I Gusti Nyoman Darmaputra's research while affiliated with Sanglah Hospital and other places

Background: One of the immunological factors that are thought to have a potential relationship to Mycobacterium leprae infection is cathelicidin. Cathelicidin is an essential component of the innate immune system against infection with various pathogens, including gram-positive and gram-negative bacteria, fungi, parasites, and viruses. This study aimed to determine the relationship between cathelicidin levels with bacterial index (BI) and duration of multi-drug therapy (MDT) treatment in multibacillary (MB) type leprosy patients. Methods: This research is an analytic observational study with a cross-sectional design at Dermatology and Venereology Polyclinic, Prof. General Hospital. dr. I.G.N.G Ngoerah Denpasar and Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University, Denpasar from April 2023 to May 2023. The research variables were the bacterial index from examining acid-fast bacteria (AFB) and cathelicidin levels. Subjects were selected by consecutive sampling method with inclusion criteria for the case group, patients with multibacillary type leprosy, and the control group, which were healthy subjects. Analysis was analyzed descriptively and analytically with the Mann-Whitney test and Spearman's correlation using the SPSS program. Results: Sixty-eight samples were divided into 34 subjects in the control group and 34 in the case group. In terms of BI, negative/zero and +4 were the most common BI with a frequency of 11.8% (n=8) and 16.2% (n=11), and IB +2 of 8.8% (n=6). The mean cathelicidin levels in the case and control groups were 21.64±12.18 g/mL and 37.92±33.86 g/mL (p<0.05; mean difference: 16.26 g/mL). The correlation between cathelicidin levels and IB was r=-0.77 (p<0.001), and cathelicidin level with the duration of treatment was r=-0.36 (p=0.033). Conclusion: Cathelicidin levels have a significant negative correlation to the BI in MB type leprosy patients. Duration of treatment has an influence on BI in MB type leprosy patients. Latar Belakang: Salah satu faktor imunologis yang diduga memiliki hubungan potensial terhadap infeksi Mycobacterium leprae adalah cathelicidin. Cathelicidin merupakan komponen penting dari pertahanan inang bawaan (innate immune system) terhadap infeksi berbagai patogen, termasuk bakteri gram-positif maupun bakteri gram-negatif, jamur, parasit, dan virus. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar cathelicidin dengan indeks bakteri (IB) dan lama pengobatan multi drug therapy (MDT) pada pasien kusta tipe multibasiler (MB). Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross-sectional, bertempat di Poliklinik Kulit dan Kelamin, RSUP Prof. dr. I.G.N.G Ngoerah Denpasar dan Laboratorium Biokimia Fakultas Kedokteran Universitas Udayana, Denpasar pada bulan April 2023 sampai bulan Mei 2023. Variabel penelitian yaitu indeks bakteri dari pemeriksaan bakteri tahan asam (BTA) dan kadar cathelicidin. Subjek dipilih dengan metode consecutive sampling dengan kriteria inkulsi kelompok kasus yaitu pasien kusta tipe multibasiler dan kelompok kontrol yaitu subjek sehat. Analisis dilakukan secara deskriptif dan analitik dengan uji Mann-Whitney dan korelasi Spearman menggunakan program SPSS. Hasil: Sejumlah 68 sampel terbagi menjadi 34 subjek kelompok kontrol dan 34 subjek kelompok kasus. Ditinjau dari segi indeks bakterinya, IB negatif/nol dan +4 merupakan IB terbanyak dengan frekuensi 11,8% (n=8) dan 16,2% (n=11), serta IB +2 sebesar 8,8% (n=6). Rerata kadar cathelicidin pada kelompok kasus dan kontrol yaitu 21,64±12,18 g/mL dan 37,92±33,86 g/mL (p<0,05; beda rerata: 16,26 g/mL). Korelasi kadar cathelicidin dengan IB didapatkan r=-0,77 (p<0,001) dan dengan lama pengobatan didapatkan r=-0,36 (p=0,033). Simpulan: Kadar cathelicidin memiliki korelasi negatif yang signifikan terhadap indeks bakteri pada penderita kusta tipe MB. Durasi pengobatan memiliki pengaruh terhadap IB pada penderita kusta tipe MB.

