC. Most common benign and overall cutaneous tumor was seborrheic keratosis. Conclusion: Cutaneous tumors presented across gender and ages, showing heterogenous clinical manifestations. Malignant and benign cutaneous tumors showed similarity on time from onset and location of lesions. However, differences were seen in demographic profiles and majority of clinical features. BCC was the most common malignant cutaneous tumors, while seborrheic keratosis was the most common benign and overall cutaneous tumors.

Background: Oral candidiasis is an infection caused by Candida sp. in areas of the oral mucosa that are often found in HIV/AIDS patients. Increased antifungal resistance, it was important to find new antifungal candidates, especially from natural ingredients, basil leaf extract (Ocimum sanctum Linn.) which had major compound of eugenol that had an antifungal effect in inhibiting of Candida sp. Purpose: To evaluate the comparison of the antifungal susceptibility of nystatin, basil leaf extract (Ocimum sanctum Linn.) and eugenol against isolates of Candida sp. Methods: This study examined the comparison of the antifungal susceptibility of nystatin 100 IU, basil leaf extract (Ocimum sanctum Linn.) with doses equivalent to 800 µg/mL and 400 µg/mL eugenol, and eugenol 800 µg/mL and 400 µg/mL against 40 stored isolates of Candida sp. from the oral cavity of HIV/AIDS patient which was reactivated. Result: The mean inhibition zone of nystatin for all isolates was 22.98 mm, while the mean inhibition zone of eugenol with doses of 800 µg/mL and 400 µg/mL were 17.07 mm and 15.89 mm, and the mean inhibition zone of basil leaf extract (Ocimum sanctum Linn.) with doses equivalent to 800 µg/mL and 400 µg/mL eugenol are 14.87 mm and 14.01 mm. The inhibition zone of basil leaf extract (Ocimum sanctum Linn.) and eugenol was significantly lower than nystatin (p = 0.001; p < 0.05). Conclusion: The zone of inhibition of nystatin was significantly higher compared to basil leaf extract (Ocimum sanctum Linn.) and eugenol against Candida albicans and Candida non-albicans isolates.

Background Oral candidiasis (OC) is an oral mucosal disorder due to Candida genus. Its predisposing factor among patients with HIV/AIDS is mainly decreasing CD4 count. OC is commonly caused by Candida albicans. As CD4 decreases, the shift to C. non-albicans has been observed. Objective To evaluate the association of Candida species with CD4 count and clinical features in HIV/AIDS patients with OC. Patients and methods This is a cross-sectional study. A total of 114 oral rinse solution samples from HIV/AIDS patients with OC were collected. Candida species identification was done by culture in Chromagar followed by VITEK 2. The association of Candida species with CD4 count and clinical features was analyzed using Pearson’s χ2 and Kruskal–Wallis tests. Results There was growth of 149 isolates in culture from 114 patients. C. albicans was found in 104 (69.7%) isolates. Candida non-albicans were found in 45 (30.3%) isolates, namely Candida krusei in 22 (14.85%), Candida glabrata in 12 (8.1%), Candida tropicalis in six (4.05%), Candida dubliniensis in two (1.3%), Candida parapsilosis in two (1.3%), and Candida lipolytica in one (0.7%) isolate. Candida species was significantly associated with clinical types, episode types, pain on swallowing, CD4 count, and antiretroviral (ARV) use among all patients. Conclusion Among HIV/AIDS patients with OC, growth of C. albicans only was more common in higher CD4 count, while mixed growth of C. albicans and C. non-albicans was more common in lower CD4 count. Clinical features associated with growth of C. albicans only were pseudomembranous type, recurrent OC, absence of pain on swallowing, and patients on ARV, whereas those associated with mixed growth of C. albicans and C. non-albicans were cheilitis type, first-episode OC, presence of pain on swallowing, and ARV-naive patients.

Background: Leprosy is a neglected tropical disease caused by chronic granulomatous infection of Mycobacterium leprae. Indonesia ranks third in new case findings, with 84% of the case being multibacillary (MB) leprosy. MB leprosy cases have a higher risk of leprosy reactions and physical disabilities that decrease quality of life. Purpose: To determine the demographic, clinical characteristics, and white blood analysis of newly diagnosed MB leprosy patients, especially concerning leprosy reactions. Methods: This is a descriptive retrospective study with a cross-sectional design that describe the following data: domicile, gender, age, treatment status, disabilities, body mass index (BMI); bacterial index (BI), morphological index (MI), white blood cell (WBC) and differential counts, and thrombocyte count. Result: This study included 176 adult MB cases, predominantly male aged 20–39 years old with average BMI, lived in Surabaya with negative history of multi-drug therapy, disability, BI, nor MI. The grade 2 disability (G2D) percentage in this study setting than in Indonesia (10.7% vs. 6.43%). The WBCs, especially neutrophil count, was higher in T2R group. Monocyte and lymphocyte counts were relatively similar. There was an increase in thrombocyte count in leprosy reaction groups. Conclusion: MB leprosy in the endemic area, which is more commonly found in productive-aged male, displayed higher G2D than global Indonesia population. Thus denotes the importance of active case findings. The difference in blood analysis characteristics between MB leprosy with and without reactions may serve as the foundation for future study.

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Background: Chickenpox caused by the varicella-zoster virus (VZV) in diabetes mellitus patients might exhibit similar clinical features with monkeypox, caused by monkeypox virus (MPXV). In May 2019, Singapore notified World Health Organization (WHO) of one laboratory-confirmed case of monkeypox. Considering Singapore is located near Indonesia, awareness about the possibility of an outbreak in Indonesia should be raised. Purpose: To report a case of chickenpox mimicking monkeypox in an adult with diabetes mellitus and acute kidney injury. Case: A 51-year-old male with poorly controlled diabetes mellitus was suspected to have a chickenpox differential diagnosis with monkeypox. His chief complaint was multiple blisters on his body and vomiting. There was a history of feeding a monkey. From dermatological status on facial, trunk, and extremities there were multiple pleomorphic vesicles. Laboratory results showed elevated renal function. Polymerase chain reaction (PCR) examination using VZV as primer revealed a positive result in the range of 810 bp. He was treated with intravenous acyclovir for 3 days and oral acyclovir for 7 days then discharged with improvement in skin lesions and normal renal function. Discussion: Chickenpox in adult and diabetes mellitus patients can give severe clinical manifestation mimicking monkeypox. PCR has a significant role especially when diagnosis could not be established from the physical examination. Acyclovir can be given as the therapy. Conclusion: Adult and poorly controlled diabetes mellitus are important risk factors associated with the severity and complication of chickenpox. A careful diagnostic approach and management are needed.

