Aspergillus fumigatus as an agent of cutaneous aspergillosis in immunocompetent patient: A rare case

Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Previous reports have described cutaneous aspergillosis as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, at or near intravenous access catheter sites, at sites of traumatic inoculation, and at sites associated with occlusive dressings, burns, or surgery. Primary cutaneous aspergillosis almost always seen in immunocompromised patients and the skin involvement occurs due to hematogenous dissemination from a primary focus or contiguous spread from underlying infected tissues. This is a rare case of an-56-years-old-immunocompetence man with chief complaint of wound and swelling at left leg since 1 year ago that worsen in last 2 months. He got a history of scalded by hot water at his left leg 1 year ago and became swollen with multiple wound on its surface. Examination on regio pedis sinistra there is tumor with verrucous surface 10 cm in diameter, hard with multiple uneven edge ulcer 5 cm in diameter and hyperpigmentation macule unsharply marginated arround. Potassium hydroxide examination showed conidiophores dichotomously branching and septated hyphae that suitable with Aspergillosis sp. From cultures there is velvety-dark-green growth. The microscope findings from the culture specimen showed conidophore, metula, vesicle, phialde, and chains of pigmented conidia that suitable with Aspergillus fumigatus. Blood culture examination showed no growth of fungi. HIV rapid test negative results obtained. Patients treated with Itraconazole 2 x 200 mg for 12 weeks and obtained satisfactory result

Profil Psoriasis Vulgaris di RSUD Dr. Soetomo Surabaya: Studi Retropektif

Latar belakang: Psoriasis vulgaris adalah penyakit kulit inflamasi kronis yang ditandai dengan plak merah berbatas tegas tertutup skuama tebal sebagai akibat dari gangguan proliferasi dan diferensiasi epidermis.  Sifat kronis dari psoriasis vulgaris sangat mempengaruhi kualitas hidup pasien. Profil pasien psoriasis vulgaris diperlukan untuk mengevaluasi morbiditas akibat psoriasis vulgaris, sehingga dapat meningkatkan mutu pelayanan. Tujuan: Mengevaluasi profil pasien psoriasis vulgaris meningkatkan mutu pelayanan terhadap pasien. Metode: Studi retrospektif dari data rekam medis pasien psoriasis vulgaris yang dirawat di Instalasi Rawat Inap (IRNA) Kemuning I dan II Kulit dan Kelamin RSUD Dr. Soetomo Surabaya selama periode 1 Januari 2016 sampai 31 Desember 2017. Hasil: Sebanyak 36 pasien psoriasis vulgaris didapatkan dari pengamatan selama 2 tahun. Faktor pencetus kekambuhan lesi terbanyak adalah fokal infeksi gigi pada 30,6% pasien. Luas lesi >30% Body Surface Area (BSA) terdapat pada 55,6% pasien. Terapi sistemik yang diberikan berupa metotreksat (55,6%) dan siklosporin (25%); sedangkan 19,4% tidak diberikan terapi sistemik terkait kontraindikasi individual. Kesimpulan: Diagnosis psoriasis vulgaris ditegakkan berdasarkan anamnesis dan gejala klinis, didukung dengan hasil histopatologi. Terapi sistemik berupa metotreksat atau siklosporin, disertai dengan terapi topikal dan terapi suportif, memberikan hasil perbaikan skor PASI 50% - 75% pada 58,3% pasien

Aspergillus fumigatus as an agent of cutaneous aspergillosis in immunocompetent patient: A rare case

Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Previous reports have described cutaneous aspergillosis as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, at or near intravenous access catheter sites, at sites of traumatic inoculation, and at sites associated with occlusive dressings, burns, or surgery. Primary cutaneous aspergillosis almost always seen in immunocompromised patients and the skin involvement occurs due to hematogenous dissemination from a primary focus or contiguous spread from underlying infected tissues. This is a rare case of an-56-years-old-immunocompetence man with chief complaint of wound and swelling at left leg since 1 year ago that worsen in last 2 months. He got a history of scalded by hot water at his left leg 1 year ago and became swollen with multiple wound on its surface. Examination on regio pedis sinistra there is tumor with verrucous surface 10 cm in diameter, hard with multiple uneven edge ulcer 5 cm in diameter and hyperpigmentation macule unsharply marginated arround. Potassium hydroxide examination showed conidiophores dichotomously branching and septated hyphae that suitable with Aspergillosis sp. From cultures there is velvety-dark-green growth. The microscope findings from the culture specimen showed conidophore, metula, vesicle, phialde, and chains of pigmented conidia that suitable with Aspergillus fumigatus. Blood culture examination showed no growth of fungi. HIV rapid test negative results obtained. Patients treated with Itraconazole 2 x 200 mg for 12 weeks and obtained satisfactory result

The Efficacy of Topical Vitamin C and Microneedling for Photoaging

Background: Photoaging is premature skin aging caused by exposure to ultraviolet (UV) radiation. Vitamin C is an antioxidant that inhibits the tyrosinase enzyme that can reduce pigmentation. Microneedling procedure can improve the penetration of topical vitamin C, and it has skin rejuvenating effects to reduce wrinkles and minimize pore size. Purpose: The main purpose of this study was to evaluate the efficacy of topical vitamin C application after microneedling intervention for the clinical improvement of photoaging. Methods: Twenty-four women with photoaged skin participated in this randomization study, and they were divided into control and intervention groups. Solution of 0.9% NaCl and microneedling were performed to control group, and topical vitamin C and microneedling were performed to intervention group. Three intervention sessions were repeated at a 2 week interval. Signs of photoaging such as pigmentation, wrinkles, and pores were evaluated using Metis DBQ3-1, and the data were obtained numerically. Result: The data analysis revealed a significant improvement in pigmentation in the intervention group compared to control group (p<0.05). Wrinkles and pores evaluation revealed no significant difference between the control and intervention groups. Conclusion: Topical vitamin C after microneedling procedure has provided a significant improvement in pigmentation compared to NaCl 0.9% after microneedling