Background: Basal cell carcinoma (BCC) is a localized malignant tumor in the basal layer of the epidermis thought to be the result of prolonged sun exposure and associated with gene mutations in most cases. Although rarely metastazises, BCC can cause high levels of morbidity due to its locally destructive nature. There are several modalities for managing BCC, and the defect caused by the lesion can reconstructed by local flap. Case presentation: We present a 55-year-old woman with a chief complaint of a blackish lump on the left maxillary region, growing bigger, and frequent episodes of bleeding. The lesion was excised and followed by histopathological examination, which revealed mixed subtype BCC. Closure of the defect with an advancement flap was performed with favorable results. Conclusion: Surgical excision is the best option for managing BCC, while a skin flap is preferred to close defects for lesions on the cheek.

Background: The latest trend in anti-aging prevention is projected through the use of antioxidants derived from natural ingredients with minimal side effects compared to chemicals. Cocoa bean (Theobroma cacao L.) is one of the sources of natural antioxidants with high flavonoid antioxidant content. This study aims to determine the effect of topical application of cocoa extract to prevent photoaging in wistar rats exposed to ultraviolet A (UVA) light. Methods: Experimental research with animal models using 36 wistar rats exposed to UVA and divided into 2 groups, given 10% cocoa extract cream and basic cream on the back area. The parameters assessed were superoxide dismutase (SOD) levels in skin tissue. Comparative analysis with independent T-test using SPSS version 21 to compare SOD levels of both groups. Results: Superoxide dismutase levels in both groups were found to be normally distributed (p> 0.05). The results of the comparative test with the Independent T-test found that the mean SOD levels of the treatment group were higher than those of the control group at 8.07 ± 1.99 ng/ml and 5.04 ± 1.54 ng/ml (p< 0.001; 95% CI: 1.82-4.24). Conclusion: Topical application of 10% cocoa extract cream on the skin of Wistar rats exposed to UVA light resulted in higher levels of superoxide dismutase in the rat skin tissue than the control.

Introduction: Skin aging is a biological process that cannot be avoided. Repeated UVB exposure increases collagen degradation by increasing MMP-9 levels. Little is known about TIMP-1's potential role in skin protection or recovery from skin damage caused by photoaging. Sugar apple leaf extract increases cell proliferation, levels and collagen deposition. This study aims to determine the topical application of sugar apple leaf cream extract (Annona squamosa L.) to increase TIMP-1 levels and decrease MMP-9 levels in Wistar rats (Rattus norvegicus) exposed to UVB light. Methods: Experimental study with a post-test-only design with a control group design using 35 male Wistar rats. There were five groups: negative control, positive control, and treatment (5%, 10%, and 20% sugar apple leaf extract cream). Skin biopsies were taken to measure TIMP-1 and MMP-9 levels using the ELISA method. Data analysis was performed using the SPSS 25.0 application. Results: The phytochemical test showed total flavonoid levels of 3583.77 mg QE/100 mL, phenol 5244.98 mg GAE/100 mL, IC50 value 226.53 ppm, and alkaloids. The highest mean TIMP-1 level in the treatment group was 38.95 ± 3.31 ng/mL, and the lowest mean MMP-9 level was 2.94 ± 1.66 ng/mL (20% concentration). One Way ANOVA showed that there were significant differences in TIMP-1 and MMP-9 levels between the test groups with a p<0.001. Post hoc LSD analysis showed significantly higher TIMP-1 and lower MMP-9 levels (p<0.05) than the control. Conclusion: Administration of sugar apple leaf cream extract increased TIMP-1 levels and significantly decreased MMP-9 levels in Wistar rats exposed to UVB light. Pendahuluan: Penuaan kulit merupakan proses biologis yang tidak dapat dihindari. Paparan UVB berulang meningkatkan degradasi kolagen dengan meningkatkan kadar MMP-9. Potensi keterlibatan TIMP-1 dalam perlindungan kulit atau pemulihan dari adanya kerusakan kulit akibat photoaging masih belum banyak diketahui. Ekstrak daun srikaya diketahui dapat meningkatkan proliferasi sel, kadar dan deposisi kolagen. Tujuan penelitian ini adalah untuk mengetahui aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) dalam meningkatkan kadar TIMP-1 dan menurunkan kadar MMP-9 pada tikus wistar (Rattus norvegicus) yang terpapar sinar UVB. Metode: Penelitian eksperimental dengan rancangan post-test-only with control group design ini menggunakan 35 tikus wistar jantan. Terdapat lima kelompok, yaitu kontrol negatif, kontrol positif, dan perlakuan (krim ekstrak daun srikaya 5%, 10%, dan 20%). Biopsi kulit diambil untuk pengukuran kadar TIMP-1 dan MMP-9 dengan metode ELISA. Analisis data dilakukan dengan menggunakan aplikasi SPSS 25.0. Hasil: Uji fitokimia menunjukkan kadar total flavonoid sebanyak 3583,77 mg QE/100 mL; fenol 5244,98 mg GAE/100 mL, nilai IC50 226,53 ppm, dan alkaloid positif. Rerata kadar TIMP-1 tertinggi pada kelompok perlakuan adalah 38,95 ± 3,31 ng/mL dan rerata kadar MMP-9 terendah yaitu 2,94 ± 1,66 ng/mL (konsentrasi 20%). Analisis One Way ANOVA menunjukkan terdapat perbedaan kadar TIMP-1 dan MMP-9 yang signifikan antara kelompok uji dengan nilai p<0,001. Analisis post hoc LSD menunjukkan kadar TIMP-1 lebih tinggi dan kadar MMP-9 lebih rendah secara signifikan (p<0,05) dibandingkan kontrol. Simpulan: Pemberian ekstrak krim daun srikaya dapat meningkatkan kadar TIMP-1 dan menurunkan kadar MMP-9 secara signifikan pada tikus wistar yang terpapar sinar UVB.

