Urethritis gonorrhea is the most prevalent venereal disease today and can be found all over the world. Timeliness of treatment, correct selection of drugs with adequate doses can eliminate infections that affect the individual, prevent the development of complications, prevent further transmission and avoid germ resistance. This article reports, 24-year-old male patient with a diagnosis of gonore urethritis who came to polyclinic Skin and Veneral at Hospital Syaiful Anwar Malang. Patients come with complaints of pus out of the genitals without itching. Patients also complain of pain during urination, as well as urinating in small volume and often. On examination of external urethra urifisium area obtained ectropion, purulent discharge, and hyperemia macula. There is a lump and duh at the tip of the genitalia caused by inflammation of the paraurethral glands. From the investigation found diplococcus bacteria Gram negative intrasellular PMN. The causative therapy given is a single oral dose of Oral 400mg. Evaluation was done 3 days after treatment and improvement was obtained. Keywords: gonorrhea urethritis; oral urethritis therapy; uretritis gonorrhea complications

Background: CD4 can assess the immune status of a patient with HIV, and this is considered the standard way of assessing and characterizing the severity of HIV-related immunodeficiency. CD4 cell counts are associated with increased mucocutaneous manifestations. This study aims to explain the relationship between CD4 and mucocutaneous manifestations in HIV-AIDS   patients. Methods: This study is analytical with a retrospective cross-sectional design. The data of the present study was obtained from a number of 614 HIV-AIDS patients with mucocutaneous manifestations, but only 149 patients met the inclusion criteria, including the CD4 level data. Results: The majority of the patients in this study were male (74.5%), which includes patients under the age group of 25-49 years (70.5%). The most common risk factor was heterosexuality (48.3%). Most CD4 levels were in the CD4 group < 200 (64.4%). Based on the distribution of mucocutaneous manifestations, the various cases were reported as infections (55.8%). Pyoderma and syphilis were significantly associated with CD4 counts ≥ 200 cells/mm3 with a risk of 3.7 and 7.8 times than CD4 cells < 200 cells / mm3. On the other hand, candidiasis was higher in CD4 count < 200 cells/mm3 with a significant difference and a risk of 0.3 times compared to CD4 count ≥ 200 cells/mm3. Conclusion: Several mucocutaneous manifestations can be considered predictors of advanced immunosuppression (low CD4 level), which were pyoderma, syphilis, and candidiasis in this study.

Current treatment guidelines include fluconazole as the main therapeutic option for treating oral candidiasis infection in HIV/AIDS patients, but resistance increases. Several in vitro studies have shown that clove leaf essential oil with the main content of eugenol can be an alternative therapy for oral candidiasis that is resistant to fluconazole. This study was conducted to determine the zone of inhibition of clove leaf essential oil and fluconazole against Candida isolates species that cause oral candidiasis in HIV/AIDS patients. This study showed that the average fluconazole disk 25 μg/mL inhibition zone in 20 isolates of Candida albicans species was larger than non-albicans Candida species. The zone of inhibition of clove leaf essential oil was significantly lower than that of fluconazole (p < 0.05), except at a concentration of 15% against non-albicans Candida isolates. Clove leaf essential oil has an antifungal effect that can inhibit the growth of Candida species, so it can be considered an alternative antifungal therapy. Clove leaf essential oil concentration of 15% showed no significant difference in antifungal activity with the standard drug fluconazole in isolates of non-albicans Candida species.

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Background: Tinea capitis (TC) is the most prevalent pediatric superficial dermatophyte infection. Scalp dermoscopy or “trichoscopy” represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to TC. Purpose: To characterize trichoscopic findings in children with clinical findings suggestive of TC. Case:  A 13-year-old boy was presented with a scaled plaque on his scalp that had appeared 1 month earlier. A physical examination revealed a scaly, nonerythematous, rounded lesion in the parietal area of the head. Wood’s lamp yielded a blue fluorescence. Microscopic morphology from fungal culture found the typical spindle-shaped macroconidia of Microsporum canis. Trichoscopy showed mainly comma hair, corkscrew hair, morse code hair, bent hair, and zig zag hair. The patient was started on oral griseofulvin 20 mg/kg/day and antifungal shampoo for 8 weeks. The patient was cured after two months of treatment and trichoscopy returned to normal. Discussion: Fungal culture remains the gold standard in TC diagnosis, but it needs time. Trichoscopy can be an additional tool to help evaluate the diagnosis, aetiology, and follow up of this disorder. The presence of characteristic trichoscopic features (comma hairs, corkscrew hairs, Morse code-like hairs, zigzag hairs, bent hairs, block hairs, and i-hairs) is predictive of TC. The present analysis confirmed that trichoscopy is a useful method in differentiating between Microsporum and Trichophyton TC, which is important from the perspective of a different therapeutic approach. Conclusion: Trichoscopy is not only of value in the diagnosis of TC but also for the etiologic agent and follow-up after treatment in this case.