Background: Fournier gangrene is necrotizing fasciitis of the genitalia and perineum that can extend to the abdominal wall, gluteus or lower extremities. Predisposing factors for Fournier gangrene include obesity, diabetes mellitus (DM), alcoholism, smoking, hypertension, chronic kidney disease, perianal trauma and immunosuppressive conditions. This case report aims to evaluate the management of Fournier gangrene on metabolic and surgical treatmentCase Presentation: A-53 years old-female with Type 2 Diabetes Mellitus (T2DM) came to the Emergency Ward of Dr. Sutomo General Hospital, Surabaya, with the chief complaint of sores on the buttocks for 1 week. The patient was diagnosed with Fournier gangrene. On physical examination in the room, erythematous macular lesions were found in the folds of the breast and armpit on chest examination. Obtained scratch marks were found because the patient is often scratched. The wound from the buttock and keep enlarged due to the Fournier gangrene ( necrotizing infection). In this case, the patient was given the antibiotics ceftriaxone and metronidazole. The patient died during the 8th day of treatment due to a suspected septic shock.Conclusion: Surgical management in this patient is debridement. Multi-disciplinary management of obstetrics, urology, digestive surgery, and plastic surgery is required for the management of Fournier gangrene in T2DM patients

Background: There are increasing number of studies that discuss the effect of sun exposure to overweight and obese individuals with vitamin D deficiency (which is UVB exposure can increase serum 25-Hydroxyvitamin D levels). However, until now there is no a literature review about these studies. This shows a weak correlation between sun bathing and serum 25-Hydroxyvitamin D elevation in overweight and obese people. Aim: Describe the effect of the sun bathing for overweight-obese patient with vitamin D deficiency. Material and Methods: Electronic searching tools (ScienceDirect, Pubmed, and Google Scholar) were conducted from the 1990s until the recent literature. A sensitive search strategy uses specific terms. Studies were included if the population with BMI > 25 Kg/m2; Sun Exposure intervention, the studies provided the comparison of implementation method, the studies provided 25-Hydroxyvitamin D status as the outcome. For the exclusion criteria: studies that included subjects metabolics syndrome. MMAT was used for eliminating biased research. Results: Two studies were fulfilled our inclusion criteria. The studies, were excluded, mainly because they lacked data, biased reseach, and failure to answer any authors questions. Conclusion: The sun exposure method has a positive corellation for increasing serum 25-Hydroxyvitamin D level in overweight and obese subjects with vitamin D deficiency, but internal factors (age and skin color) and external factors (season, temperature, dose, and duration) need to be considered to get effective result. Keywords: Obese, Overweight, Sun bathing, Vitamin D deficiency, 25-Hydroxyvitamin D.