ABSTRAKReaksi lepra berkontribusi besar terhadap terjadinya kecacatan akibat kerusakan saraf perifer. Pemeriksaan nerve conduction study (NCS) memberikan gambaran fisiologis saraf perifer secara mendalam. Studi ini bertujuan untuk melaporkan kasus polineuropati pada lepra dengan reaksi tipe 2 yang dievaluasi dengan menggunakan NCS. Wanita 33 tahun mengeluh muncul benjolan nyeri pada lengan dan tungkai, demam, dan kaki bengkak sejak 2 hari yang lalu. Pasien riwayat terdiagnosis kusta. Pemeriksaan dermatologis, pada palpebra superior kanan, lengan dan tungkai kanan dan kiri didapatkan nodul eritema multipel dengan nyeri tekan; claw hand manus sinistra; dan edema kedua tungkai. Pemeriksaan slit skin smear positif. Pemeriksaan histopatologis mendukung gambaran reaksi lepra tipe 2. Kesimpulan pemeriksaan NCS, terjadi polineuropati sensorik dan motorik demyelinasi akson berat, dengan derajat lebih berat pada sisi kiri. Pasien diterapi MDT-MB, tirah baring, metilprednisolon peroral, vitamin B kompleks, parasetamol, sulfas ferosus, dan oleum olivarum topikal. Didapatkan perbaikan klinis setelah 2 minggu terapi. Pemeriksaan NCS berfungsi untuk menilai konduksi impuls saraf di sepanjang saraf perifer. Pada kasus ini, didapatkan bahwa temuan NCS menunjukkan neuropati dini pada saraf-saraf yang secara klinis belum terdeteksi. Dapat disimpulkan bahwa pemeriksaan NCS menjadi uji diagnostik penting untuk deteksi dini neuropati dan mengkonfirmasi diagnosis neuropati klinis pada lepra. Kata kunci: Nerve conduction study, reaksi lepra ABSTRACT Leprosy reaction contributes to disability due to peripheral nerve damage. Nerve conduction study (NCS) provides a profound physiological description of peripheral nerves. This study aims to report a case of polyneuropathy in leprosy with type 2 reactions (T2R) which is evaluated using NCS. A 33-year-old woman complain of painful bumps in her arms

ONYCHOMYCOSIS FINGER AND TOE NAIL BY Cryptococcus laurentii, Trychophyton verrucosum, and Candida sp  Dhelya Widasmara, Diane Tantia SariDepartment of Dermatology and Venereology, Medical Faculty, Brawijaya Universitydr.Saiful Anwar Regional Public Hospital, Malang, IndonesiaEmail: dhelya.widasmara@gmail.com AbstractIntroduction : Onychomycosis is included in most common nail disease and contributes to 50% of onychodystropic events. So far, there are rare cases of onychomycosis due to Cryptoccus laurentii and Trychophyton verrucosum. Case : Woman, 54 y.o, complaining of brittle nails and cracked on the soles of the feet and hands since 6 months ago. Patients have daily habits to go to rice fields without gloves and footwear, and rarely wash their hands and feet after the rice fields. Dermatologic examination of all unguium digiti manus and the right and left hand, obtained discolorization of yellow and white and some blackish, subungual hyperkeratosis, onikolisis, and onikodistrofik. In plantar dekstra et sinistra, obtained erythema plaque, multiple, irregular shape, varied size, with rough skuama, as well as multiple yellow and white hyperkeratotic plaques with fissures. A 20% KOH examination of a hand and foot nail, both of which obtained a long septae hyphae. Periodic Acid-Schiff coloration (PAS) obtained a description of spores. Fungal culture from fingernail obtained growth of Criptococcus laurentii and Trichophyton spp., culture of toenails obtained growth Trichophyton verrucosum and Candida sp. Patients were treated with itraconazole tablet dose of 2x200mg / day dose for a week every month, gentamicin ointment, and 20% urea cream, myologic improvement after 4 weeks of therapy. Discussion : The incidence of onychomycosis due to Cryptoccus laurentii and Trychophyton verrucosum is still rare. The predisposing factor of infection in these patients is due to the patient's habitual contact with the paddy fields. Keywords : onychomycosis, Cryptococcus laurentii, Trychophyton verrucosum

Background: Acne vulgaris (AV) is an inflammatory disease of the pilosebaceous unit, which often causes stress and disrupts quality of life. Correctly identifying precipitating factors and preventing disease development will holistically increase the effectiveness of acne therapy, enabling better therapeutic outcomes to be achieved. Purpose: The objective of this study is to identify the clinical profile and precipitating factors of AV patients who visited Dr. Saiful Anwar Hospital between 2015 until 2017. Methods: This was a descriptive study, using a retrospective case study approach. The sample data was collected from medical records of AV patients from the period of 2015–2017 who met the following inclusion criteria: new AV cases with a complete medical record including gender, age, and precipitating factors. The dependent variable of this study was new AV patients, while the independent variables were the patient clinical profile and precipitating factors. Results: This study included 930 samples, with the number of female patients significantly higher (75.48%) than the number of males. The highest AV prevalence was found in the 15–24 years age group. The most common precipitating factors in females were hormonal issues, stress, and cosmetics; in males, these were stress, genetics, and dietary factors. Conclusion: The incidence of AV at Dr. Saiful Anwar Hospital mostly occurs in the 15–24 years age group, with varying trigger factors. The most frequent AV trigger factor in female patients was hormonal issues; in males, this was stress.