Coronavirus Disease 2019 (COVID-19) merupakan penyakit baru yang terjadi akibat infeksi virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Manifestasi klinis umumnya berupa gangguan sistem respirasi. Namun, COVID-19 juga dapat bermanifestasi sebagai gejala ekstraparu, salah satunya dermatologi. Mekanisme pasti terjadinya manifestasi kulit pada COVID-19 masih belum dipahami secara penuh, namun diduga disebabkan oleh efek langsung virus terhadap sel keratinosit, respon imun berlebihan, maupun karena obat-obatan yang digunakan untuk tatalaksana COVID-19. Manifestasi kulit dari COVID-19 dapat dibagi menjadi lima kelompok lesi, yaitu lesi pseudo-chilblains, vesikuler, urtikaria, makulopapular eritematosa, dan vaskular. Lesi makulopapular eritematosa (44,18%) dan chilblains (19,72%) merupakan lesi yang paling sering ditemukan. Lesi vesikuler dan vaskular lebih jarang ditemukan. Lesi chilblains biasa ditemukan sebelum atau bersamaan dengan timbulnya gejala COVID-19 yang lain, dan seringkali muncul pada pasien kontak erat atau asimptomatik sehingga pengenalan lesi secara dini dapat digunakan untuk mendeteksi adanya COVID-19.

Introduction: Syphilis is a sexually transmitted infection that is chronically progressive, with a broad spectrum of active clinical and asymptomatic periods. A total of 80.6% of men with syphilis were Men Who Sex with Men (MSM), 47% of the population was coinfected with Human Immunodeficiency Virus (HIV). Case Presentation: Male, 23-yo, MSM, unmarried, HIV, complaining of red bumps and spots on the palms, soles, and upper arms since 4 days ago. One week earlier, he complained of sores in the genitals, which recurred 1 year ago and healed on their own. Dermatological examination revealed multiple erythematous patches and papules. The corpus penis, glans penis, and scrotum showed erosions and multiple ulcers with an erythematous-based, covered with yellowish crusts. VDRL and TPHA were reactive. The patient was diagnosed with secondary syphilis and treated with an intramuscular injection of benzathine penicillin 2.4 million IU once. A 1-month evaluation showed significant lesion improvement, VDRL titer 1:64. Evaluation of the 3rd and 6th months revealed a VDRL titer of 1:4. Conclusion: The clinical manifestations of syphilis patients with HIV coinfection are generally more atypical, aggressive, and overlap caused by changes in the immune system in HIV infection. Unsafe sexual behavior in MSM increases the transmission of syphilis infection. Diagnosis and therapy are generally the same. Men Who Sex with Men is a factor that allows the transmission of syphilis in HIV patients. Administration of benzathine penicillin injection once gave lesion improvement and significantly reduced VDRL.

Introduction: Herpes zoster (HZ) is caused by reactivation of latent varicella-zoster virus (VZV) infection due to disturbance in T-cell mediated immunity. Risk factors include malignancy and therapy related to malignancy. Bladder cancer has a moderate association with HZ, with a risk increment of 10-50%. The rate of HZ in bladder cancer patients is 8/1000. Case description: A 57-years-old man with bladder cancer T4bN3M0 complained of a painful erythematous vesicular rash on the left front abdomen extended to the back 1 week prior, accompanied by fever and burning sensation. He has had regular chemotherapy using Gemcitabine and Cisplatin, and radiotherapy with 2 Gray doses each session. Dermatological examination showed multiple well-defined erythematous-based vesicles, clustered on the left abdominal, flank, and posterior thorax region at T7-T9 dermatome. Tzanck-smear examination showed multinucleated giant cells. The patient was given acyclovir, paracetamol, and wet dressing on vesicles. His chemoradiotherapy was also halted. On the 7th day of evaluation, there were no new lesions and his complaints improved. In cancer patients, CD4+ and CD8+ levels decreased, accompanied by lymphocyte proliferation impairment. Cytotoxic chemotherapy agents work by attacking proliferation cells, affecting immune-related cells. Ion radiation in radiotherapy interferes with a regional cellular immune response that inhibits viral reactivation. Conclusion: Principal HZ management in cancer patients includes antiviral and analgesics. In cancer patients, the occurrence of HZ can disturb and postpone management related to malignancy. The postponement of chemoradiotherapy is based on the patient's conditions and the severity of the disease.