Background: Oral candidiasis is an oral infection caused by Candida albicans. It is one of the most common opportunistic infections found in patients with Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). Due to growing resistance and side effects to common antifungal drugs in recent years, there have been many studies on natural substances as antifungal agents. In this study, Epigallocatechin gallate (EGCG) were examined for in vitro antifungal activity against Candida strains. Purpose: To compare the in vitro antifungal activity of EGCG and nystatin towards Candida sp. isolate in HIV/AIDS patients with oral candidiasis. Methods: This research was an experimental laboratory study conducted at the Dr. Soetomo General Academic Hospital, Surabaya. Forty isolates of Candida albicans and Candida non-albicans were included. The isolates were tested for antifungal activity using the well diffusion and microdilution method for nystatin 1000 IU and EGCG 1.25%. Result: Diffusion test results showed a greater inhibition zone for nystatin against all analyzed Candida strains with an average diameter for Candida albicans formed by EGCG of 2.15 mm and 7.4 mm for Candida non-albicans. Meanwhile, based on the microdilution test, EGCG was better than nystatin towards all analyzed Candida strains. This study showed EGCG Minimum Fungicidal Concentration (MFC) as high as 50% (p < 0.05). Conclusion: Nystatin antifungal activity was better than EGCG supported by a greater inhibition zone in the well diffusion method. However, the antifungal activity of EGCG was better than nystatin based on microdilution methods.

Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in human immunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more common in untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriate treatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immune deficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR who were hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: There were more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr. Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the most commonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most common diagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscure erythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatment was dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation was morbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form of topical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.

Background: Syphilis is one of the most serious sexually transmitted diseases worldwide, and has tremendous consequences for the mother and her developing fetus if left untreated. The burden of morbidity and mortality due to congenital syphilis is high. Purpose: Screening and prompt to know the importance of treatment of syphilis during pregnancy. Case: A 32-year-old multigravida in 5 months of pregnancy presented with multiple raised lesions over her labia. It was accompanied by fluor and smelly fishy odor. There was no history of genital ulcers in either spouse and no history of sexual promiscuity. History of antenatal care in public health showed non-reactive status of HIV, syphilis and hepatitis B. Clinical examination revealed multiple flat, moist warts over her labia mayora and minora, and multiple roseola syphilitica on the plantar pedis sinistra. Darkfield microscopic examination presence spirochete, venereal disease research laboratory (VDRL) titer was 1:16 and T. pallidum particle agglutination assay (TPHA) titer was 1:2560. Obstetric ultrasonography examination was suggestive no mayor congenital abnormalities. Both of serology VDRL and TPHA were non-reactive in her husband. Significant of lesion improvement and decrease a fourfold titer serologic in VDRL (1:4) and TPHA (1:320) as follow-up 3 months after being treated with single intra-muscular injections of benzathine penicillin 2.4 million units. Discussion: Coordinated prenatal care and treatment are vital. It’s implemented before the fourth month of pregnancy to reduce vertical transmission and all associated side effects of congenital syphilis. Penicillin is highly efficacious in maternal syphilis and prevention of congenital syphilis. Conclusion: Universal screening and adequate pregnancy care must be a priority.

Background: Atopic Dermatitis (AD) is a complex multifactorial disease that includes defects in skin architecture, immune dysregulation, and changes of skin flora, and it predominantly occurs in infancy and childhood. The defects in skin barrier structures are mentioned as one of the factors that facilitates bacterial colonization. Bacterial infection in AD can worsen the inflammation. It requires treatment with antibiotics, which takes longer therapy time, higher costs, and ultimately affects the patient’s quality of life and his/her family members. Purpose: To find out the epidemiology, diagnosis, management of AD, and analyze the risk factors of secondary bacterial infection in new AD patients at the Pediatric Dermatology Division, Dermatovenereology Outpatient Clinic, Dr. Soetomo General Academic Hospital. Methods: This was a retrospective study with a total sampling method. The research data were medical records of new AD patients at the Pediatric Dermatology Division, Dermatovenereology Outpatient Clinic, Dr. Soetomo General Academic Hospital Surabaya from January 2012 to December 2018. Result: There were 404 new patients with AD at the Pediatric Dermatology Division from January 2012 to December 2018, and 210 of them were accompanied by secondary bacterial infection. There was a correlation between a history of dry skin (p=0.000) with the incidence of secondary bacterial infection in AD patients. Conclusion: In this study, AD patients with a history of dry skin had a risk of complication such as bacterial secondary infection.

Background: Gonorrhea (GO) is a sexually transmitted infection that remains an important clinical and public health problem worldwide. Its incidence tends to increase both in males and females. Given the scale of the public health impact of GO, the selection of appropriate therapy is essential. Purpose: This study aimed to evaluate the characteristics, management, and recovery of gonorrhea patients. Methods: The research material was obtained from the medical record of gonorrhea patients at the Sexually Transmitted Infections (STI) Outpatient Clinic, Dermatology and Venerelogy Department, Dr. Soetomo General Academic Teaching Hospital, Surabaya, from January 2016 to December 2018. Result: We found 84 new GO patients (0.02%) out of the total new outpatients at the Dermatology and Venereology Department, Dr. Soetomo General Academic Teaching Hospital, Surabaya. Most of them were males (92.9%), 17–25 years age group (52.4%), unmarried (67.9%), and heterosexual (90.5%). The majority of therapy is dual therapy, was combination of doxycycline and cefixime (78%). Only 34 patients (40.5%) attended the follow-up visits, and 94.1% of them recovered, and 5.9% presented with cystitis. Conclusion: The characteristics features of GO varies in each variable. One of important to control GO is provide effective and appropriate treatment and routinely clinical and laboratories were needed control.