Introduction: Household contacts are the group most at risk of contracting subclinical leprosy, which acts as a transmission source. Immunoglobulin M (IgM) anti-Phenolic Glycolipid-1 (PGL-1) serological indicates the abundance of M. leprae in person and Interleukin-17 (IL-17) levels play an important role in preventing clinical leprosy. Thus, this study aims to determine the correlation of IL-17 to IgM-anti PGL-1 in household contacts of multibacillary type leprosy patients. Methods: This study was an analytic observational study with a cross-sectional approach. The research was conducted from October to November 2022 at the Skin and Venereology Polyclinic and the Clinical Pathology Laboratory, Prof. Hospital. Dr. I.G.N.G. Ngoerah Denpasar. Samples were selected using a consecutive sampling technique. The total sample was divided into groups of contacts and non-contacts. Data were analyzed using SPSS 23. The bivariate analysis used was chi-square, man-withney. Then a correlation analysis was performed using the Spearman rho test. The significant p-value was <0.05. Results: The total number of samples obtained was 72. The mean levels of IL-17 and anti-PGL-1 IgM levels in the contact group were 45.47 ± 20.57 pg/ml and 605.59 ± 2,94.30 u/ml, while in the non-contact group were 31.46 ± 19.25 pg/ml and 140.46 ± 93.42 u/ml. There was a significant difference in IL-17 and anti-PGL-1 IgM levels in the contact and non-contact groups (p<0.001). Correlation analysis showed a weak positive relationship (r=0.290, p=0.014) between IL-17 levels and anti-PGL-1 IgM levels. Conclusion: The levels of anti-PGL-1 and IL-17 IgM in contacts were higher than in non-contacts, with a significant difference. There was a significant weak positive correlation between levels of IL-17 and anti-PGL-1 IgM. Pendahuluan: Narakontak serumah merupakan kelompok paling berisiko terjangkitnya kusta subklinis yang berperan sebagai sumber penularan. Pemeriksaan serologis Imunoglobulin M (IgM) anti Phenolic Glycolipid-1 (PGL-1) dapat menjadi indikasi banyaknya M. leprae dalam tubuh narakontak dan kadar Interleukin-17 (IL-17) berperan penting mencegah terjadinya kusta klinis. Untuk itu penelitian ini bertujuan untukmengetahui korelasi IL-17 terhadap IgM-anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler. Metode: Studi ini merupakan observasional analitik dengan pendekatan potong lintang. Penelitian dilaksanakan mulai bulan Oktober - November 2022 di Poliklinik Kulit dan Kelamin dan Laboratorium Patologi Klinik, RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Sampel dipilih menggunakan teknik consecutive sampling. Total sampel di bagi menjadi kelompok narakontak dan bukan narakontak. Data di analisis menggunakan SPSS 23. Analisis bivariat yang digunakan adalah chi-square, man-withney. Selanjutnya dilakukan analisis korelasi menggunakan uji Spearman rho. Nilai p dikatakan signifikan jika <0.05. Hasil: Total sampel yang diperoleh adalah 72. Rerata kadar IL-17 dan kadar IgM anti PGL-1 pada kelompok narakontak yaitu 45,47 ± 20,57 pg/ml dan 605,59 ± 294,30 u/ml sementara pada kelompok bukan narakontak yaitu 31,46 ± 19,25 pg/ml dan 140,46 ± 93,42 u/ml. Terdapat perbedaan yang signifikan pada kadar IL-17 dan IgM anti PGL-1 pada kelompok narakontak dan bukan narakontak (p<0.001). Analisis korelasi menunjukkan hubungan positif lemah nilai (r=0,290, p=0,014) antara kadar IL-17 dengan kadar IgM anti PGL-1. Kesimpulan: Kadar IgM anti PGL-1 dan IL-17 pada narakontak lebih tinggi dari bukan narakontak dengan perbedaan yang signifikan. Terdapat korelasi positif lemah yang signifikan antar kadar IL-17 dan IgM anti PGL-1.

