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Background: Basal cell carcinoma (BCC) is the most common skin cancer and can cause local tissue damage. BCC can occur in all populations, regardless of skin color. Dermoscopy has compatibility with histopathology in determining the benign or malignant nature of a lesion. Dermoscopy can improve the diagnostic accuracy of BCC by >90%, with 7 parameters that can be found: arborizing vessels, blue-gray ovoid nests, blue-gray dots/globules, maple leaf-like areas, spoke-wheel areas, ulceration, and hiny white areas. Purpose: To assess the compatibility of each dermoscopy parameter with its corresponding histopathological parameters. Methods: Observational analytic study with a cross-sectional approach was performed. Dermoscopy parameters were obtained by reassessing all photographs, while histopathological parameters were obtained from pre-existing slide reviews. Cohen's Kappa test was performed to analyze both variables. Result: A Total of 26 samples met the inclusion criteria. Most BCCs were found in female sex (65.4%), age >50 years (80.8%), and facial location (88.5%). Cohen's Kappa test was significant in 2 out of 7 dermoscopy parameters: "blue-gray ovoid nests" (p = 0.0019; r = 0.458) and "spoke wheel areas" (p = 0.037; r = 0.371). The "shiny white areas” parameter could not be analyzed because there was no negative variation in the examination. The possibility of false positives and negatives could not be ruled out. Conclusion: Significance between the two variables is found in 28.6% of the 7 parameters analyzed...

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 <0.05) in the quality-of-life value of research subjects in the treatment group when compared between the initial arrival to week 12 with a p-value of 0.000. Distribution of DLQI values in research subjects who were given 3% EGCG cream therapy as adjuvant therapy with 0.025% tretinoin cream. Conclusion: Both groups showed an improvement in the DLQI value with the interpretation of the DLQI value at week 12 being both 100%, but the treatment groups DLQI decline faster than the control groups.

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: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that affects peripheral nerves and skin. The interaction between M. leprae and Schwann cells causes irreversible damage to peripheral nervous tissue afterward disability occurs. Involvement of the major nervous trunks of the extremities can produce sensory-motor deficits. The risk factors are delay in diagnosis, gender, age, type of leprosy, duration of disease, number of affected nerves, leprosy reaction, type of treatment, socioeconomic factors, education, ethnicity, and occupation. Purpose: The aim was to study the profile of leprosy patients with disability who seek treatment in Leprosy Division Dermatovenerology Outpatient Clinic RSUD Dr. Soetomo Surabaya. Methods: This was a descriptive retrospective study of leprosy patients with disability from January 2017 to December 2019. Result: The results of this study obtained a total of 275 leprosy patients with disabilities, which consisted of 76 patients (27.6%) with grade-1 disability and 199 patients (72.4%) with grade-2 disability. The majority were male (73.4%) and aged 25-44 years old (42.2%). Other dominant risk factors were MB type leprosy (92%), duration of disease more than 12 months (52.3%), no leprosy reaction (68%), and had received multidrug therapy (45.5%). Conclusion: Knowledge of disability risk factors can assist in improving management and education to prevent disability in leprosy patients.

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Cases of leprosy in children are rarely found because of the long incubation period of Mycobacterium leprae. Purpose: To report a case of mid-borderline leprosy with a mild type 1 reaction in a seven-years-old girl patient. Case: A 7-years-old girl patient presented with multiple red and white patches on her face, body, arms, legs, and buttocks since 6 months before. There was no itching, numbness, painr fever. There was no thickening of peripheral nerves and no nerve function impairment. Her grandmother was suspected to have leprosy, but she had never been treated and had already passed away. From the acid fast bacilli (AFB) examination, the bacterial index (BI) was 1+ and the morphological index (MI) was 2%. A serologic test examination was also performed and the result were Immunoglobulin (Ig) G 3716 u/ml and IgG 284 u/ml. The patient got multidrugs therapy for 12 months and after 9 months of treatment, the pre-existing patches became erythematous, thickened, and felt pain when touched, but there was no fever. In the presence of pain, oral ibuprofen was then administered and the patches began to improveDiscussion: Due to the possibility of leprosy reaction, it is important to immediately give prompt treatment to children with type 1 leprosy reaction that is associated with neuritis and leads to deformities. Conclusion: Early diagnosis and therapy for a type 1 leprosy reaction are very important to prevent deformities.