Background: Psoriasis is an inflammatory, chronic, and recurring skin disease that affects patient’s quality of life. Environment, drugs, and infections in the form of antigen and toxin such as Candida spp. are assumed responsible for triggering and exacerbating psoriasis. Purpose: To compare the prevalence of skin colonization of Candida spp. on psoriasis vulgaris patient and control. Methods: This study was observational analytic research involving 33 psoriasis vulgaris patients and 33 healthy individuals. They were matched up based on sex, age, and lesion location. Swab of skin lesions on the Koebner area of both groups was cultured on CHROMagar media. Candida spp. was later identified and the colonization was calculated. Result: Candida spp. was found on 51.5% of lesions in psoriasis vulgaris patients and 21.2% in the control group with a significant difference of p < 0.05. The average colony number of Candida spp. in psoriasis vulgaris group was lower than the control group with no significant difference of p > 0.05. The predominant Candida spp. in the psoriasis vulgaris and control groups was Candida krusei, which were 35.5% and 85.6%, respectively. No significant difference between sex, age, period of complaints, age onset, degree of severity (Psoriasis Area and Severity Index), and therapy history, with positive culture of Candida spp. Conclusion: There was no difference in the number of Candida spp. colonization in the psoriasis vulgaris group and the control group. However, the culture positivity of Candida spp. in the psoriasis vulgaris patients was higher than in the control group.

Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections. HPV high risk (HPVHR) were HPV16,18 related with invasive penile carcinomas, and HPV low risk (HPVLR) were HPV6,11 related to anogenital warts. Male infection is usually asymptomatic that it would be explain increasing the incidence of HPV associated cancers. Identification HPV genotype is very important for predicting the development of the diseases, to be benign or malignant cancer. The objective of this study was to identify the genotype of HPV that infect men with anogential warts. This research used 12 biopsy specimens from men patient with anogenital warts at Outpatient clinic of Department Dermatology and Venereology, Dr. Soetomo General Hospital period 2016-2017. The specimens were diagnozed by pathologist and HPV gentoyping was done to detect 40 HPV genotype including HPVHR and HPVLR. The result showed that 58% (7/12) were positive for HPVLR and 42% (5/12) were positive for HPV LR/HR. The genotype HPV that infected men patient with anogenital warts is HPVLR (HPV6,11) and HPVHR (HPV18,51,52,82) with single infection of HPVLR or mutiple infection HPVLR/LR or HPVLR/HR. The infection of HPVHR would be develops to be malignant transformation. It suggested that HPV genotype needs to be checked the for the anogenital warts cases for predicting the development of the diseases.

Background: Scabies, an infectious disease caused by Sarcoptes scabiei mites, is still one of the most common skin diseases found in developing countries, including Indonesia. The 5% permethrin cream for scabies treatment has been investigated as having 2–3 time to cure scabies. Tea Tree Oil (TTO) is one of the agents that has been proven to have acaricidal potential as an anti-inflammatory, antibacterial, and antipruritic agent. It has minimal side effects in topical use. Purpose: To evaluate the effectiveness of 5% TTO cream and 10% TTO cream in scabies treatment of pediatric patients. Methods: This was an experimental, analytical study with controlled clinical trial methods, and a double-blind, parallel design comparing 5% TTO cream (treatment 1), 10% TTO cream (treatment 2), with 5% permethrin cream (control) to children with scabies. Result: The 5% TTO cream gave a cure rate of 61.5% and was significantly different from the 5% permethrin cream groups with a p-value = 0.044 in the first week of the study. The 5% permethrin cream gave a cure rate of 15.4%, and the cure rate of 10% TTO cream was 53.8% in the first week of the study. Conclusion: There was a significant difference between the 5% TTO cream and 5% permethrin cream in the first week of the study. The highest and fastest cure rates were found in the 5% TTO cream treatment group.

Background: Oral candidiasis is one of the most common infections in Human Immunodeficiency Virus/Acquired Immuno Deficiency Syndrome (HIV/AIDS) patients. Some studies have reported an increased number of resistances of Candida sp. against several antifungal therapies. Purpose: To evaluate the pattern of Candida sp. causing oral candidiasis and the pattern of resistance among the Candida sp. against nystatin, ketoconazole, and fluconazole in oral candidiasis patients with HIV/AIDS infection. Methods: This was a descriptive observational study conducted at the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo General Academic Teaching Hospital. Candida sp. was identified using conventional methods, while the sensibility test was done by using disc diffusion methods. Result: There were 26 subjects with 50 isolates of Candida sp. that had been cultured successfully. Non-albicans Candida sp. was the most common species, which was observed in 28 subjects (56%). The results of the sensibility test on Candida sp. against nystatin, ketoconazole, and fluconazole were 0 (0%), 3(6%), dan 23(46%) respectively. Conclusion: The increased resistance among Candida sp. against antifungal drugs, especially fluconazole, could raise awareness in drug prescription, especially for HIV/AIDS patients.

Background: Oral candidiasis is the most common clinical manifestation in a person infected with HIV which has been linked with the severity of the disease. Candida albicans responsible for most oral candidiasis. The increased resistance to the available antifungal drugs can reduce the efficacy of therapy. Therefore, it will be crucial to discover novel antifungal agents. One of them is tea tree oil (TTO) or Melaleuca alternifolia which has a potent antifungal effect to inhibit the growth of Candida sp. Purpose: To evaluate the antifungal susceptibility of TTO 5% compared with nystatin against Candida sp. taken from HIV/AIDS patients. Methods: The study assessed the antifungal effect of TTO 5% and nystatin against 33 isolates of Candida sp. that was isolated from the oral cavity of 30 HIV/AIDS patients in Dr. Soetomo General Academic Teaching Hospital Surabaya, Indonesia. Antifungal susceptibility was evaluated by the disc diffusion method. The diameter of the inhibition zone was determined as the result of this study. Result: The most strains found in this study was Candida albicans (84.8%). The mean inhibition zone of nystatin against all strains was 23.24 mm whether it was 17.55 mm for TTO 5%. The inhibition zone of both TTO 5% and nystatin in Candida non-albicans were tended to be higher than in Candida albicans. It revealed that the inhibition zone of TTO 5% significantly lower than nystatin (P = 0.00; P < 0.05).Conclusion: Therefore, the antifungal susceptibility of nystatin was significantly higher than TTO 5% against Candida albicans and non-albicans.

