A successfully treated Basal Cell Carcinoma using elliptical excision surgery

 Basal cell carcinoma (BCC) is a non-keratinization cell-derived neoplasm. Surgical excision is the most common way to remove a tumor. The excision depends on the tumor type, size, and location. This paper reported a 44- years-old woman presented with the chief complaint of a single bump that bleeds easily in the facial region that began one year ago. Dermatology examination revealed hyperpigmented plaque with an ulcer in central, solitary, oval, 2 cm x 1 cm in size, covered with blackish crust on top. A Dermoscopy examination showed blue dots and globules, arborizing vessels, and ulceration. Histopathology examination findings were in concordance with BCC. The patient was treated with elliptical surgical excision. The lesion was successfully removed and showed good results with minimal scarring. BCC occurs in 75% of all skin cancers. Elliptical surgical excision on the left cheek was performed after considering the location anatomy, defect size, age, and general condition patient and postoperative cosmetic estimates. The minimal scar that occurs is planned to be performed with a fractional laser. The prognosis is generally good. There is no recurrence until one year later. In conclusion, elliptical surgical excision is an effective standard treatment if performed with a safe margin. In this case, we used 5 mm safe outer margin

The Stress of Leprosy as a Mediator of the Relationship Between Coping Resources, Coping Strategies, and Psychological Well-Being in Persons Affected by Leprosy. The Structural Equation Models Through a Correlation Study

Intoduction: 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 physical, psychological, and social problems for “People Affected by Leprosy”, and simultaneously these two attributes are used to achieve prosperity. psychological. better

Diagnosis and Management of Leprosy

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which tends to attack peripheral nerves and skin. The diagnosis of leprosy is based on the presence of one of three cardinal signs. Early diagnosis of leprosy is critical and is made through clinical examination and investigation. Purpose: To discuss the diagnosis, laboratory examination, and treatment of leprosy, considering that early diagnosis and appropriate treatment are the key elements in breaking the chain of transmission and preventing leprosy patients' disabilities. Review: Leprosy is a chronic granulomatous infectious disease caused by the Mycobacterium leprae. Based on clinical appearance, histopathology findings, and immunological, leprosy is grouped into six forms using the Ridley-Jopling classification, namely Tuberculoid (TT), Borderline Tuberculoid (BT), Borderline-borderline Mid-borderline (BB), Borderline-lepromatous (BL), Subpolar Lepromatous (LLs), and Polar Lepromatous (LLp). Based on the treatment category, leprosy is grouped into paucibacillary (PB) and multibacillary (MB). Leprosy is often diagnosed clinically, and skin scraping smear remains the preferred laboratory method. The negative results of smear skin scraping may not necessarily exclude leprosy. Therefore, a higher sensitivity test might be needed to detect M. leprae. Treatment with Multi-Drug Therapy (MDT) is adjusted based on the type of leprosy, whether it belongs to the PB or MB group. Treatment of PB type, regimens are rifampicin and dapsone, while in MB type, the patients received rifampicin, dapsone, and clofazimine regimens. Conclusion: A proper diagnosis for leprosy, both through physical examination and laboratory examination, is required to determine an effective MDT treatment and break the chain of disease transmission

A Retrospective Study: Epidemiology, Onset, and Duration of Erythema Nodosum Leprosum in Surabaya, Indonesia

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

A simpler diagnostic method using blood collection on filter paper to determine anti-natural octyl disaccharide-leprosy infectious disease research institute diagnostic in household contacts of leprosy patients

The high prevalence among children shows continued transmission from adult and lack of disease control by the health system. Detection of anti-NDO-LID-1 has been known to be more effective to predict the development of leprosy in household contacts than just detecting PGL-1 or LID- 1 alone. However, serodiagnosis is not available in poorer-settings area and the procedure (venepuncture) is still inconvenient to some people. These problems can be solved by using finger-prick blood sample on filter paper. This study aims to prove the effectiveness of using capillary blood samples on filter paper to detect the positivity of Ig G antibody against NDO-LID-1 antigen in asymptomatic household contacts. Seventeen samples of capillary blood on filter paper and sera were tested for IgG anti-NDO-LID-1 using ELISA. There was no significant difference between IgG level from filter paper and serum (p=0.754) and there was also a strong positive correlation (R=0.906) between the two procedures. These findings show that the use of filter paper and NDO-LID-1 is worthy of further investigations, especially for those with lower bacillary load or contacts of leprosy patients

Efficacy and Side Effects of Fractional Carbon Dioxide Laser for Acne Scars, Keloids, and Striae Albae in the Dermatovenereology Clinic of Tertiary Hospital: A Retrospective Study

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

Beneficial Effect of Resveratrol on Conditioned Medium Human Adipose-derived Mesenchymal Stem Cell for Cutaneous Wound Healing Related Growth Factors