Introduction: Psoriasis is a chronic inflammation of the skin. The remission rate of psoriasis is 10-60%, with the risk of depression, skin cancer and suicide. Inflammation leads decrease of skin hydration, and pH, thus it makes destruction of skin barrier. Therefore, this study aimed to determine the function and integrity of the skin barrier as seen from TEWL and pH in psoriatic and non-psoriatic lesions in psoriasis vulgaris patients. Method: This was a crossectional study, that was conducted in RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar around May – July 2022. This study used a consecutive sampling technique, after that the sample was adjusted with the inclusion and exclusion criteria. The data was analyzed by using SPSS version 25. Bivariate analysis used Independent T-Test, for the multivariate analysis used linear regression. Results: This study obtained 28 samples with the majority was male (60.7%). The average age of the sample was 45.68±15.04. The mean TEWL value in the psoriatic lesion group (24.78 ± 4.77) was higher and the mean pH was lower (5.25 ± 0.18) than the non-psoriatic lesion (TEWL:11.75 ± 2.79; pH 5.63 ± 0.21). TEWL and pH ratio between psoriatic lession and non psoriatic lesion is (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). The difference was statistically significant (p<0,01). Conclusion: There was a significant relationship between an increase in TEWL value and a decrease in pH value in the psoriatic group of lesions compared to the non-psoriatic group. Latar Belakang : Psoriasis merupakan penyakit inflamasi kronis pada kulit. Psoriasis dilaporkan memiliki tingkat remisi yang tinggi sebesar 10-60%, dengan risiko depresi, kanker kulit, dan bunuh diri. Inflamasi dapat menyebabkan penurunan hidrasi dan PH kulit, sehingga menyebakan kerusakan barrier kulit. Tujuan dari penelitian ini adalah untuk mengetahui fungsi dan integritas barrier kulit dilihat dari TEWL dan pH pada lesi psoriatic dan non-lesi psoriatic pada pasien psoriasis vulgaris. Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar, dilakukan pada bulan Mei – Juli 2022. Teknik pengambilan sampel yang digunakan yaitu consecutive sampling dan diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah di tentukan. Data di analisis menggunakan SPSS versi 25. Analisis bivariat menggunakan Independent T-Test, dan analisis multivariat yang digunakan menggunakan regresi linear. Hasil : Penelitian ini mendapatkan 28 sampel dengan mayoritas berjenis kelamin laki-laki (60,7%). Rata-rata sampel berusia 45,68±15,04. Rerata nilai TEWL pada pada kelompok lesi psoriatic (24,78 ± 4,77) lebih tinggi dan rerata pH lebih rendah (5,25 ± 0,18) dibandingkan non-lesi psoriatic (TEWL:11,75 ± 2,79; pH 5,63 ± 0,21). Rasio TEWL dan pH lesi psoriatic dibandingkan non-lesi psoriatic adalah (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). Perbedaan tersebut signifikan secara statistik (p<0,01). Simpulan: Adapun kesimpulan dari penelitian ini yakni lesi psoriatic secara signifikan memiliki nilai TEWL yang lebih tinggi namun pH yang lebih rendah dengan rasio TEWL sebesar 2,19 ± 0,11 dan rasio pH sebesar 0,93 ± 0,01.

Introduction: Keloid is an excessive formation of scar tissue (proliferative growth) that appears on the skin that has been traumatized or over a surgical wound and is not in accordance with the severity of the trauma, cannot heal spontaneously, and can recur after excision. Treatment of keloids on the face is difficult and challenging and has consequences for aesthetics. Various types of combination therapy, such as electrosurgery (radiofrequency) followed by frozen surgery (cryotherapy) are recommended to reduce the risk of keloid recurrence. Case Illustration: A 15-year-old male came with the chief complaint of a lump on his face. at the location of the submandibular region found a solitary tumor, with firm boundaries, oval shape, skin color, a diameter of 1 cm, and a smooth and shiny surface. On palpation, the consistency is firm and immobile. On dermoscopy examination, a purple vascular structure was obtained, and arborizing vascular structures were seen. A clinical diagnosis of keloid was given. The treatment was given by radiofrequency electrosection and was followed by cryotherapy for lesions in the submandibular region. Discussion: The combination of radiofrequency and cryotherapy was considered in this case because the location of the keloid lesion was located on the facial area which could reduce the risk of bleeding and also from a cosmetic point of view of the patient. The combination of the 2 therapies also functions to reduce the possibility of recurrence in patients. Conclusion: Radiofrequency and cryotherapy measures show significant clinical improvement; the lesions shrink and soften.

