Secondary Syphilis in Human Immunodeficiency Virus (HIV)-Infected Men Who Have Sex with Men (MSM): A Case Report

Background: Recently, the incidence of syphilis among men who have sex with men (MSM) has increased rapidly, especially among Human Immunodeficiency Virus (HIV)-infected MSM. Coinfection with these two organisms alter the symptoms and signs, progression of the disease, and the risk of progressing to the tertiary stage. Purpose: To report a case of secondary syphilis in HIV-infected MSM.  Case: A 24-year-old male complaint of multiple redness macule for 1-month duration on his chest, back, groin, palm, and soles. The rash was neither painful nor pruritic. He also complains of hair loss resulting "moth eaten" alopecia. One month before, he had a painless ulcer on his genital, which resolved without treatment. His HIV infection was diagnosed two years earlier. He had been sexually active with multiple homosexual partners without using a condom since 2010. The Venereal Disease Research Laboratory test (VDRL) titer was 1/32, and Treponema pallidum haemagglutination assay (TPHA) was 1/20480. Initial treatment was a single dose of 2.4 million units of benzathine penicillin. Serologic examination was reevaluated on month 1, 3, 6, and 9 after therapy and declined in the third month. Discussion: For HIV-infected persons, the clinical manifestations of syphilis in most of the cases remain the same. However, the lesions are more aggressive, and coexistence of primary and secondary syphilis is more frequent. Serologic tests are accurate and reliable for the diagnosis and for following a patient’s response to treatment. Penicillin is effective but physical and serological follow up is needed. Conclusion: HIV-infected MSM have higher risk of syphilis. Staging is needed to determine the treatment. Serologic examination should be repeated and long enough to monitor the treatment success

Superficial Mycoses

Background: Superficial mycoses were superficial fungal infections caused by fungal or yeast colonization. The prevalence of fungal infection is estimated 20-25% of the world’s population and one of the most common infection in humans. Purpose: To evaluate the profile of superficial mycoses patients. Method: A retrospective study of all new cases of superficial mycoses who visited the Mycology Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya from January 2011 until December 2013 (3 years). Results: The total new patients in 2011-2013 was 1.136 with the percentage 5,47% in 2011, 4,91% in 2012, and 5,90% in 2013. Men were more affected than women, and it was more common in the age group 15-24 and 25-44. Most patients complaint were itchy and most commonly used therapies were ketoconazole 200 mg and griseofulvin 125 mg orally. Conclusion: Superficial mycoses is still a common issue in Indonesia, especially in Surabaya

Studi Retrospektif: Karakteristik Dermatofitosis

Latar Belakang: Dermatofitosis merupakan salah satu penyakit mikosis superfisialis akibat jamur yang menginvasi jaringan yang mengandung keratin seperti stratum korneum epidermis, rambut, dan kuku. Seringkali disebut tinea dan diklasifikasikan menurut bagian tubuh yang terkena. Tujuan: Mengevaluasi gambaran penyakit dermatofitosis di Divisi Mikologi Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya periode tahun 2014 sampai 2016. Metode: Penelitian retrospektif dengan mengevaluasi data rekam medis elektronik Divisi Mikologi URJ Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya periode Januari 2014 – Desember 2016.  Hasil: Jumlah kunjungan pasien baru dermatofitosis mengalami peningkatan, yaitu 71,9% dari seluruh pasien yang datang ke divisi Mikologi dibandingkan penelitian retrospektif sebelumnya. Tinea korporis merupakan diagnosis terbanyak yakni sebesar 56,1%. Sebagian besar pasien adalah wanita. Usia terbanyak yang ditemukan sedikit bervariasi yakni 45-64 tahun pada tahun 2014 dan 25-44 tahun pada tahun 2015 dan 2016.  Keluhan utama terbanyak adalah gatal dan bercak kemerahan. Pemeriksaan mikroskop langsung dengan larutan KOH 10% merupakan pemeriksaan rutin yang dilakukan   pada seluruh pasien dermatofitosis. Sebanyak 51,2% kasus dermatofitosis yang ditemukan disebabkan oleh spesies Trichophyton mentagrophytes. Pengobatan terbanyak dengan griseofulvin. Simpulan: Terdapat peningkatan jumlah pasien dermatofitosis. Usia terbanyak yang terinfeksi adalah kelompok usia produktif, karena pada kelompok usia ini terjadi peningkatan dari aktivitas fisik dan memiliki kecenderungan untuk banyak berkeringat dan lembab