Background: Oral candidiasis is caused by the mycotic activity of Candida albicans present in the oral cavity, and it is one of the most common opportunistic infections found in patients with Human Immunodeficiency Virus (HIV)/acquired immune deficiency syndrome (AIDS). The growing resistance and side effects to common antifungal drugs have promoted herbal essential oils as antifungal agents in recent years. In this study, essential oils (EO) of Rosmarinus officinalis (Lamiaceae) were examined for in vitro antifungal activ­ity against Candida species. Purpose: To evaluate the antifungal activity of essential oils of Rosmarinus officinalis (Lamiaceae) and nystatin using the microdilution technique by determining the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of Candida spesies. Methods: This was an experimental laboratory study with a post-test-only design conducted in Dr. Soetomo General Academic Teaching Hospital, Surabaya. Forty isolates consisted of twenty isolates of Candida albicans and twenty isolates of Candida non-albicans were collected. The isolates were tested for antifungal activity using the microdilution on 96-well plates. Result: There was a significant difference from the results of the MIC concentration of rosemary essential 100% to 6.25% microdilution method between nystatin and rosemary essential oil (p < 0.05). Conclusion: The antifungal activity of rosemary essential oil was better than nystatin that the lowest MIC value, which was 6.25%, has been obtained the microdilution method. The minimum fungicidal concentration of rosemary essential oil was 25%, while the minimum fungicidal concentration nystatin was higher than 100%.

Background: Bacterial vaginosis (BV) is a clinical syndrome caused by the changing of Lactobacillus spp., a producer of hydrogen peroxide, in the normal vagina with a high concentration of anaerobic bacteria, Gardnerella vaginalis and Mycoplasma hominis. This study reports a resistance of BV therapy regimens, high recurrence rates, and side effects of an antibiotic. Therefore, adjunctive therapy for BV management is needed. Research has reported the therapeutic effects of probiotic in BV; however, the results are inconsistent. Purpose: To evaluate the efficacy of standard therapy using metronidazole and Lactobacillus plantarum for BV measured by the cure rate and vaginal flora balance. Methods: A randomized, double-blind, placebo-controlled trial, 30 subjects were randomized to take metronidazole 500 mg twice a day for seven days with weekly evaluation. The Lactobacillus plantarum or placebo group was evaluated every 4 weeks. The cure rate and vaginal flora balance were evaluated using the Amsel criteria and Nugent score before and after the intervention. Result: A total of 30 subjects returned for 28-day follow-up, of which 60% subjects of the antibiotic/probiotic group were cured compared to 40% in the antibiotic/placebo group (p>0.05). Conclusion: There was no difference in the increase of cure rate and vaginal flora balance between the treatment group and significant control group.

Background: The most common opportunistic infection obtained in patients with Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) is Oral Candidiasis (OC). Currently widely reported about increased fluconazole resistance, as a therapy that is often used in patients with HIV/AIDS with OC. For this reason, effective antifungal agents are needed as alternative therapies. Several studies have reported some antifungal activity from rosemary essential oils. Purpose: The aim of this study is to evaluate the antifungal activity between rosemary essential oils and fluconazole against the isolates used by Candida sp. taken from HIV / AIDS patients with OC. Methods: This research was an experimental laboratory study with a post-test only design of 40 Candida sp. isolates from HIV / AIDS patients with OC in the Outpatient Unit and Inpatient Installation of the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo General Academic Teaching Hospital, Surabaya. Examination of antifungal activity using conventional test methods with disk diffusion. Result: Disk diffusion test result revealed average inhibition zone of rosemary essential oil in Candida albicans 1,75±3,64 mm and Candida non-albicans 1,5±3,08 mm, while the average inhibition zone of fluconazole in Candida albicans 17,9±8,62 mm and Candida non-albicans 4,85±7,9 mm. There was significant difference (p

Background: Photoaging, also called extrinsic aging, is a premature skin aging mainly resulting from prolonged and extended exposure to ultraviolet (UV) radiation. Amniotic Membrane Stem Cell Metabolite Products (AMSC-MP) are derived from amniotic membranes that contain cytokines and growth factors that have a role in the skin rejuvenation process. Vitamin E is an antioxidant that has a photoprotective effect, so it is expected to reduce the appearance of clinical signs of photoaging. Not only having skin rejuvenation effect, but microneedling is also expected to facilitate the penetration to increase the efficacy of AMSC-MP and vitamin E. This combination is expected to have a better effect on clinical photoaging improvement. Purpose: To evaluate the effect of a topical combination of AMSC-MP and vitamin E after microneedling on the clinical improvement of photoaging compared to previous skin conditions. Methods: Thirty adult women with photoaging topically administered a combination of AMSC-MP and vitamin E after 3 microneedling sessions at 2 weeks intervals. The evaluation of the improvement of the degree of pores, wrinkles, skin tone and dark spots were performed with the Janus-II Facial Skin Scope System. Result: There was a clinical improvement with a statistically significant difference in terms of the degree of pores, wrinkles, polarized black spots, and UV black spots, which were statistically significant differences (p

Background: Vitiligo is an acquired and commonly found pigmentation disorder characterized by milky-white patches on the skin, hair, and mucosa due to melanocyte damage. The cause of vitiligo is still unclear. A study proves that cell-mediated immunity plays a role in the pathogenesis of vitiligo. Melan-A is a melanoma-related antigen that is recognized by autologous cytotoxic T cells and one of the critical markers for detecting melanocytes. Objective: To evaluate the expression of Melan-A in depigmented lesions of vitiligo patients. Methods: A descriptive study aimed to describe the expression of Melan-A in the depigmented skin of vitiligo patients at the Dermatovenerology Outpatient Clinic Cosmetic Division of Academic General Hospital Dr. Soetomo Surabaya. Eleven study subjects were selected through a sequence of selection. Results: Melan-A expression in the depigmented skin of vitiligo patients was lower than the average. This result was found in 6 (54.55%) out of 11 patients. Conclusion: Melan-A expressions on depigmented skins of vitiligo patients are generally below the average value; therefore, adequate intervention is needed to increase the Melan-A expression.