Background: Heavy smokers have four times more facial wrinkles than non-smokers. Superoxide dismutase (SOD) levels are an indicator of premature aging in blood and tissues. The premature aging process can take place more quickly at a relatively younger age. The purpose of this study was to determine smoking and low levels of superoxide dismutase (SOD) as risk factors for premature aging in women aged 20-35 years. Method: Using a case-control study, this study determined smoking and low levels of superoxide dismutase (SOD) as risk factors for premature aging in women aged 20-35. Subjective clinical observation of wrinkles with the smoker’s face criteria (Daniel 1971) and objective use A-One-Facial Analyzer tool. Analyze using SPSS 26. Result: The smoking increased the risk of premature aging by 16 times (OR 16; 95% CI= 4,2-60,7); p<0,001) and passive smoker 36 times (OR 36; IK95% 7,6-168,9; p<0,001). Low SOD levels (<2.93 U/ml) increased the risk of premature aging by 9.7 times (OR 9.7;95%CI =3.2-29.1); p <0.001) and levels of superoxide dismutase (SOD) of smokers were lower than non-smokers with a median (IQR) [min-max] of smokers 1,5 (1,6) [0,4-9,7]U/ml while non-smokers were 7,5 (6,3) [0,1-14,2]U/ml and p<0.001. The results of the multivariate analysis showed that smoking and low SOD as risk factors for premature aging in women aged 20-35 years with smoking (AOR 18; 95%CI=5,5-66,8; p<0,001) and low SOD (AOR 10,2; 95%CI=1,5-67,1; p<0,001). Conclusion: That smoking and low levels of superoxide dismutase (SOD) as risk factors for premature aging in women aged 20-35 years.

Introduction: Leprosy is a contagious disease that has the potential to cause health problems, giving a psychological impact due to discrimination and stigma caused by the disabilities it causes. Leprosy, also known as Morbus Hansen (MH), is a chronic inflammatory disease caused by Mycobacterium leprae (M. leprae), which has obligate intracellular. Apart from bacterial factors, the incidence of leprosy is strongly influenced by the host, immunity status, and also genetic variation. Lepromatous type (LL) leprosy is characterized by the appearance of skin lesions, high bacterial index, nerve damage, and also the production of T helper-2 cytokines, such as interleukin-4, I interleukin-5 and interleukin-10. One of the cytokines that play a role in multibacillary type leprosy is interleukin -10 (IL-10). The aim of this study is to determine the correlation between IL-10 serum with bacterial index in multibacillary type of leprosy. Method: This study was a cross-sectional observational analytic study involving 50 subjects of multibacillary type leprosy, consist of 25 subjects who were receiving MDT therapy and 25 subjects who had completed therapy or release from treatment (RFT). Sample were taken using consecutive sampling and have fulfilled inclusion and exclusion criteria, with age range of 18-65 years. Interleukin-10 serum levels were derived from venous blood sampling that was measured by the ELISA method. Result: The results of this study were significant differences between IL-10 serum levels between MB type of leprosy that receiving therapy and MB type leprosy that had completed therapy with median 22,67 (12,87) dan 2,22 (5,87), p<0,001. In this study, a very strong positive correlation (Spearman Correlation r = 0.974; p <0.001) was found between serum IL-10 levels and the bacterial index. Conclusion: The conclusion of this study is that there is a significant between IL-10 serum levels in multibacillary type leprosy patients who are receiving MDT therapy and who have completed therapy or release from treatment (RFT), and high IL-10 serum levels are correlated with a high bacterial index in patient with multibacillary type of leprosy. Pendahuluan: Kusta merupakan salah satu penyakit menular yang berpotensi menimbulkan masalah kesehatan, memberikan dampak psikologis akibat diskriminasi dan stigma yang disebabkan oleh karena kecacatan yang ditimbulkan. Kusta dikenal juga dengan sebutan Morbus Hansen (MH) merupakan penyakit inflamasi kronik yang disebabkan oleh