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All Journal Medical Journal of Indonesia Universa Medicina Journal of General Procedural Dermatology and Venereology Indonesia Majalah Kedokteran Andalas Media Dermato-Venereologica Indonesiana Journal of General-Procedural Dermatology & Venereology Indonesia Jurnal Kedokteran Meditek Ophthalmologica Indonesiana

Wresti Indriatmi B. Makes

Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia

Author-ID : 312908

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The role of dermoscopy in non-pigmented skin disorders Hafiza Fathan; Wresti Indriatmi; Rahadi Rihatmadja; Inge Ade Krisanti
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 2 (2016): June
Publisher : Universitas Indonesia

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The use of dermoscopy in non-pigmented skin disorders includes dermoscopy as a diagnostic tool for non-pigmented skin tumors, inflammatory diseases (inflammoscopy) and/or infectious disease (entomodermoscopy), lesions on nail fold and as a tool to monitor skin reaction as a response to treatment and/or side effect. The diagnosis becomes easier, faster and less expensive with dermoscopy without the need for invasive procedures. Knowledge on vascular pattern and its architectural arrangement; which is coupled with additional dermoscopic features, can aid clinicians to the diagnosis. Dermatoscopy can also predict, monitor and evaluate therapeutical response and/or side effect of skin disorders. Nonetheless, dermoscopy has its limitations. Many of various non-pigmented disorders have more specific clinical features than dermoscopic ones, for clinicians to rely on to establish a diagnosis. Keywords: dermoscopy, non-pigmented disorders, diagnosis

Multiplex nested polymerase chain reaction for Treponema pallidum using blood is more sensitive than using serum Effendi, Ida; Rosana, Yeva; Yasmon, Andi; Indriatmi, Wresti
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.75-84

BackgroundSyphilis is a multistage disease transmitted primarily through sexual intercourse. Nowadays, the polymerase chain reaction (PCR) test for Treponema pallidum has been widely used and is expected to overcome problems in diagnostic tests for syphilis. The Treponema pallidum PCR is influenced by type of specimens, PCR methods and target genes. This study aimed to assess the use of blood and serum in multiplex nested PCR for Treponema pallidum, targeting the 23S rRNA.MethodsA cross-sectional study was conducted from April 2015 - April 2016. Sampling was carried out consecutively among patients with clinical features of secondary syphilis who came to Sexually Transmitted Disease (STD) clinics in Jakarta. All sera were also tested with Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA) assay, which was considered as the gold standard for this study. We determined the sensitivity and specificity of the multiplex nested PCR for Treponema pallidum using blood and serum.ResultsPCR test was performed on 122 clinical specimens (61 blood and 61 serum). The positive results of PCR test on blood was 22.95% and serum was 6.56%, while the positive results of serology was 68.85%. The sensitivity of Treponema pallidum multiplex nested PCR on blood was 30.95% compared to serum 9.52% (p=0.006). PCR test on blood is able to detect 3.25 times higher than serum. ConclusionThe use of blood has a higher proportion of positives compared to serum in Treponema pallidum multiplex nested PCR using 23S rRNA target gene.

Detection and identification of azithromycin resistance mutations on Treponema pallidum 23S rRNA gene by nested multiplex polymerase chain reaction Gultom, Desy A.; Rosana, Yeva; Efendi, Ida; Indriatmi, Wresti; Yasmon, Andi
Medical Journal of Indonesia Vol 26, No 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Background: Azithromycin-resistant strains of Treponema pallidum is associated with the mutation of 23S rRNA gene of T. pallidum. Although these strains are now prevalent in many countries, there is no laboratory test kit to detect and identify these mutations. Thus, in this study we developed a nested multiplex polymerase chain reaction (PCR) to detect and identify A2058G and A2059G mutations in 23S rRNA gene.Methods: Three primer sets were designed for nested PCR reactions. To obtain maximum PCR reaction, all parameters were optimized. The specificity of the primer sets was evaluated towards some microorganisms. A sensitivity test was conducted to get detection limit of deoxyribonucleic acid (DNA). Forty-five whole blood specimens were tested by PCR, and positive results were confirmed by the DNA sequencing.Results: The assay could detect at least 4,400 DNA copy number and showed no cross reaction with other microorganisms used in the specificity test. A total 13 of 45 whole blood specimens were PCR positive for T. pallidum, and no single mutations (either A2058G or A2059G) were detected. Two positive specimens were confirmed by the DNA sequencing and showed no mutation.Conclusion: Nested multiplex PCR developed in this study showed a specific and sensitive test for the detection and identification of A2058G and/or A2059G mutations of 23S rRNA T. pallidum gene.

A double-blind randomized controlled trial of topical Curcuma xanthorrhiza Roxb. on mild psoriasis: clinical manifestations, histopathological features, and K6 expressions Rahmayunita, Githa; Jacoeb, Tjut N.A.; Novianto, Endi; Indriatmi, Wresti; Rihatmadja, Rahadi; Pusponegoro, Erdina H.D.
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.