Background: Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit, particularly among adolescents. The pathogenesis of AV is multifactorial, developing research studies the role of free radicals and antioxidants imbalance that cause oxidative stress in AV. The main antioxidant found in the skin is vitamin E, which functions as a protector against lipid peroxide. Purpose: To compare serum vitamin E levels in adolescents with AV and healthy adolescents without AV (controls). Methods: This is a cross-sectional observational analytic study that involved 17 adolescents with AV and 17 controls in Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Academic Hospital Surabaya. The subjects have met the inclusion and exclusion criterias. Result: The mean of vitamin E level in adolescent patients with AV was 7.8 ± 1.07 mg/mL and 10 ± 1.06 mg/mL in controls with the p-value in this study was p = 0.0001. Conclusion: It was found that serum vitamin E levels in adolescent AV patients were significantly lower than the controls. Further research is required to find out more about the role of antioxidants in the pathogenesis of AV.

Background: Malassezia folliculitis is a pilosebaceous follicular infection disease caused by Malassezia species. There are many misdiagnosed Malassezia folliculitis cases, causing the maladministration of therapy. A routine diagnostic test performed for Malassezia folliculitis cases is the identification of fungal elements (spore) with a microscope using potassium hydroxide, but it has several weaknesses. Purpose: To evaluate the suitability of Malassezia folliculitis diagnostic test using Potassium Hydroxide 20% + Blue-Black Parker Ink, May Grunwald Giemsa, and Potassium Hydroxide 10% + Chicago Sky Blue. Methods: Analytic observational study conducted in the Dermatomycology Division of Dermatology and Venereology outpatient clinic, Dr. Soetomo General Hospital Surabaya. The samples were thirty patients with clinical features of Malassezia folliculitis. The research material was obtained from the body as many as three pieces of papulomoluscoid lesion extracted. The material obtained was then divided into three glass objects for Potassium Hydroxide 20% + Blue-Black Parker Ink, May Grunwald Giemsa, and Potassium Hydroxide 10% + Chicago Sky Blue staining. Result: The identification of spores using Potassium Hydroxide 20% + Blue-Black Parker Ink was 90%, May Grunwald Giemsa was 90%, and Potassium Hydroxide 10% + Chicago Sky Blue was 93% with a value of κ=0.348 and p=0.051. The diagnostic values of May Grunwald Giemsa and Potassium Hydroxide 10% + Chicago Sky Blue were 96.6% sensitivity, 33.3% specificity, 92.9% Positive Predictive Value, and 50 % Negative Predictive Value. Conclusions: There was no significant concordance between May Grunwald Giemsa and Potassium Hydroxide 10% + Chicago Sky Blue with Potassium Hydroxide 20% + Blue-Black Parker Ink in establishing the diagnosis of Malassezia folliculitis. Potassium Hydroxide 20% + Blue-Black Parker Ink is still needed as a routine examination in cases with clinical features of Malassezia folliculitis.

The majority of HIV / AIDS patients have common secondary infections including of oral candidiasis. Fluconazole can be used to treat oral resistance in candidiasis. Management that can reduce risk can be minimized. However, some evidences suggest that the use of fluconazole is not effective for oral candidiasis. A 34-year-old male patient went to Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, with main complaint of discomfort and pain in the tongue. The physical examination showed a white pseudomembrane on the tongue and palate, which could be removed but left reddish and painful marks. The examination from tongue and palate swab found a colony of white Candida albicans and showed resistant to fluconazole, intermediate to ketoconazole, and sensitive to nystatin. The patient received nystatin oral suspension for three times a day as much as 5 ml (500,000 units). The pseudomembrane disappeared on day 10. The medication continued for fourteen days. No sign of recurrent found in two weeks after the treatment. The administration of nystatin can be used as an effective medication for oral candidiasis.

Oral candidiasis is the main symptom that often appears in patients with Human Immunodeficiency Virus (HIV) / Acquired Immune Syndrome (AIDS). Recent studies reported that some bacteria causing oral candidiasis are resistant to antifungal drugs. Describing nystatin profile against candida species in HIV / AIDS patients with oral candidiasis. Twenty-nine subjects were divided into 2 groups based on sex (23 male subjects and 6 female subjects). Subjects carried out tissue culture procedure and were tested for sensitivity to fluconazole and nystatin. The analysis was conducted by comparing sex and type of infecting bacteria. Statistical analysis used chi-square test, fisher, or ANOVA with 95% CI with p

Latar Belakang: Sifilis laten merupakan stadium sifilis tanpa gejala klinis namun menunujukkan hasil pemeriksaan serologis yang reaktif. Sifilis laten merupakan stadium yang asimtomatik dan tidak didapat adanya gejala-gejala sifilis primer ataupun sekunder. Diagnosis ditegakkan berdasarkan hasil uji serologi treponemal dan non treponemall yang reaktif. Tujuan: Mengevaluasi angka kejadian dan penatalaksanaan pasien baru sifilis laten. Metode: Penelitian ini adalah studi deskriptif retrospektif. Data berasal dari rekam medis pasien baru sifilis laten di Divisi Infeksi Menular Seksual (IMS) Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya periode tahun 2009-2017. Hasil: Selama tahun 2009-2017, didapatkan 37 pasien baru sifilis laten. Pasien terbanyak berusia 26-35 tahun, mayoritas adalah pria dan berstatus menikah. Berdasarkan anamnesis, sebesar 64,9% pasien sifilis laten datang berobat tanpa keluhan dengan membawa hasil laboratorium serologi sifilis yang reaktif. Hasil pemeriksaan penunjang, sebesar 32,4% pasien baru sifilis laten menunjukkan nilai titer VDRL 1:4 dan sebanyak 21,6% pasien baru sifilis laten menunjukkan hasil serologi treponemal TPHA 1:640. Sifilis laten lanjut merupakan diagnosis terbanyak sebesar 75,8%. Sekitar 62,2% pasien sifilis laten mendapat terapi dan 56,5 % pasien dari pasien tersebut mendapat terapi injeksi Benzatin Penisilin G. Simpulan: Penegakan diagnosis sifilis laten dilakukan dengan anamnesis, pemeriksaan fisik, dan pemeriksaan serologi. Sifilis laten sebagian besar ditatalaksana dengan injeksi Benzatin Penisilin G sebagai terapi pilihan pertama dari berbagai rekomendasi. Evaluasi hasil serologi non treponemal setelah terapi didapatkan yang paling banyak adalah pasien melakukan kunjungan ulang pada bulan ke 3 sebanyak 9 orang dengan penurunan titer dari 1: 4 menjadi 1:2 sebanyak 4 pasien.

Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.

Latar Belakang: Kondilomata akuminata (KA) merupakan penyakit infeksi menular seksual yang disebabkan oleh Human papillomavirus (HPV) dengan gejala berupa pertumbuhan tunggal atau multipel pada daerah anogenital. HPV risiko tinggi mempunyai kemampuan untuk berkembang menjadi keganasan, sedangkan HPV risiko rendah sangat jarang menimbulkan keganasan. Pemeriksaan p16ink4a digunakan untuk mendeteksi HPV yang berpotensi kearah keganasan. Deteksi genotipe HPV dengan menggunakan PCR memiliki sensitivitas yang sangat tinggi. Tujuan: Mengevaluasi profil ekspresi p16INK4a pada lesi KA pada wanita dengan infeksi HPV tipe risiko rendah, risiko tinggi, dan infeksi multipel HPV. Metode: Penelitian deskriptif, observasional, cross sectional dengan melakukan pemeriksaan p16INK4a dan genotyping HPV dengan teknik PCR lesi KA pada wanita. Hasil: Satu pasien dengan HPV risiko rendah (HPV 6 dan 11) memiliki gambaran p16ink4a negatif, 4 pasien memiliki gambaran p16ink4a sporadis, dan 2 pasien memiliki gambaran p16ink4a fokal, 1 pasien dengan HPV 18 memiliki gambaran p16ink4a difus, 1 pasien dengan infeksi multipel HPV 6,81,82,89 memiliki gambaran p16ink4a fokal, 4 pasien dengan infeksi multipel HPV memiliki gambaran p16ink4a difus. Simpulan: Terdapat 5 pasien dengan gambaran p16INK4a yang difus. p16ink4a yang difus menunjukkan bahwa pada pasien tersebut memiliki kemampuan untuk berkembang menjadi keganasan.

Latar Belakang: Penuaan merupakan proses penurunan fungsi dan kapasitas cadangan seluruh organ dalam tubuh manusia, termasuk kulit. Proses menua instrinsik di kulit dipercepat oleh berbagai faktor ekstrinsik, dan yang paling dominan adalah pajanan sinar ultraviolet (UV). Proses ini disebut sebagai skin photoaging atau premature aging skin (kulit menua dini). Berbagai terapi fisik topikal telah digunakan untuk menghilangkan gejala penuaan. Penelitian stem cell di bidang kosmetik merupakan hal baru yang menjanjikan. Tujuan: Mengevaluasi efek terapi Produk Metabolit Amniotic Membrane Stem Cell (PM-AMSC) pada penuaan kulit. Metode: Dua belas subjek photoaging di Divisi Kosmetik Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin Rumah Sakit Umum Daerah Dr. Soetomo Surabaya dipilih untuk diberikan PM-AMSC sebanyak tiga kali dengan interval dua minggu. Evaluasi variabel pori, kerutan, spot (polarized), spot (UV), dan skin tone dengan alat skin analyzer (Janus), yang dilakukan pada minggu 0, 4, dan 8. Hasil: Dua belas (12) subjek menyelesaikan studi. Rerata perbaikan klinis photoaging dari baseline hingga akhir studi pada variabel pori yakni 53,58±4,252 menjadi 48,17±4,859 (p=0,006), variabel kerutan yakni 13,75±6,930 menjadi 8,17±4,366 (p=0,019), dan spot (UV) yakni 17,17±9,024 menjadi 10,83±5,967 (p=0,029). Efek samping minimal berupa eritem pada 4 subjek (33,3%) dan urtikaria pada 1 subjek (8,3%). Simpulan: Terapi PM-AMSC sebagai terapi rejuvenasi alternatif memberikan perbaikan klinis photoaging dan memiliki efek samping minimal yang dapat ditoleransi.

Latar Belakang: Keloid adalah hiperplasia jinak dari jaringan fibrosa kulit. Gambaran histopatologi menunjukkan fibroblas dan serat kolagen yang berlebih. Prevalensi pasien keloid di Poli Kulit dan Kelamin RSUD Dr. Soetomo Surabaya adalah 1,4% (tahun 2013), 1,6% (tahun 2014), dan 1,5% (tahun 2015). Angka kekambuhan keloid pascaterapi injeksi triamsinolon mencapai 33% dalam 1 tahun. Laser CO2 dengan mode kontinu yang diikuti dengan injeksi triamsinolon memiliki efektifitas yang lebih baik dibanding injeksi triamsinolon monoterapi, dengan angka kekambuhan 15,4%. Laser CO2 mode fraksional memiliki masa penyembuhan lebih cepat daripada mode kontinu, karena ablasi terbatas hanya pada microscopic treatment zone (MTZ). Terapi kombinasi laser CO2 fraksional dan injeksi triamsinolon memadukan efek fototermolisis selektif dan efek antimitotik. Tujuan: Mengetahui efektifitas terapi kombinasi laser CO2 fraksional dan injeksi triamsinolon terhadap pasien keloid. Metode: Penelitian ini merupakan uji klinis terbuka yang membandingkan terapi kombinasi laser CO2 fraksional dan triamsinolon asetonid intralesi (perlakuan) dengan terapi tunggal triamsinolon intralesi (kontrol) pada pasien keloid. Hasil: Penelitian ini melibatkan 26 pasien keloid, 13 pasien kelompok kontrol dan 13 pasien kelompok perlakuan. Penurunan tinggi keloid yang signifikan terjadi pada kelompok kontrol dan perlakuan (p=0,005 dan p=0,000), tetapi selisih penurunan tinggi keloid antara kedua kelompok tidak signifikan (p=0,598). Penurunan kepadatan fibroblas pada kelompok kontrol terjadi secara signifikan (p=0,016), tetapi pada kelompok perlakuan meningkat tidak signifikan (p=0,958). Peningkatan kepadatan fibroblas dapat dikarenakan penyusutan kolagen, sehingga fibroblas tampak semakin padat. Simpulan: Terapi injeksi triamsinolon asetonid yang dikombinasi dengan laser CO2 fraksional belum memberikan dampak yang lebih baik daripada terapi tunggal injeksi triamsinolon.

