Background: Cutaneous Adverse Drug Reaction (CADR) is a reaction that can cause changes in the structure, the function of the skin, and mucous membranes caused by drug use. One of the risk factors of CADR is a comorbid disease. Objective: to determine the relationship between comorbid diseases and the severity of Cutaneous Adverse Drug Reaction (CADR) at Dr. Saiful Anwar Hospital, Malang. Methods: This study used secondary data taken from medical records of skin and genital patients at Dr. Saiful Anwar Hospital Malang in 2018-2020 and was analyzed using SPSS software version 23 with the Chi-Square test method to determine the significance of the relationship between variables. Result: This study was conducted on 167 patients with mild CADR (52.7%) more than severe CADR (47.3%). The most frequently experienced mild and severe CADR was exanthematous drug eruption and DRESS. In addition, there were also 68 CADR patients with the comorbid disease (40,7 %). Seen from the statistical tests performed, obtained p-value = 0.074 and Odds Ratio (OR) = 1.861. Judging from the p-value, it can be concluded that there is no significant relationship between comorbid disease and the severity of CADR (p > 0.05). Despite that, when viewed from the OR results, it shows that patients with comorbid diseases have a statistically higher risk of 1.861 times higher of experiencing the mild type of CADR than the severe type. Conclusion: One to suggest for this research is to collect medical record data within a longer time span. It is expected that the data is complete and as needed so that it can support the shortcomings in this study.

Macrophage and Schwann cells are target cell on leprosy disease, where apoptotic is assumed as one of elimination mechanism of macrophage previously infected by M.leprae. Several study showed various result in apoptotic on leprosy disease. Apoptotic level can be evaluated by observing caspase-3 activity, an executioner caspase on cell death. This study is aimed to observe the relationship of caspase-3 expression with paucibacillary and multibacillary types of leprosy. We used observational analytic and cross sectional study with consecutive sampling method. The subject was leprosy patient which had been diagnosed on dermatovenereology division outpatient clinic Saiful Anwar Hospital, and fullfilled the inclusion-exclusion criteria. Total subject was 19 persons (11 multibacillary and 8 paucibacillary). Sampling was taken with punch biopsy on skin lession, followed by immunohistochemical staining with caspase-3 antibody, and caspase-3 expression was measured by ImmunoRatio method. Comparation test revealed significant difference (p<0.05%) between caspase-3 expression mean on paucibacillary patient (84.46%) compared to multibacillary patient (65.39%). Pearson correlation test revealed caspase-3 expression tend to be higher in paucibacillary patient than multibacillary (coefficient correlation -0.759). In conclusion, there is a significance relationship between caspase-3 expression with leprosy type.

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Koinfeksi lepra dan tuberkulosis (TB) paru pada satu individu jarang terjadi, tercatat 2-6 per 100.000 penduduk per tahun di dunia. Koinfeksi dapat terjadi akibat kondisi imunokompromais. Seorang perempuan berusia 51 tahun datang dengan keluhan benjolan kemerahan yang nyeri di seluruh tubuh, hilang timbul sejak 1 tahun. Pasien minum metilprednisolon 2 kali sehari selama setahun. Pemeriksaan fisik didapatkan nodul dan plak eritem multipel di seluruh tubuh, konjungtiva hiperemis dan penebalan saraf common perineus kiri. Tidak didapatkan bercak mati rasa dan slit skin smear negatif. Biopsi kulit tampak gambaran infiltrat limfosit dan neutrofil di dermis, foam cells, grenz zone dan pannuculitis lobular yang sesuai dengan lepromatous leprosy dan eritema nodosum leprosum. Radiologi thorak tampak fibroinfiltrat dan konsolidasi, dicurigai TB paru. Pemeriksaan sputum Tes Cepat Molekuler menunjukkan very low detected untuk kuman tuberkulosis yang sensitif rifampisin. Pasien mendapatkan multidrug therapy untuk Morbus Hansen Multibasiler, metilprednisolon serta Obat Anti Tuberkulosis kategori 1 dan memperlihatkan perbaikan klinis. Koinfeksi lepra dan TB jarang terjadi, diduga karena adanya kekebalan silang. Biasanya infeksi lepra mendahului TB, karena periode inkubasi lepra lebih lama. Mekanisme koinfeksi pada kasus diduga akibat penggunaan kortikosteroid jangka panjang. Terapi koinfeksi TB paru dan lepra dilakukan secara bersamaan dengan dosis rifampisin mengikuti dosis terapi tuberkulosis. Kata kunci: lepra, koinfeksi, tuberkulosis.

Physalis angulata adalah tanaman family Solanaceae yang telah lama digunakan sebagai obat tradisional dan telah dimanfaatkan untuk menyembuhkan berbagai macam penyakit di berbagai negara, termasuk Indonesia. Berbagai fitokimia yang dapat diisolasi dari P. angulata seperti karbohidrat, lipid, mineral dan vitamin serta metabolit sekunder yakni physalin, withangulatin, saponin, tannin dan flavonoid, dipercaya memiliki aktivitas farmakologis seperti antiinflamasi, imunomodulasi, antiproliferasi, antioksidan, antibakteri dan sebagainya. Physalis angulata juga digunakan sebagai obat herbal untuk berbagai macam kelainan kulit, seperti obat luka atau bisul maupun peradangan pada kulit. Saat ini penelitian P. angulata untuk kelainan pada kulit tengah banyak dikembangkan seperti sebagai adjuvant terapi Scleroderma, akselerasi penyembuhan luka dan dermatitis kontak iritan. Mengingat aktivitas farmakologi tanaman ini sangat luas, tanaman ini sangat berpotensi sebagai modalitas terapi untuk berbagai macam penyakit kulit lain. Selain untuk meneliti manfaat yang dikandung, diperlukan juga penelitian mengenai keamanan dan untuk menentukan bahan aktif yang bermanfaat untuk setiap kelainan pada kulit.