Muhammad Yulianto Listiawan,1 Cita Rosita Sigit Prakoeswa,1 Medhi Denisa Alinda,1 Bagus Haryo Kusumaputra,1 Felix Hartanto,1 Abd Nasir,2,3 Ah Yusuf3 1Faculty of Medicine, Airlangga University, Surabaya, Indonesia; 2Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia; 3Faculty of Nursing, Airlangga University, Surabaya, IndonesiaCorrespondence: Muhammad Yulianto Listiawan, Email m.yulianto@fk.unair.ac.idIntoduction: Psychological strength plays an important role in reducing stress due to leprosy because leprosy can cause physical, psychological, and social problems. For that reason, this study aims to investigate the relationship between coping sources, coping strategies, and psychological well-being through leprosy stress.Methods: This research instrument uses a stress perception scale, coping sources, coping strategies, and psychological well-being scale to collect data from 125 participants consisting of women (33.60%) and men 66.40%. The test analysis in this study uses SmartPLS through structural equation modeling to prove the correlation.Results: The results of the SEM test indicate that there is a negative relationship between coping resources and leprosy stress, with a coefficient value of (− 0.380), p-value of (0.000) < 0.05, and a positive relationship is obtained with psychological well-being with the coefficient value of (0.427), p-value of (0.000) < 0.05. Meanwhile, the SEM test shows a negative relationship between coping strategies and stress of leprosy, with the coefficient of (− 0.566), p-value of (0.000) < 0.05, and a positive relationship is obtained with psychological well-being (0.355), p-value of (0.000) < 0.05. Furthermore, on psychological well-being, stress shows a negative relationship, with the coefficient of (− 0.212), p-value of (0.002).Discussion: Exploration of important coping sources is done to weaken the power of leprosy as a stressor and the use of effective coping strategies is needed to solve

Background: According to WHO data, the number of new cases of leprosy has decreased in 2019. However, Indonesia continues to provide a significant number of cases. According to statistics, India, Brazil, and Indonesia account for 79 percent of all instances. Purpose: This study aims to describe the profile of leprosy patients, and involves all Dermatology and Venereology Academic Hospitals in Indonesia. Methods: This study was a retrospective study of 2461 patients from Dermatology and Venereology Outpatient Clinic at 13 Academic Hospitals in Indonesia between January 2018 and December 2020. Result: Subjects in this study were dominated by males (66.8%) and aged > 14 years (95.3%). The most common type of leprosy was multibacillary (MB) (86.2%), and erythema nodosum leprosum (ENL) was the most leprosy reaction (20.3%). Majority of the subjects experienced disability in the hands (26.6%), in grade 1. Conclusion: Leprosy cases in Indonesia are mostly experienced by adult males. The most common type of leprosy is MB, with ENL being the most common leprosy reaction. Grade 1 disability is the most prevalent, therefore proper education is necessary to keep patients from progressing to grade 2 disability.

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.

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: The damage of the peripheral nerves that occurs in Morbus Hansen (MH) patients can cause disability due to loss of sensory, motor and autonomic functions can cause wounds, infections, ulcers and disability. Ulcers are the most common cause of disability complications in MH patients and requires a certain time of healing. As many as 10-20% of MH patients experience ulcers on the soles. Tea Tree Oil (TTO) is extracted from steam distillation of the leaves and twigs of the Australian native shrub Melaleuca Alternifolia. In ulcers, TTO can work as an antimicrobial, anti-inflammatory, and antioxidant. TTO preparation in the form of hydrogel is believed to help the wound healing process. Purpose: To investigate the effect of TTO hydrogel 5% on the healing of Chronic Plantar Ulcer of Leprosy (CPUL). Methods: Tea tree oil hydrogel 5% was applied every 3 days for up to 8 weeks in 22 subjects with chronic MH plantar ulcers. Ulcer size, side effects, and possible side effects are evaluated weekly. Result: There were significant clinical and statistical differences in ulcer size (p = 0.000) and in ulcer depth (p = 0.000) after TTO hydrogel 5%. No side effects occurred in this study. The ulcer healed was 59%, the ulcer improved by 36.4%, the persistent ulcer was 4.6%, and there was no ulcer that got worse. Conclusion: TTO hydrogel 5% is effective in the healing process of chronic MH plantar pedis ulcers.

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.

Background: Erythema nodosum leprosum (ENL) has a chronic and recurrent nature which could reduce patient's quality of life in addition to the onset of ENL that occurs before, during, or after multidrug treatment, further emphasizing the importance of regular control and education.Purpose:This study aimed to evaluate the epidemiology, onset, duration, and recurrence of ENL. Methods:Data from medical records were obtained for a 3-year retrospective study of multibacillary leprosy patients at the Leprosy Division of the Dermatology and Venereology Outpatient Department, Dr. Soetomo General Hospital Surabaya, with a minimum of 2–5 years follow-up period.Result:The prevalence of ENL continued to increase almost every year especially in 2017 (32% in 2015; 32% in 2016; and 36% in 2017). ENL most often occurs during the first year of multi-drug therapy (MDT) administration followed by after the release from treatment (RFT) with the latest onset occurring 4 years after RFT. The majority of patients experienced chronic and recurrent reactions with the longest reactions lasting up to 4.5 years (55 months). Conclusion:Knowledge about the onset, duration, and recurrences of ENL are essential, and strict supervision for routine control shall be encouraged to increase the patients' compliance so as to increase their quality of life.