Latar Belakang : Malondialdehid (MDA) adalah senyawa dialdehida yang merupakan produk akhir peroksidasi lipid dalam tubuh, konsentrasi MDA yang tinggi menunjukkan adanya proses oksidasi dalam membran sel. Dermatitis Atopik (DA) adalah penyakit radang kulit yang bersifat kronis dan residif, dengan gejala gatal dapat terjadi pada bayi, anak, dewasa dan biasanya terdapat riwayat asma maupun rhinitis alergi pada diri sendiri atau pada anggota keluarga. Sejumlah penelitian terdahulu menunjukkan MDA telah membantu menjelaskan peranan stres oksidatif pada sejumlah penyakit termasuk pada DA yang berperan dalam proses terjadinya inflamasi. Tujuan: Mengevaluasi status stres oksidatif pada pasien DA di Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya. Metode: Penelitian analitik observasional dengan 50 sampel yang terbagi menjadi dua kelompok dengan jumlah 25 untuk pasien DA dan 25 non DA yang memenuhi kriteria penerimaan dan penolakan. Hasil: Rerata kadar MDA kelompok DA diperoleh nilai 129,14 + 57,31 ng/mL sedangkan pada kelompok non DA diperoleh nilai MDA 73,91 + 32,89 ng/mL. Dari hasil yang ada diketahui bahwa kadar MDA plasma pada pasien DA lebih tinggi bila dibandingkan dengan non DA dan perbedaan ini bermakna signifikan. Simpulan: Kadar MDA pada pasien DA lebih tinggi dibanding non DA. Diperlukan penelitian lebih lanjut menggunakan desain time series untuk mengetahui lebih jauh peran MDA dalam patogenesis DA dan perlu dilakukan penelitian lanjutan yang menunjukkan korelasi peningkatan kadar MDA degan derajat keparahan DA.

Background: Genital herpes infection was sexual transmitted disease, caused by Herpes simplex virus (HSV) especially type 2. The characteristic of clinical sign is group of vesicles, based on eritematous macule, and often recurrent. Purpose: To evaluate the pattern of genital herpes patients at Sexual Transmitted Infection (STI) Division, Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya, since January 2011 until December 2015. Methods: A retrospective study took, data were obtained medical record of herpes simplex genitalis patients at STI Division, Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya, since January 2011 until December 2015. Results: The number of genital herpes infection cases decreased, 1.8% of patients who came to STI division Outpatient Clinic. Mostly women who were 25–34 years of age. Most common main complaints were pain. Erosion was the most clinical manifestation. The patients mostly got oral acyclovir and analgesic as the treatment. The majority of patient had counseling for about 55.9%. They came to be followed up at least once. Conclusion: The number of genital herpes cases decreased. The most of age affected were sexually active group.

People with a weakened immune system may develop the severe form of scabies called crusted scabies. We have two cases of female patients with history of using long-term oral corticosteroid and then developing scabies infection. The first patient had other comorbidities which caused her become more susceptible while the second patient had been diagnosed with bullous pemphigoid. Both patients complained thick crust on some parts of their bodies, accompanied with itchy papules. Based on microscopic examination from lesion scraping, we found the adult form of sarcoptes scabiei and crusted scabies diagnosis was established. The lesions were improving when they got combination of topical sulfur precipitate, salicylic acid, and permethrine 5%. Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites resulting from an altered host response. Combination of topical antiscabies and keratolytic can make the crusts thinner and improve topical absorption.

Atypical appearance of scabies such as chronic excoriation and eczematization of the skin, is frequently found in patients with long-standing infestations. Cases of less impressive scabies are not easily diagnosed, especially when topical or systemic corticosteroids mask the typical itch and inflammation. These cases frequently occur in individuals with good hygiene and are referred as scabies incognito – a diagnosis that can be easily mistaken for other skin diseases. A fourteen-year-old male patient had been irregularly taking systemic corticosteroid for two months due to intermittent papular reaction and itching. Four weeks after treatment with anti-scabiotic therapy, the patient has no complaint of itch and no sign of new papular lesion suggesting that he had scabies all along. It is very important to make a correct diagnosis of scabies incognito because misdiagnosis is associated with serious consequences such as spreading and superinfection of the lesions; this can sometimes lead to life-threatening consequences.

Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites. It is resulting from an altered host response to the infestation. There are some various cutaneous and immunologic diseases that have been described to predispose to crusted scabies. It is typically associated with congenital and acquired immunocompromised conditions including human immunodeficiency virus (HIV), hematologic malignancy, and connective tissue diseases, including systemic lupus erythematosus (SLE). Adults with crusted scabies may lack the characteristic rash or itching. Sites of presentation have been reported on the scalp, face, neck, extremities, trunk, hands, and feet. The severe condition of SLE and super infection of scabies in the immunocompromised state highlight the need for appropriate care to avoid further morbidity. This case report aims to describe the characteristic of skin lesions and clinical aspects of crusted scabies in SLE. A 28-year-old man was diagnosed with crusted scabies who was treated more intensely with permethrin 5% cream that was combined with 2-4 ointment. There was clinical improvement and no side effect found during this study.

Human Papilloma Virus (HPV) cause the most common sexually transmitted infection in women. HPV may lead to clinical manifestation as condyloma acuminata. The type of HPV are divided into two categories: low risk and high risk. Objective: To determine the type of HPV in female condyloma acuminata patient. Material and methods: A cross sectional study was conducted in Dermatology Venereology Outpatient Clinic Dr. Soetomo Hospital Surabaya from February, 2007 to May, 2007. A total of 13 female patients with condyloma acuminata were includ in this study. Nucleic acids amplification assays (Polymerase Chain Reaction) used to detect the HPV infection. Results: Condyloma acuminata mostly caused by HPV-11 (30,76%) and HPV-6 (23,07%). Only 1 patient in this study caused by HPV 18. 38% of condyloma acuminata in this study caused by multiple infection of HPV. Conclusion: Molecular assay are gold standard to identification of HPV in the condyloma acuminata patient.

