Introduction: Uremic xerosis with pruritus (UXP) is a chronic cutaneous complication among patients undergoing maintenance renal dialysis. Uremic xerosis level is directly related with pruritus severity or vice versa. Uremic xerosis with pruritus may lead to discomfort and negative psychological effect. The ethiopathogenesis still unknown, Most of treatments are empirical, and there is no effective and safe therapy. Emollient has not been effective enough to improve quality of life. There is some report about efficacy of topical vitamin D in xerosis and chronic pruritus. Objective: We evaluate the efficacy of calcipotriol 0.005% ointment for uremic xerosis and uremic pruritus in chronic kidney disease patients undergoing hemodialysis. Material & methode: Sixty two patients with UXP were enrolled, randomized double blind study. Patients were divided to two group, calcipotriol 0.005% ointment group or placebo. In baseline, patients were instructed to apply twice daily for four weeks. We assesesment the efficacy and safety of calcipotriol 0.005% ointment and placebo after 2nd and 4th weeks treatment using overall dry skin score (ODSS), visual analog scale (VAS), corneometer and sebumeter. We also assessed adverse effect and tolerance this drugs using visual assessment scale. Results: Overall dry skin score (ODSS) and visual analog scale (VAS) significantly decreased in calcipotriol 0.005% ointment group than in placebo group (p <0.05). Skin hydration level based on Corneometer score and skin surface lipid based on Sebumeter score was significantly increased in calcipotriol 0.005% ointment group than in placebo group (p <0.05). Cure rate and clinical improvement for calcipotriol 0.005% ointment group was significantly higher than placebo group. There was no adverse effect between two groups after treatment. Conclusion: calcipotriol 0.005% ointment is effective than placebo and can be used as alternative or adjuctive treatment and safe and tolerance for UXP.

Syphilis, is sexually transmitted disease caused by spirochete Treponema pallidum subsp.pallidum. It have many diverse clinical manifestations that occur in distinct stages. Early diagnosis and management are the main things to prevent transmission and complication. Direct test or morphological observation is the definitive diagnosis of syphilis. This can be done through animal inoculation test, dark field microscopy, direct fluorescence antibody (DFA), and nucleid acid amplification test (NAAT). While the indirect test is a nontreponemal serologic test consist of Wasserman test, venereal disease research laboratory (VDRL), toluidine red unheated serum test (TRUST), unheated serum reagin (USR), rapid plasma reagin (RPR) and treponemal serologic test, such as T. pallidum passive particle agglutination (TPPA), T. pallidum haemagglutination assay (TPHA), fluorescent treponemal antibody absorption (FTA-Abs), enzyme immunoassay (EIA) and rapid test. The algorithm of serologic test can be divided into traditional or reverse.

Syphilis, is sexually transmitted disease caused by spirochete Treponema pallidum subsp.pallidum. It have many diverse clinical manifestations that occur in distinct stages. Early diagnosis and management are the main things to prevent transmission and complication. Direct test or morphological observation is the definitive diagnosis of syphilis. This can be done through animal inoculation test, dark field microscopy, direct fluorescence antibody (DFA), and nucleid acid amplification test (NAAT). While the indirect test is a nontreponemal serologic test consist of Wasserman test, venereal disease research laboratory (VDRL), toluidine red unheated serum test (TRUST), unheated serum reagin (USR), rapid plasma reagin (RPR) and treponemal serologic test, such as T. pallidum passive particle agglutination (TPPA), T. pallidum haemagglutination assay (TPHA), fluorescent treponemal antibody absorption (FTA-Abs), enzyme immunoassay (EIA) and rapid test. The algorithm of serologic test can be divided into traditional or reverse.

Herpes zoster (HZ, shingles, zoster) is a disease due to reactivation and multiplication of persistent varicella zoster virus (VVZ) after suffering from previous varicella with characteristics of dermatomal rashes, pain, and unilateral. Dermatoms most often involved in HZ lesions are thoracal, trigeminal, lumbal, and cervical. The first lesion is usually erythematous macule or papule, which then turns into vesicle, then to pustule and to become crust, and persists for 2-3 weeks. The main goal of antiviral therapy in HZ patients is to reduce the expansion, duration, and severity of rashes and pain in primary dermatomes; prevent the spread of HZ to other places; and prevent post-herpes neuralgia. One of the prevention strategies for HZ in the elderly and high-risk individuals is vaccination using the varicella zoster virus vaccine that is live zoster vaccine or recombinant zoster vaccine.

Granuloma ingunale (GI) or donovanosis is a genital ulcer disease caused by theCalymmatobacterium granulomatis. It is a Gram-negative, facultative, obligateintracellular and pleomorphic bacterium. This bacterium has phylogeneticallyclosed to and placed within the Klebsiella genus. Clinically, the disease is com-monly characterized as painless, slowly progressive ulcerative lesions on thegenitals or perineum without regional lymphadenopathy. The lesions are highlyvascular and bleed easily on contact Extragenital lesions may occur but are rareand more common in newborns from mothers with GI genital lesions. Thisdisease is often neglected, therefore it is often misdiagnosed and inaccuratetherapy. Treatment time is 3 weeks or until clinical cure has been achieved forall proposed regimens. It often occurs both in men and women of reproductiveage (20-40 years). This article consists of several theoretical references that havebeen viewed to have a better understanding of GI.