Ulcus vulvae acutum - A rare case Irene Dorthy Santoso; Ika Anggraini; Wresti Indriatmi; Yudo Irawan; Hanny Nilasari; Melani Marissa; Sondang Pandjaitan Sirait; Rahadi Rihamadja
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 3, No 2 (2019): June 2019
Publisher : Universitas Indonesia

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Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy. Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of Behçet’s. The patient was treated with a combination of 2.5% lidocaine and 2.5% prilocaine creams for 1 week, 2% fusidic acid ointment for 1 week, with no significant progression. Later, the therapy was changed to 0.05% clobetasol propionate ointment for 10 days. Complete healing occurred in about 10 weeks with no scarring. Discussion: Diagnosis of ulcus vulvae acutum in this patient was made by excluding other differential diagnoses. Conclusion: Ulcus vulvae acutum is a difficult diagnosis, and clinician should be aware of this entity especially when encountering young woman without previous sexual experience problem with ulcer. Keywords: ulcus vulvae acutum, genital ulcer, young women

Efficacy of inosine pranobex as an adjuvant oral therapy in anogenital warts: an evidence-based case report Benny Nelson; Indina Sastrini; Lidwina Anissa; Patricsia Manalu; Peppy Fourina; Rahmaniar Desianti Kuraga; Wresti Indriatmi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 3, No 2 (2019): June 2019
Publisher : Universitas Indonesia

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Background: Human papillomavirus (HPV) causes the most prevalent sexually transmitted infection and is an important etiological factor in genital cancer. HPV infection manifests in broad spectrum, from genital warts to cervical intraepithelial neoplasia and cancers. Genital warts remain a frequent problem in primary care. Current modalities provide unsatisfactory result in curing genital warts completely. To date, there are many convincing studies encouraging oral inosine pranobex as an adjuvant therapy to improve post-conventional therapy cure-rate. Aim: To assess the efficacy of inosine pranobex as an adjuvant oral therapy in anogenital warts. Methods: Literature search was performed using Pubmed, Ebsco and Science Direct database. Inclusion criteria were human subjects, randomized controlled trial on patients with genital warts, and inosine pranobex as adjuvant therapy. The studies were appraised and findings were formulated to find the best evidence for collating recommendations in treating genital warts patients. Results: There were three articles related to the clinical questions. All articles were found to be valid after selection based on exclusion and inclusion criteria. Discussion: All articles recommended the addition of oral inosine pranobex as an adjuvant therapy in treating patient with genital warts. Based on the critical appraisal performed previously, addition of oral inosine pranobex may minimize conventional therapy failure. Conclusion: Based on the best evidence available, we would recommend the addition of oral inosine pranobex as adjuvant for treating genital warts, except in special conditions, such as for patients with financial problem as this therapy was not covered by national health insurance. Keywords: effectiveness, genital warts, inosine pranobex

Vaginal microbiota in menopause Martinus Tarina; Larisa Paramitha; Evita Halim Effendi; Shannaz Nadia Yusharyahya; Hanny Nilasari; Wresti Indriatmi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 3 (2016): December
Publisher : Universitas Indonesia

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The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp, and Streptococcus sp. The normal vaginal microbiota’s imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H2O2-producing Lactobacillus. They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp. Keywords: vagina, microbiota, menopause, Lactobacillus, bacterial vaginosis

Photodermatoses in Children Siti Nurani Fauziah; Wresti Indriatmi; Lili Legiawati
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 2, No 2 (2017): December 2017
Publisher : Universitas Indonesia

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Photodermatoses cover the skin’s abnormal reactions to sunlight, usually to its ultraviolet (UV) component or visible light. Etiologically, photodermatoses can be classified into 4 categories: (1) immunologically mediated photodermatoses (idiopathic photodermatoses); (2) drug- or chemical-induced photosensitivity; (3) hereditary photodermatoses; and (4) photoaggravated dermatoses. The incidence of photodermatoses in the pediatric population is much lower than in adults, Polymorphous light eruption (PMLE) is the most common form of photodermatoses in children, followed by erythropoietic protoporphyria. Early diagnosis and investigations should be performed to avoid long-term complications. Photoprotection is the mainstay of photodermatoses management, including use of physical protection and sunscreen. Keywords: children, photodermatoses, photoprotection, polymorphous light eruption.

Microscopic examination using negative staining for rapid diagnosis of syphilis Rosana, Yeva; Effendi, Ida; Indriatmi, Wresti; Yasmon, Andi
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.64-70

BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions. METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification. RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions. CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.