The histopathologic view of keloid shows dense fibroblasts and bundles of collagen throughout dermis. Treatment that completely cure keloid still not exist, although there are many treatment options. The monotherapy fractional CO2 laser shows good results, but is still as an adjuvant therapy. Fractional CO2 laser affects fibroblast and its functions in producing collagen. The combination therapy will combine the selective phototermolysis effect of CO2 lasers with antimitotic and antiinflammatory effects of corticosteroids. This study was an open trial with parallel design that compared fractional CO2 laser-intralesional triamcinolone acetonide combination therapy (treatment group) and intralesional triamcinolone acetonide (control group) in keloid patients with collagen density as evaluation parameter. The dose of triamcinolone was 10 mg/ml of 0.05-0.1 ml/cm2 of keloid. Fractional CO2 laser energy setting was 10-20 mJ. The decrease of collagen density in control and treatment group was significant (p=0.008 and p=0.001), although the decrease difference between control and treatment group was not significant (p=0.328). The collagen density that decrease in a shorter time shows that fractional CO2 laser could be a good combination therapy.

Introduction: Nonspecific genital infection (NSGI) is an inflammation of urethra, rectum, or cervix that caused by nonspecific bacteria. Chlamydia trachomatis is known as the most causal organism of NSGI, usually mild (mucopurulent discharge) or asymptomatic, and if untreated it can cause serious complication such as pelvic inflammatory disease that leads to infertility in women. The diagnosis of Chlamydia trachomatis needs an advanced method, such as polymerase chain reaction (PCR). PCR has high sensitivity and specificity, and endocervical swab is specimen of choice that also has high sensitivity and specificity to diagnose Chlamydia trachomatis. Method: This research aims to evaluate if Chlamydia trachomatis is the most causal organism of NSGI by PCR Chlamydia trachomatis using 201bp primers. Results: Eighteen NSGI married patients who came to outpatient clinic were evaluated from endocervical swab. The result demonstrated that 16,67% from eighteen NSGI patient positive Chlamydia trachomatis. Conclusion: The low incidence of Chlamydia trachomatis in low risk population such in this study need further study, the cause of NSGI needs to be known certainly so the exact treatment can be given.

Female sex workers have a high risk of suffering from sexual transmitted infections (STIs). If the female sex workers suffer from STIs, besides affecting themselves, they also have potential to transmit the disease to their clients. Fluor albus is one of the symptoms of STIs. The purpose of this research is to evaluate the type of STIs that the female sex workers suffer from. This research was conducted retrospectively on 100 female sex workers in Puskesmas Putat Surabaya in 2013-2014. The result of this research showed that from 100 female sex workers, 14 subjects (14%) suffered from gonococcal cervicitis, 51 subjects (51%) suffered from nongonococcal cervicitis, 10 subjects (10%) suffered from nongonococcal cervicitis accompanied by bacterial vaginosis, 9 subjects (9%) suffered from bacterial vaginosis, 1 subject (1%) suffered from trichomoniasis, and 14 subjects (14%) had no data. This research concluded that nongonococcal cervicitis is the most major cause of STIs suffered by female sex workers. Therefore, the vigilances to prevent transmission of nongonococcal infection to the clients is highly needed.

Background: Psoriasis vulgaris is an inflammatory, chronic, recurrent, and, non-contangious skin disease. The severity grade of psoriasis is measured with psoriasis area and severity index (PASI) score. C-reactive protein (CRP) is a sensitive, but not specific indicator of inflammation. In the active stage of psoriasis, highly increased CRP levels were found, whereas at remission they present a decrease level. Purpose: To evaluate the profile of CRP level in psoriasis vulgaris patients with various degress of psoriasis vulgaris severity in Dr. Soetomo Hospital Surabaya. Methods: Blood samples were collected in 16 patients to measure the CRP level in psoriasis vulgaris patients with various degrees of severity. Results: There were 16 patients (10 male and 6 female) with various degrees of psoriasis vulgaris severity (5 patients with mild severity, 8 patients with moderate severity, and 3 patients with severe severity). All CRP results were within normal limits. Conclusion: Many factors can influence the CRP levels, CRP can not be as single indicator of inflammation in psoriasis vulgaris. Key words: psoriasis vulgaris, c-reactive protein, PASI score.

Background: Oral hairy leukoplakia (OHL) is an asymptomatic white plaque with vertical corrugations most commonly found on the lateral borders of the tongue. It is caused by local infection of Epstein- Barr Virus (EBV). OHL is usually associated with immunocompromised condition, and mainly described in patients with human immunodeficiency virus (HIV). Purpose: to report a case of oral hairy leukoplakia in an HIV patient that is often misdiagnosed as oral candidasis. Case: A 44-years old female came to the Dermato-Venereology Outpatient Clinic of Dr. Soetomo General Hospital Surabaya with complaint of persistent asymptomatic whitish color on both borders of her tongue. History taking revealed that at first the whitish color appeared spreading on the tongue, but after taking antifungal treatment, only the lesion on the borders still persisted, all attempts to scrub off the lesion failed. There were also history of diarrhea, fever and cough for almost 1 month. Further examination of HIV antibody 3 method tests revealed reactive result with CD4+ count of 1 cel/uL. Physical examination revealed bilateral painless white well demarcated plaque with “hairy” like corrugated appearance on the lateral borders of the tongue. Discussion: From history, clinical findings, and the reactive HIV antibody examination, the patient was diagnosed with AIDS with oral hairy leukoplakia. The patient was treated with acyclovir 200 mg, 5 times daily. After 2 weeks of treatment, clearance was achieved. Conclusion: The establishment of OHL which oftenly mistaken as oral candidiasis has a diagnostic value for HIV infection. Systemic antiviral institution and antiretroviral (ARV) medications as prevention for recurrence gave satisfying result. Key words: oral hairy leukoplakia, HIV, acyclovir.