Mycobacterium leprae (M. leprae), yang memiliki sifat obligat intraseluler. Selain faktor bakteri, kejadian kusta sangat dipengaruhi oleh host yaitu status imunitas, dan juga variasi genetik. Kusta tipe lepromatosa (LL) ditandai dengan munculnya lesi di kulit, indeks bakteri yang tinggi, dan adanya kerusakan saraf, serta adanya produksi berbagai sitokin oleh T helper-2 yaitu interleukin-4, interleukin-5 dan interleukin-10. Salah satu sitokin yang berperan pada kusta tipe multibasiler adalah interleukin-10 (IL-10). Penelitian ini bertujuan untuk mengetahui korelasi IL-10 serum dengan indeks bakteri penderita kusta tipe multibasiler. Metode: Penelitian ini adalah penelitian analitik observasional cross sectional yang melibatkan 50 subjek kusta tipe multibasiler, yang terdiri dari 25 subjek yang sedang mendapat terapi MDT dan 25 subjek yang telah menyelesaikan terapi atau release from treatment (RFT). Pengambilan sampel menggunakan cara consecutive sampling dan telah memenuhi kriteria inklusi dan eksklusi, dengan rentang usia 18-65 tahun. Kadar IL-10 serum berasal dari pengambilan darah vena yang diperiksa dengan metode ELISA. Hasil: Hasil penelitian ini terdapat perbedaan kadar IL-10 serum antara kusta tipe MB yang sedang mendapat terapi dan kusta tipe MB yang telah menyelesaikan terapi secara bermakna dengan nilai median 22,67 (12,87) dan 2,22 (5,87), p<0,001. Pada penelitian ini juga didapatkan korelasi positif sangat kuat (Spearman Correlation r = 0,974; p<0,001) antara kadar IL-10 serum dengan indeks bakteri. Simpulan: Terdapat perbedaan antara kadar IL-10 serum pada penderita kusta tipe multibasiler yang sedang mendapat terapi MDT dan yang telah menyelesaikan terapi atau release from treatment (RFT) secara bermakna, dan kadar IL-10 serum yang tinggi berkorelasi dengan indeks bakteri yang tinggi pada penderita kusta tipe multibasiler.

Introduction: Basal cell carcinoma (BCC) is a malignant neoplasm originating from non-keratinized cells. The incidence increases worldwide and one of the triggering factors is excessive exposure to ultraviolet (UV) rays. The therapy aims to eradicate the tumor and maintain optimal organ function and cosmetic results after the procedure, one of which is the excision technique accompanied by an island pedicle flap. Case Description: A man, 67 years old, came with a complaint of a black lump on the left cheek accompanied by a wound that did not heal. Based on the history, physical examination, and investigations, the patient was diagnosed with mixed type BCC. Excision and wound closure were performed with the island pedicle flap technique. Conclusion: The treatment chosen in this case is surgical excision and island pedicle flap. Although the wound healing is classified as good, the prognosis of the patient is dubius. Considering the location of the lesion and the histopathological results showing an aggressive tumor with a tendency to metastasize, the patient is advised to take precautions. Pendahuluan: Karsinoma sel basal (KSB) adalah neoplasma ganas yang berasal dari sel non keratin. Terjadi peningkatan insiden KSB di seluruh dunia dan salah satu faktor pencetusnya adalah paparan sinar ultraviolet (UV) berlebih. Terapi yang dilakukan bertujuan untuk mengeradikasi tumor serta tetap mempertahankan fungsi organ dan hasil kosmetik yang optimal paska tindakan, salah satunya dalah dengan teknik eksisi yang disertai island pedicle flap. Deskripsi kasus: Seorang laki-laki, usia 67 tahun, datang dengan keluhan benjolan kehitaman pada pipi kiri yang disertai luka yang tidak kunjung sembuh di atas benjolan. Berdasarkan anamnesis, pemeriksaan fisik dan penunjang, pasien terdiagnosis KSB tipe campuran. Dilakukan tindakan eksisi dan penutupan luka dengan teknik island pedicle flap. Simpulan: Tatalaksana yang dipilih pada kasus ini adalah pembedahan eksisi serta island pedicle flap. Meskipun penyembuhan luka tergolong baik, namun prognosis pasien dubius. Mengingat lokasi lesi dan hasil histopatologi yang menunjukkan tumor agresif yang memiliki kecenderungan metastase, pasien disarankan untuk melakukan pencegahan.