Abstract Introduction: Cutaneous wound healing, a type of soft tissue injury, needs the interaction between multiple growth factors (epidermal growth factor [EGF], transforming growth factor [TGF], platelet-derived growth factor [PDGF], and vascular endothelial growth factor [VEGF]) in order to attain physiological healing. Nevertheless, in certain conditions, i.e., chronic wound, certain growth factors might be insufficient. VEGF is among the most significant pro-angiogenic mediators during wound healing to increase migration and invasion of endothelial cells. Conditioned medium adipose-derived mesenchymal stem cells (CM-AdMSCs) are a new hope to ameliorate impaired healing. Resveratrol (RV), a small molecule that can increase the effect of CM-AdMSCs, is needed to help stimulates growth factors from stem cells for culture. This study aims to evaluate growth factors in CM-AdMSCs with resveratrol. Methods: Isolated and characterized MSCs from CM-AdMSCs treated with RV supplemented Serum Deprived Medium (SDM) were used in this study. Growth factors level were measured using ELISA. Results: A decrease of mean were noted in EGF (290.19±53.19 VS 271.64±52.58) and VEGF (788.76±204.82 VS 117.92±49.22), while an increase of mean in TGF (633.14±11.38 VS 824.73±121.15) and PDGF (2999.00±203.54 VS 3961.40±378.68) between CM-AdMSCs without resveratrol and with resveratrol group, respectively. PDGF and VEGF were statistically significant (p < 0.05). Conclusion: In conclusion, RV promotes PDGF secretion and decreases VEGF in CM-AdMSCs

A 5‑year evaluation of chemoprophylactic treatment in elementary school children with subclinical leprosy

Subclinical leprosy is an infectious disease in which the immune system remains infected with Mycobacterium leprae (M. leprae). The progress of subclinical leprosy to clinical cases within 1 year of infection is 1.5%, with an increase to 6% in the following 4 years. Rifampicin is frequently used for prevention of leprosy, and clarithromycin has a bactericidal effect on M. leprae. Thus, the combination of both is expected to improve disease control in patients with subclinical leprosy. The aim of the present study was to evaluate the efficacy of a chemoprophylactic treatment involving rifampicin and clarithromycin against subclinical leprosy in elementary school children from endemic areas of East Java over a 5‑year period. The study was performed between 2011 and 2015. Samples were collected from 2,548 healthy elementary school children in Nguling (Pasuruan) and Raas (Sumenep), and analysed using ELISA for anti‑PGL (phenolic glycolipid)‑1 IgM antibodies. Children who were seropositive for anti‑PGL‑1 IgM antibodies received a chemoprophylactic regimen consisting of rifampicin (300 mg/day) and clarithromycin (250 mg/day) daily for the initial 10 days, followed by the same regimen every 2 weeks for 3 months. Clinical and serological evaluations were performed annually for 5 years. Amongst the 2,548 healthy elementary school children, 200 were seropositive. The anti‑PGL‑1 IgM antibody levels significantly decreased between 2011 and 2015 in Nguling (from 1,066.7 to 137.4 U/ml) and Raas (from 773.1 to 563.4 U/ml), the levels decreased every year. In addition, the proportion of patients with decreased anti‑PGL‑1 IgM antibody levels was consistently higher than patients with increased anti‑PGL‑1 IgM antibody levels in all periods, except during 2013‑2014, in Nguling and Raas. Chemoprophylactic treatment involving rifampicin and clarithromycin may thus be effective against subclinical leprosy amongst elementary school children

PROFIL IgE SPESIFIK dan ATOPY PATCH TEST terhadap TELUR AYAM pada PASIEN DERMATITIS ATOPIK dengan RIWAYAT ALERGI TELUR AYAM di DIVISI DERMATOLOGI ANAK UNIT RAWAT JALAN KESEHATAN KULIT dan KELAMIN RSUD DR. SOETOMO SURABAYA

Background:. Food allergies are found in 1/3 cases of children with atopic dermatitis (AD) as a trigger of inflammation. Oral food challenge (OFC) is the gold standard for diagnosing food allergies, but spend the time, cost and have a life-threatening risk. Other diagnostic tools include examination of serum specific IgE and atopy patch test (APT). Purpose: To determine the profile of specific IgE and APT to hen’s egg in AD children with history of hen’s egg allergy. Methods: A cross-sectional descriptive study among 20 AD children with history of hen’s egg allergy at Dr. Soetomo Hospital Surabaya. APT with egg yolk and white were applied at the back of patients and measurement of serum specific IgE to egg yolk and white. Results: From 20 patients, the value of serum specific IgE to hens’s egg increased in 4 people (20%), where 2 people experience an increase in both specific IgE both egg yolk and white, and 2 people have increased specific IgE to egg whites only. While the results of APT obtained positive in 13 patients (65%), where 10 positive APT in both egg yolk and white, 1 egg yolk alone and 2 egg whites only. Conclusions: In this study, only 20% of patients experience an increase in specific IgE to hen’s egg, while APT positive in 65% of patient

Wide excision of Basal Cell Carcinoma on the upper extremity: A case report

Basal cell carcinoma (BCC) is the most common skin cancer, usually occurring in the sun-exposed area, such as the head and neck, but also seen in less common areas like the upper or lower extremities. The initial treatment of BCC lesions is completing tumor removal. One of the standard therapy for BCC is wide surgical excision, as it is highly efficacious. A 76-year-old female patient complained of a wounded blackish lump on the left upper extremity for about 2 years. It started small, then grew bigger. Complained of itchiness, but no pain. The lump easily bled when accidentally touched. Dermatology examination identified a hyperpigmented nodule about 1.5 cm, with a clear border, irregular raised edges, slightly rough surface, and erosion. A dermoscopy examination showed short-fine telangiectasia, blue-grey ovoid nests, and ulceration. The patient was diagnosed with suspected BCC and underwent biopsy, also wide excision surgery. Histopathology showed pigmented BCC. One month later, surgery proved a good result. Selecting appropriate therapy in BCC should be given to reduce the recurrence rate. The common treatment for BCC is wide surgical excision, because of its association with a low recurrence rate and the ability to confirm residual tumor pathologically. In conclusion, wide excision surgery is one of the effective therapy options for BCC