Objective: Health-care workers (HCWs) in Indonesia have been participating in the war against the coronavirus disease-2019 since March 2020. Ever since HCWs were exposed to the regular use of personal protective equipment (PPE) with varying levels and maintain hand hygiene more as recommended by the World Health Organization. Adverse skin reactions to PPE in Indonesia has yet to be acknowledged. This study aimed to study the prevalence and characteristics-, possible risk factors-, and suggest possible solutions towards adverse skin reactions to PPE among HCWs in a multi-center setting of Indonesia. Methods: A cross-sectional survey was conducted online among HCWs in the Siloam Hospitals Group of Banten province. HCWs of Banten Province were surveyed from June 1 to August 31, 2020. The data was obtained using avalidated online survey questionnaire including (1) demographic characteristics; (2) occupational-related characteristics; (3) adverse skin reactions. Results: A response rate of 40.2% was obtained and 200 valid respondents were yielded. The mean age of respondents was (26.94 ± 7.23) years old. Adverse skin reactions (66.5%) were reported primarily in female (73.7%) working as doctors (82.7%) of a non-referral center for coronavirus disease-2019 (60.2%) wearing level 2 and 3 PPE (43.6% and 37.6%, respectively). The cheeks and chin was the most common site involved (69.9%) with dryness/tightness (63.9%) and acne (77.4%) as the highest symptoms and signs reported. Sex, age group classification, level of PPE worn, hand hygiene frequency, and duration of PPE worn daily were factors considerably associated with adverse skin reactions to PPE (P < 0.05). Conclusions: Adverse skin reactions to PPE are common among HCWs in Indonesia. Comprehensive strengthening of the skin condition and awareness on adverse skin reactions should be advocated.

Objective: Awareness regarding the negative effects of ultraviolet radiation are commonly neglected in Asian countries. This study sought to evaluate the ultraviolet radiation knowledge and photoprotective behaviors of university students in Indonesia. Methods: This observational cross-sectional was conducted at Pelita Harapan University, Indonesia. Results: A total of 89 (45.4%) medical students and 107 (54.6%) nonmedical students participated in this study. Their mean age was 21.03 ± 2.03 years, and 46.4% of them had Fitzpatrick type III skin. Medical students as well as older students exhibited a higher level of knowledge regarding photoprotection (P ≤ 0.05). Factors related to good photoprotective behaviors were sex, older age, and average expenditure on skincare. Further analysis revealed that a high level of knowledge regarding photoprotection was related to acceptable photoprotective behaviors (P = 0.01; odds ratio = 1.97; 95% confidence interval = 1.13–3.54). Conclusions: Knowledge regarding sun-related damage and practice of photoprotective behaviors were low among the participants. The results indicate that formal education and academic subjects should incorporate the topic of sun-related damage and promote the practice of photoprotective behaviors early on to increase awareness among populations.

Male, Cutaneous adverse drug reaction • drug induced immune thrombocytopenia Symptoms:Pruritic skin lesion in the entire body since seven days prior to admission and skin lesion with red patches in the trunk Medication:-Clinical Procedure:-Specialty:Infectious Diseases Objective:Unknown etiology Background:Many drugs have been reported to cause immune-mediated adverse drug reactions (IM-ADRs) in human immunodeficiency virus (HIV) patients; the most common is cutaneous adverse drug reaction (CADR). Immune thrombocytopenia purpura (ITP) is frequent in HIV patients, and it can be caused HIV, opportunistic infections, or drugs. Although drugs can cause immune thrombocytopenia, termed drug-induced immune thrombocytopenia (DIIT), there has been no study on DIIT in HIV patients. Case Report:A 33-year-old male patient was admitted to our hospital with pruritic skin lesion over the entire body, which started 7 days before. He was diagnosed with HIV infection, brain toxoplasmosis, and pulmonary tuberculosis 2 weeks before admission, and was given trimethoprim sulphamethoxazole, isoniazid, rifampicin, pyrazinamide, and ethambutol. Clindamycin was added 10 days before admission. Skin examination revealed generalized erythematous macules with palpable petechiae and purpura. The platelet count was 141 000/µL when he was diagnosed with HIV, and it was 2000/µL at the time of admission. Clindamycin was discontinued and he was given steroids and platelet transfusion. The skin lesions improved along with an increased platelet count. He was discharged on the 10 th day of admission, with platelet count of 42 000/µL. When he returned to the outpatient clinic on the 15 th day, his platelet was 54 000/µL. The skin lesions had resolved completely and become hyperpigmented, and no purpura or petechiae were seen. Conclusions:We present a case of an HIV patient with IM-ADR in the form of DIIT in conjunction with CADR that might have been caused by clindamycin.

Background: Lateral ankle sprain (LAS) is one of the most prevalent and recurring injuries occurring during physical activities, especially sports. The resulting morbidity forces individuals to limit or change their physical activities. Medical rehabilitation can prevent recurrent injuries by restoring dynamic balance deficits. Previous studies have shown contradictory results. We investigated the effect of medical rehabilitation on dynamic balance in patients with LAS.Methods: This was a numerical, analytical study with a prospective cohort design. Two groups, consisting of 13 LAS subjects each, were purposively chosen. Only the former participated in the three sessions of the rehabilitation program. The modified star excursion balance test was performed initially and three weeks later. Normalized composite scores were recorded in Microsoft Excel and statistically analyzed using SPSS 24 with a 5% significance level.Results: LAS was commonly found in males (57.69%), with an average age of 20.62 ± 6.24 years old, on the dominant foot side (57.69%). Both groups were matched for age (p = 0.292), sex (p = 0.247), and dominant injured foot (p = 0.193). The rehabilitation group presented a greater increase in normalized composite score than the control (∆ = 3.10 ± 4.71 vs. 2.04 ± 7.05, p = 0.654).Conclusion: Dynamic balance increased more in the rehabilitation group than in the control group, but the difference was insignificant. Medical rehabilitation should not be mandatory but optional for patients with LAS with limited resource access. Nevertheless, rehabilitation should be continued for other important aspects of treatment.