PERBEDAAN SKIN CAPACITANCE DAN TRANSEPIDERMAL WATER LOSS PADA KULIT NON-LESI PASIEN PITIRIASIS VERSIKOLOR DENGAN NON-PITIRIASIS VERSIKOLOR Satya Wydya Yenny; Zainal Hakim; Kusmarinah Bramono; Wresti Indriatmi
Majalah Kedokteran Andalas Vol 32, No 2: Agustus 2008
Publisher : Faculty of Medicine, Universitas Andalas

AbstrakPada pitiriasis versikolor sering timbul kekambuhan, diduga salah satu penyebabnya adalah kelembaban kulit yang tinggi. Kelembaban kulit dipengaruhi oleh skin capacitance dan transepidermal water loss.Mengetahui skin capacitance dan transepidermal water loss kulit pasien pitiriasis versikolor dan perbedaannya dengan non-pitiriasis versikolor.Penelitian ini merupakan studi potong lintang perbandingan antar kelompok, yang dilakukan pada bulan September sampai dengan Nopember 2004 di Rumah Sakit Dr. Cipto Mangunkusumo. Subyek penelitian pasien pitiriasis versikolor dan kontrol non-pitiriasis versikolor yang dipasangkan dalam hal umur dan jenis kelamin dan dilakukan pemeriksaan skin capacitance dan transepidermal water loss pada kulit yang tampak normal di punggung menggunakan alat Tewameter/Corneometer 350.Dalam kurun waktu tersebut telah diperiksa sebanyak 32 pasien pitiriasis versikolor dan 32 kontrol non-pitiriasis versikolor. Skin capacitance pasien pitiriasis versikolor secara statistik tidak berbeda dengan kontrol non-pitiriasis versikolor (p = 0,730). Transepidermal water loss pasien pitiriasis versikolor secara bermakna lebih rendah dari pada kelompok kontrol non-pitiriasis versikolor (p = 0,000).Tidak ada perbedaan skin capacitance kulit pasien pitiriasis versikolor dengan non-pitiriasis versikolor. Transepidermal water loss kulit pasien pitiriasis versikolor lebih rendah daripada non-pitiriasis versikolor.Kata kunci: pitiriasis versikolor, skin capacitance, transepidermal water lossAbstractThe recurrence of pityriasis versicolor is high, it could be caused by high skin hydration. Skin hydration was influenced by skin capacitance and transepidermal water loss.ARTIKEL PENELITIAN168The purpose of this study was to compare the differences of the skin capacitance and transepidermal water loss between the pityriasis versicolor skin and healthy non-pityriasis versicolor skin.The design of this study was comparative cross-sectional study. Pityriasis versicolor subjects and non-pityriasis versicolor subjects were matched in age and sex. The study was done in September until November 2004, at Dr. Cipto Mangunkusumo Hospital. The measurement of the skin capacitance and transepidermal water loss were done on the back at the non-PV area, using Tewameter/Corneometer 350.During that periode there were 32 pityriasis versicolor and 32 healthy non-pityriasis versicolor subjects. No significant differences was observed for skin capacitance of pityriasis versicolor and healthy non-pityriasis versicolor skin (p = 0.730). The transepidermal water loss of PV skin is significantly lower than in the healthy non-pityriasis versicolor skin (p=0.000).There was no differences between skin capacitance of pityriasis versicolor and healthy non-pityriasis versicolor skin, but the transepidermal water loss of pityriasis versicolor skin was significantly. lower than non-pityriasis versicolor.Keywords: pityriasis versicolor, skin capacitance, transepidermal water loss

Co-Authors Aldri Frinaldi Andi Yasmon Anggraini, Ika Anissa, Lidwina Aria Kekalih Arlha Aporia Debinta Benny Nelson Caroline Oktarina Christa Desire Gracia Efendi, Ida Effendi, Ida Effendi, Ida Emma Rusmayani Endi Novianto Evita Halim Effendi Evita Halim Effendi Fathan, Hafiza Fauziah, Siti Nurani Fourina, Peppy Githa Rahmayunita Gultom, Desy A. Hafiza Fathan Hanny Nilasari Hartono Gunardi Haswinzky, Rose Amalia Heri Wibowo Hutabarat, Hernayati Ika Anggraini Indina Sastrini Inge Ade Krisanti Irawan, Yudo Irene Dorthy Santoso Jacoeb, Tjut N.A. Joedo Prihartono Kayika, I Putu Gede Kemal N. Siregar Krisanti, Inge Ade Kuraga, Rahmaniar Desianti Kurniawan, Kristian Kusmarinah Bramono Larisa Paramitha Lesmana, Elvira Lidwina Anissa Lili Legiawati Manalu, Patricsia Marissa, Melani Martinus Tarina Martinus, Martinus Mawardi, Prasetya Melani Marissa Melani Marissa Nelson, Benny Patricsia Manalu Peppy Fourina Pusponegoro, Erdina H.D. Rahadi Rihamadja Rahadi Rihatmadja Rahadi Rihatmadja Rahmaniar Desianti Kuraga Santoso, Irene Dorthy Sastrini, Indina Satya Wydya Yenny Shannaz Nadia Yusharyahya Sirait, Sondang P. Siti Nurani Fauziah Sondang Pandjaitan Sirait Sri L. Menaldi Suyatna, Fransiscus Dhyanagiri Widya Artini Windy Keumala Budianti Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Yeva Rosana Yudo Irawan Zainal Hakim

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