A retrospective study of condyloma acuminata profile in outpatient clinic of dermato-venereology Sanglah General Hospital Denpasar, Bali-Indonesia period 2015-2017

Introduction: Condylomata acuminata (CA) is human papillomavirus (HPV) infection, and one of the most common sexually transmitted disease, characterized with papul or papillomatous nodule in genital, perineum and anal, this disease can be asymptomatic as well. Some study proved sexually transmitted infection increases the incidence of Human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), and vice versa. Management of CA is Trichloroacetic acid (TCA), Tincture Podophyllin, and Electrocautery. This study aims to determine profile of condyloma acuminata in Dermatovenereology Outpatient Polyclinic Sanglah General Hospital Denpasar Bali period 2015-2017. A retrospective study during three years (2015-2017).

Method: Data was obtained from medical record in Dermatovenereology Outpatient Polyclinic Sanglah General Hospital Denpasar Bali period 2015- 2017.

Result: Total patient condyloma acuminata is 260 patients (5.48%), male is dominant 70 patients (67.31%), range age 12-35 years old (123%), there was 59 patient who infected with HIV (22.31%), with five pregnancy (1.92%). Most therapy is given trichloroacetic acid (TCA) (79.62%).

Conclusion: Men suffered from condyloma acuminata more commonly than women, the most common treatment for this condition is trichloroacetic acid (TCA)

Necrotic lower extremities ulcers caused by calciphylaxis in chronic renal failure patient

Introduction: Lower extremity ulcers often create diagnostic challenges and influence patient morbidity and mortality. The most common causes are venous insufficiency, arterial insufficiency, and neuropathic. Ulcers associated with systemic condition often face diagnostic and therapeutic challenge. We report a necrotic lower extremity ulcer caused by calciphylaxis in a patient with chronic renal failure. Case: We reported a 48-year-old Javanese woman, complained of painful lower extremities ulcers since 1.5 months ago. The patient had a history of renal failure and hypertension, undergone routine hemodialysis since 13 years ago, and used Continuous Ambulatory Peritoneal Dialysis (CAPD) since one year ago. Dermatology status on dorsum pedis sinister as well as cruris dexter and sinister showed multiple ulcers on livid skin covered by black eschar, accompanied by tenderness. Laboratory results showed anemia (Hb 7.6), hypoalbuminemia (2.7), increased serum urea level (170.4 mg/dl), increased serum creatinine (11.23 mg/dl), increased calcium (10.4 mg/dl), high inorganic phosphorus (8.5 mg/dl) and high parathyroid hormone (2,164). BOF examination showed abdominal calcification, while radiographic examination on cruris dexter et sinister showed soft tissue calcification and osteoporosis. Histopathology result supported the presence of calciphylaxis. The patient was diagnosed with stage V chronic renal failure, hypertension, and calciphylaxis caused by secondary hyperparathyroidism. She was managed by low calcium and phosphate diet, lanthanum, paracetamol, folic acid, adalat oros, captopril and wound debridement. Conclusion: Calciphylaxis is a rare phenomenon of cutaneous necrosis associated with end-stage renal disease. Control of end-stage renal disease may be an important factor for treatment of calciphylaxis and patient with calciphylaxis usually had a poor prognosis.

Keywords: necrotic lower extremity ulcer, chronic renal failure, calciphylaxis

Profile of onychomycosis in dermatology outpatient department at Sanglah General Hospital Denpasar, Bali-Indonesia periods 2016-2017

Introduction: Onychomycosis is a fungal infection of the nails that causes discoloration, thickening, and separation from the nail bed. Onychomycosis is caused by various organisms, most often dermatophytes of the genus Trichophyton. Other organisms include Candida, which is more common in fingernail infections and patients with chronic mucocutaneous candidiasis. Nondermatophyte molds are a less common cause in the general population. This study aimed to identify sex, age, classification, fungal culture, treatment, and incident of secondary infection in onychomycosis at Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods January 2016 – December 2017.

Methods: Study design using descriptive retrospective model done by taking data from medical record in Dermatology Outpatient Department at Sanglah General Hospital Denpasar Periods 2016-2017.

Result: There were 268 patients in Dermatovenereology Outpatient Department at Sanglah General Hospital Denpasar, 29 (10,82%) of whom were diagnosed with onychomycosis in Periods 2016-2017. According to age group, the most cases occur in 26-65 year age groups. Females were more frequently affected than males. The most classification finding is distal and lateral subungual onychomycosis and the most commonly isolated fungi were yeasts from the Candida species. The most commonly given therapy is a combination therapy of systemic antifungal with topical. Fluconazole is the most common drug that uses orally and ciclopirox as topical agent.

Conclusions: Onychomycosis is one of the common fungal infection observed in patient attending dermatology outpatient department with the most classification finding is distal and lateral subungual onychomycosis. The most commonly isolated fungi were Candida sp.

Keywords: onychomycosis, fungal, nail