Introduction Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute severe cutaneous adverse reactions commonly caused by medication. Precise evaluation of disease severity in initial setting must be obtained to start appropriate treatment. Neutrophil and lymphocyte ratio (NLR) plays a role in displaying inflammatory reaction while eosinophils count (EC) influences immunological dysregulation including the proliferation of cytotoxic cells in early onset of SJS/TEN. Objective To evaluate whether NLR and EC serve as prognostic markers of disease severity in patients with SJS/TEN using SCORTEN. Methods A single center study with retrospective study included SJS/TEN patients at Dr. Moewardi General Hospital Surakarta in January 1st 2018–December 31st 2020. The required laboratory data was assessed at the beginning of the patient’s admission through medical records. The significance analysis were performed using one-way ANOVA and Spearman while the receiver-operator curve were used to evaluate the prognostic value of variables for severity in SJS/TEN patients. Results The total sample in this study was 24 patients with majority female (58%) and range from 25 to >50 years (54%). The results demonstrated of significant difference and positively correlated between NLR and EC with severity of SJS/TEN (p<0.01; r>0.05). The specificity and sensitivity of 51%;61% and 70%;60%, respectively. Conclusion NLR and EC can be used as prognosticators of severity in SJS/TEN while further research on other inflammatory markers with increased number of samples and study centers are needed to provide more actual data.

Acne vulgaris (AV) is the most common and multifactorial skin disease in adolescents affecting the pilosebaceous unit that involves hormonal imbalance, increased sebum production, and bacterial colonization, which causes both physical and psychological disorders. Cutibacterium acnes is considered one of the key contributing factors even though many Cutibacterium acnes colonies are on healthy skin. Cutibacterium acnes induces lipogenesis and production of sebum. Through its production of porphyrins, it may act as a catalytic agent in squalene oxidation that is comedogenic, thus aggravating comedogenesis. We review the dual role of Cutibacterium acnes to provide an understanding of the pathophysiology of acne vulgaris.

Background: Seborrheic keratoses are benign intraepidermal neoplasms arising from epidermal keratinocytes. Age and UV exposure have a role in the course of the disease. Seborrheic keratosis consists of several types of cells, and transformation into various epithelial tumors originating from the same cell type can occur. Therefore, basal cell carcinoma may arise from the basaloid cells, which is the most commonly reported malignant neoplasm in seborrheic keratosis. Various treatment modalities are available to treat seborrheic keratoses. We report a case report of seborrheic keratosis resembling basal cell carcinoma and treated using surgical excision with the advancement flap technique. Case presentation: A 76-year-old man came with complaints of itchy, blackish-brown lumps on his left ear 3 months ago. On examination of the dermatological status on the helix auricula sinistra, there was a solitary nodule of blackish brown color with a diameter of 1cm x 1cm x 1cm and an ulcer with an uneven surface, well-defined, telangiectatic (+). An examination of the biopsy showed the results of seborrheic keratosis, keratotic type. The management of this case is excision with an advancement flap. Conclusion: Seborrheic keratosis is one of the most common benign skin tumors that occur in old age. Excision with an advancement flap showed good clinical improvement.