Retrospective Study: Malassezia Folliculitis Profile

Background: Malassezia folliculitis (MF) is a chronic infectious disease of pilosebaceous follicles caused by Malassezia sp.  Clinical features of MF include erythematous papules and itchy perifollicular pustules, especially on the upper body, neck, upper arms, and face. The disease is usually reported on adolescents. Objective: To evaluate the profile of MF patients in four years (2014-2017) period in the Mycology Division of  Dermatovenerology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya. Methods: This study was a retrospective study to examine the medical records of MF patients in the Mycology Division of Dermatovenerology Outpatient Clinic General Academic Hospital Dr. Soetomo Surabaya from January 2014 to December 2017. Results: The number of new MF patient visits during 2014-2017 was 196 patients, and the average annual visit was 55 patients in 2014, 49 patients in 2015, 65 patients in 2016, and 27 patients in 2017. The majority of patients were males, were aged 15-24 years old. The chief complaint was reddish papules accompanied by moderate itching in the predilection area and most often found in the upper body. The Wood's lamp examination revealed greenish-yellow color, and 20% KOH examination showed spores. Most systemic therapies was ketoconazole and tretinoin 0.05% cream for topical therapy. Conclusions: There  was  a decrease in the number of MF patients. The diagnoses of MF were based on history taking, physical examination, 20% KOH, and Wood's lamp

Patch Test Result in Patient with Allergic Contact Dermatitis to Toothpaste: A Case Report

Background: Allergic contact dermatitis (ACD) is a common diagnosis resulting from exposure to a chemical or chemicals in a patient's personal care products, home, or work environment. It is a delayed type of hypersensitivity reaction caused by contact with allergens in the environment. Patch testing is a gold standard to establish the diagnosis. After the causative allergens have been identified, patient education is needed to the proper treatment and management of the patient. Case: Herewith, we report A 23-year-old woman with suspected ACD due to lipstick and was planned to perform patch test. She complained about dry lips that appear after she used new lipstic for about 3 months and there was not history of applying another agent. After recovery, the patch test was performed with allergens that might contact with her lips and the result was positive one in toothpaste allergen while negative in lipstick allergen. Conclusion: The allergen which is suspected to the patient from history-taking might be different with the result of patch test, so that performing patch testing is needed to investigate the cause of ACD

A comparative study of Chicago Sky Blue and ParkerTM ink blue black potassium hidroxide in the diagnosis of dermatophytes

Parker ink blue black potassium hydroxide (KOH) is a regular stain for the diagnosis of dermatophytoses. KOH giving less color contrast to the fungal element. The Chicago Sky Blue (CSB) solution is a new contrast have various sensitivity and specificity values. This is analytical observational,cross sectional design study conducted at Dermatomycology Division of Outpatient Clinic, Dr. Soetomo General Hospital. 40 samples from lesion and perilesional infected area, diagnosed dermatophytoses with culture positive was include in this study. All two tests were performed examined by KOH and CSB. The slides were examined after incubation in x 10 and x 40 magnifications by experienced observer. The sensitivity, specificity and McNemar test of CSB and KOH was calculated using culture as the standard test. The sensitivities, specificities, PPV, NPV of the Chicago sky blue and KOH respectively are 95% and 100%, 95,24% and 100%, 100% and 100%, with McNemar test p = 1 and Kappa score is 0,950. The Chicago Sky Blue stain provides a good color contrast and IT could be a alternative staining for the dermatophytoses

Kadar Hormon 17α-Hydroxyprogesterone (17-Ohp) Serum pada Pasien Pria dengan Akne Vulgaris Sedang-Berat dan Tanpa Akne Vulgaris

Latar Belakang: Akne vulgaris (AV) adalah penyakit kulit kronis pada unit pilosebaceous. Kelebihan androgen dapat menimbulkan akne dengan cara menginduksi kelenjar sebum. AV pada pria mungkin satu-satunya tanda adanya kelebihan androgen. Tujuan: Mengevaluasi kadar 17-OHP serum pada pasien pria AV sedang-berat dan pria tanpa AV di URJ Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya. Metode: Sebuah studi kasus kontrol observasional analitik termasuk 15 kasus AV dan 15 kontrol dari klinik Kulit dan Kelamin rawat jalan rumah sakit Dr.Soetomo, berdasarkan kriteria inklusi dan eksklusi. Hasil: Rerata 17-OHP pada kelompok AV adalah 1.58 ±0,25 ng/mL dan pada kelompok kontrol adalah 0,98 ±0,15 ng/mL. Dengan nilai P adalah P = 0,0001 (P <0,05) Kesimpulan: Kadar serum 17-OHP pada kelompok AV signifikan lebih tinggi dibanding kelompok kontrol. Diperlukan penelitian lebih lanjut untuk menyingkirkan faktor perancu untuk mengetahui lebih peran hormonal dalam patogenesis AV

