Background: Health workers are the first line in health services, especially during the COVID-19 pandemic. High work pressure, busy working hours, irregular shifts, and fatigue are factors that can contribute to decreased sexual function in health workers, especially erectile function in men. This study aims to determine the relationship between the level of depression with the incidence of erectile dysfunction in health workers at Dr. Moewardi General Hospital Surakarta. Methods: This research is an observational analytic study conducted at Dr. Moewardi General Hospital Surakarta during June - July 2021. The subjects of this study were health workers (doctors and nurses), totaling 44 people aged 20 - 50 years, who agreed to participate in the study. The level of depression was assessed using a Patient Health Questionnaire-9 (PHQ-9), while the assessment of erectile dysfunction was carried out using the International Index of Erectile Function (IIEF) questionnaire in the domain of the erectile function. Both of these questionnaires were given to the subject in the form of a google form questionnaire. The data were then collected and statistically analyzed using bivariate analysis using the Spearman rank correlation test using SPSS with a significance value of p<0.05. Results: The results showed that the variables that had a significant relationship with the incidence of erectile dysfunction were depression (r=0.414 and p=0.005) and chronic disease (r=0.528 and p=0.001) with a moderate correlation level (r=0.400-0.599). Conclusion: The level of depression is positively correlated with the incidence of erectile dysfunction experienced by health workers at Dr. Moewardi General Hospital Surakarta, Indonesia.

Syphilis is a chronic and systemic sexually transmitted infection caused by Treponema pallidum. The prevalence of syphilis according to the World Health Organization (WHO) is around 12 million cases worldwide and in pregnant women around 1.8 million cases. Syphilis screening in pregnancy is important to break the chain of transmission of congenital syphilis. We reported Mrs. S, 33 years old, 18 weeks pregnant, came with history of itchy patches appeared 8 months ago along with her husband and abortion 1 year ago. The plantar pedis dextra et sinistra showed multiple hyperpigmented macules and no clinical founding in the vagina. Serological tests, reactive Venereal Disease Research Laboratory (VDRL) 1:32, Treponema pallidum hemagglutination (TPHA) >1:5120 and non-reactive human immunodeficiency virus (HIV), support the diagnosis of latent syphilis. Patients were injected with benzathine penicillin 2.4 million units 3 times (1 week apart). Serological test evaluated at months 1, 3 and 6. At month 6, there was a decrease in VDRL value 4 times the initial value, indicating successful therapy in laten syphilis and had received therapy according to the guidelines for late latent syphilis. Syphilis in pregnancy can cause congenital syphilis in the fetus, although latent syphilis has no symptoms. The patient's VDRL titer was reactive in early latent syphilis (>1:8), but based on history and duration of infection more than 1 year including late latent syphilis. Based on this case report, we found that the VDRL titer value did not always correspond to the duration of infection.

Exogenous ochronosis (EO) is a rare, cosmetically disfiguring condition, resulting from the long term use of topical hydroquinone in treatment of melasma. The studies about it are small and many of the treatments have mixed result. Autologous human platelet rich fibrin (PRF-L) is contains platelet that are purpose to release numerous growth factor that valuable in numerous dermatologic application.Platelet rich fibrin lysate used for EO has not been reported. We presented three cases with EO treated with split-face of the PRF-L applied right before dermaroller on right face and intradermal injection on the left for 8 weeks.The treatment re-apply every 2 weeks. The improvement was measuring by 10-point grading scale and dermoscopic examination, including five-point grading scale to assessment of patient satisfaction. All of three patients demonstrated significant improvementand very satisfied in 4th week of treatment. This result suggests that PRF-L can be used as of one modality for EO treatment.

Background: Seborrheic keratoses are benign intraepidermal neoplasms arising from epidermal keratinocytes. Age and UV exposure have a role in the course of the disease. Seborrheic keratosis consists of several types of cells, and transformation into various epithelial tumors originating from the same cell type can occur. Therefore, basal cell carcinoma may arise from the basaloid cells, which is the most commonly reported malignant neoplasm in seborrheic keratosis. Various treatment modalities are available to treat seborrheic keratoses. We report a case report of seborrheic keratosis resembling basal cell carcinoma and treated using surgical excision with the advancement flap technique. Case presentation: A 76-year-old man came with complaints of itchy, blackish-brown lumps on his left ear 3 months ago. On examination of the dermatological status on the helix auricula sinistra, there was a solitary nodule of blackish brown color with a diameter of 1cm x 1cm x 1cm and an ulcer with an uneven surface, well-defined, telangiectatic (+). An examination of the biopsy showed the results of seborrheic keratosis, keratotic type. The management of this case is excision with an advancement flap. Conclusion: Seborrheic keratosis is one of the most common benign skin tumors that occur in old age. Excision with an advancement flap showed good clinical improvement.

Hiperhidrosis merupakan produksi keringat yang berlebihan akibat disfungsi saraf otonom, yang sering terjadi di daerah dengan konsentrasi kelenjar ekrin yang lebih tinggi seperti telapak tangan, telapak kaki, dan aksila. Tata laksana hiperhidrosis meliputi pendekatan farmakologis dan nonfarmakologis. Pasien dengan kondisi hiperhidrosis fokal yang berat perlu mempertimbangkan terapi dengan tindakan pembedahan atau injeksi botulinum toxin. Salah satu teknik pembedahan pada kasus hiperhidrosis aksila yang dinilai efektif adalah dengan prosedur kombinasi liposuction dan kuretase. Kasus: Perempuan berusia 32 tahun, dengan keluhan keluar keringat berlebih, terutama pada daerah ketiak. Pasien sebelumnya pernah mendapatkan terapi oral dari dokter kulit, namun pasien merasa keluhan belum mengalami banyak perbaikan, kemudian pasien disarankan untuk melakukan prosedur pembedahan. Pada pasien ini dilakukan prosedur liposuction-kuretase dengan anestesi tumesen. Diskusi: Penanganan hiperhidrosis dengan agen topikal maupun sistemik pada umumnya hanya memberikan supresi sementara terhadap hyperhidrosis. Pada kasus berat yang sangat mengganggu, terapi pilihan untuk hiperhidrosis aksilaris adalah prosedur pembedahan. Pilihan metode pembedahan dengan kombinasi liposuction-kuretase menggunakan teknik anestesi tumesen relatif sederhana dan aman. Penurunan sekresi kelenjar apokrin pascatindakan liposuction-kuretase memerlukan waktu yang relatif lama. Teknik pembedahan ini memiliki banyak keuntungan, seperti luka yang relatif minimal serta masa pemulihan yang singkat. Pengamatan dan penilaian hasil tindakan kombinasi liposuction-kuretase sebaiknya dilakukan berkala secara subjektif dan objektif pada bulan ke-3, 6, dan 12 pascaoperasi.