Profile of Malassezia Folliculitis

Background: Malassezia folliculitis (MF) is a chronic infection of the pilosebaceous follicles caused by a skin fungus Malassezia sp. most often in teenagers who marked the onset of itchy erythematous perifolicular papules and pustules, especially in the upper body area and rarely on the face. The clinical appearance must be distinguished from acne vulgaris which has a similar clinical picture, so often have the wrong diagnosis that will affect the prognosis of the disease. Objective: To evaluate the profile of MF in Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital. Methods: A cross-sectional, observational, descriptive study, total samplingin three months of forty-five new patients with acne vulgaris appearance visiting Dermatology and Venereology Outpatient Clinic Dr. Soetomo General Hospital according to inclusion and exclusion criteria. Diagnosis based on history, clinical examination, Wood's lamp and KOH 20%. Malassezia sp. identification using Mycobiotic culture that is added to the olive oil. Results: Forty five patients with a clinical appearance of acne vulgaris in the upper body and slightly exposed on the face area, the new MF patients showed a total of 36 patients (80%) and the remaining 9 patients (20%) were diagnosed with acne vulgaris. Conclusions:Thirty six MF patients with the highest age range 15-24 years, anamnesis obtained itching is moderate grade, predilection in the area of the upper body, and Wood's Lamp examination produces greenish yellow color, KOH 20% examination obtained spores, whereas culture is not required for the diagnosis of MF Key words: Malassezia sp., Malassezia folliculitis, acne vulgaris, Wood's lamp, KOH 20%

Increasing of Urinary 8-Hydroxydeoxyguanosine (8-OHdG) Levels in Children with Atopic Dermatitis

Background: Atopic dermatitis (AD) is a chronic inflammation of the skin occurring in individuals with allergic diathesis. Reactive oxygen species (ROS) is assumed to be involved in the pathogenesis of allergic inflammation. 8-Hydroxydeoxyguanosine (8-OHdG) is a marker of oxidative DNA base damage. Previous research showed a various result in urinary 8-OHdG levels of AD in children. Purpose: To evaluate urinary 8-OHdG level of children with AD in Dermatology and Venereology Outpatient Clinic at Dr. Soetomo general hospital Surabaya. Methods: This is a descriptive observational cross sectional research in children with AD at Dermatology and Venereology Outpatient Clinic Dr. Soetomo hospital who qualified inclusion and exclusion criteria in three months period (March to June 2016). Urine sampling for 8-OhdG examination were underwent from all subjets.  Results: Mean urinary 8-OHdG level of children with AD was 17.236 ± 13.596 ng/mL. Mean urinary 8-OHdG level of AD in children with mild, moderate, and severe based on grade of severity were 7.892 ± 5.596 ng/mL, 16.006 ± 13.662 ng/mL, and 27.321 ± 12.668 ng/mL respectively. Conclusion: There is a tendency of increased levels of urinary 8-OHdG in accordance with increasing grade of severity in children with AD which possibly caused by the role of oxidative stress in the pathogenesis of AD. Further research is needed to reveal the role of antioxidant in AD and the connection between the severity of AD and urinary 8-OHdG levels

Profile of patients with tinea capitis

Tinea capitis is dermatophyte infection of the scalp and hair, affecting mainly prepubertal children. Its incidence has increased over the last decades. If not diagnosed and treated properly, it might reach epidemic soon. This study was descriptive retrospective study which evaluated the incidence and profile of tinea capitis among patients of Micology Division, Outpatient Clinic of Dermatology and Venereology Department, Dr. Soetomo General Hospital Surabaya in 2014 - 2016. There were 42 tinea capitis new cases. It was most prevalent among the age group of 5-14 years old. Male was more common. The most common main complaint was itching. The most frequent predisposing factor was cat exposure. Squama was the most prevalent efflorescence. KOH examination data showed that 57.1% patients were arthrospore positive and 66.7% were positive in Wood lamp examination. Culture was done among 24 patients with positive result of 52.4% and Microsporum canis as the most prevalent dermatophytes. There were 33.3% patients diagnosed with grey patch type. The most common treatment was oral griseofulvin. Follow-ups were done to all patients but only 64.3% who visited back