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Abstrak :
Latar belakang: Akne vulgaris AV adalah penyakit inflamasi kronik yang ditandai adanya lesi polimorfik di area predileksi AV. Tatalaksana AV terdiri dari terapi standar dan terapi adjuvan. Salah satu terapi adjuvan yang selalu diberikan pada pasien AV adalah frekuensi cuci wajah AV. Sampai saat ini, rekomendasi frekuensi cuci wajah pasien dengan AV di negara tropis adalah berdasarkan rekomendasi umun dan pendapat ahli. Tujuan: Mengetahui efektivitas frekuensi cuci wajah sebagai terapi adjuvan pada akne vulgaris derajat ringan dan sedang. Metode: Uji klinis acak buta tunggal dilakukan terhadap mahasiswa AV di Klinik UI Makara pada bulan Mei hingga Juni 2018. Mahasiswa yang memenuhi kriteria penerimaan dan tidak memenuhui kriteria penolakan serta bersedia ikut dalam penelitian mendapat perlakuan berupa frekuensi cuci wajah 2 kali dan 3 kali per hari sesuai hasil randomisasi. Seluruh SP memperoleh terapi standar dan pembersih wajah yang sama. Jumlah lesi AV, kadar sebum, nilai TEWL, serta efek samping pada wajah SP akan dinilai selama 6 minggu dan evaluasi dilakukan pada minggu ke-3 dan minggu ke-6. Analisis hasil penelitian dilakukan dengan metode intention to treat. Hasil: Diperoleh total 36 subjek penelitian. Pada penelitin ini terdapat 1 SP drop out yaitu SP pada kelompok cuci wajah 2 kali per hari. Efektivitas frekuensi cuci wajah 3 kali per hari tidak berbeda bermakna dengan 2 kali per hari dalam penurunan jumlah lesi AV dengan median 23 (0-62) dibandingkan 20 (0-37), p = 0,341. Tidak terdapat perbedaan bermakna antara frekuensi cuci wajah 3 kali dibandingkan 2 kali per hari dalam hal penurunan kadar sebum, peningkatan nilai TEWL dan efek samping yang terjadi. Kesimpulan: Tidak terdapat perbedaan efektivitas frekuensi cuci wajah 3 kali per hari dibandingkan 2 kali per hari sebagai terapi adjuvan dalam hal penurunan jumlah lesi AV pada wajah mahasiswa AVR dan AVS yang mendapat terapi standar.

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Background: Acne vulgaris (AV) is a chronic inflammatory disease characterized by polymorphic lesions in the predilection area. Management of AV consists of standard therapy and adjunctive therapy. One of the adjunctive therapies that must be given to AV patients is the frequency of face washing. Recently, the recommendation of face washing frequency for AV patients in tropical countries is based on the general recommendation and expert opinion. Objective: To evaluate the effectiveness of face washing frequency as an adjuvant therapy on mild and moderate AV. Methods: A single blind randomized clinical trial was conducted on AV students at UI Makara Clinic from May to June 2018. Students who met the criteria of acceptance and did not meet the criteria of rejection and were willing to join the study were treated 2 and 3 times per day according to randomization. All participants were given standard therapy and same cleanser. AV lesions counts, sebum level, TEWL scores, and side effects on participant face would be assessed within six weeks by evaluating at week-3 and week-6. The analysis of study result was done by intention-to-treat method. Result: The total of 36 participants was recruited. In this study, there was 1 participant dropped out from the twice-per-day face washing group. There was no significant difference from the thrice-per-day and twice-per-day groups in terms of decreasing of total AV lesions with median 23 (0-62) versus 20 (0-37), p = 0,341. In addition, there was no significant difference in terms of decreasing sebum level, increasing of TEWL score, and adverse events. Conclusion: There was no difference in effectiveness of face washing frequency 3 times per day compared to 2 times per day with regard to decrease AV lesions in the face of mild and moderate AV students receiving standard therapy.

Abstrak :

Akne vulgaris (AV) adalah penyakit inflamasi yang kronis pada bagian pilosebasea.  Pada umumnya akne terjadi pada masa pubertas, dewasa muda, dan banyak terjadi pada remaja. AV mempengaruhi 85% dewasa muda usia 12-25 tahun dan secara konsisten menduduki “the top three most prevalence skin condition“ dalam populasi umum Salah satu faktor yang mempengaruhi timbulnya akne vulgaris dan yang masih menjadi perebatan adalah faktor nutrisi. Dengan menggunakan cut-off <20 ng/mL, prevalensi defisiensi vitamin D bervariasi antara 6-70% di Asia Tenggara, hasil penelitian di Malaysia lebih dari setengah (58%) jumlah remaja memiliki 25(OH)D <50 nmol/L. Penelitian ini merupakan studi potong lintang yang membandingkan nilai rerata kadar vitamin D serum antara dua kelompok derajat akne pada remaja siswa sekolah menengah atas usia 15-18 tahun di kota Depok. Jumlah subjek total 60 orang terbagi dalam 2 kelompok, 30 orang kelompok akne vulgaris ringan (AVR) dan 30 orang akne vulgaris sedang-berat (AVS). Rerata kadar vitamin D serum subjek adalah 17,29±6,77 ng/ml. Sebanyak 21 subjek (35%) berada pada kondisi sufisiensi vitamin D dan 39 subjek (65%) berada dalam kondisi insufisiensi-defisiensi (terdiri dari 43,3% insufisiensi, 21,7% defisiensi). Kadar rerata vitamin D serum pada kelompok AVR 15,45±6,7 ng/ml dan pada AVS 19,13±6,8 ng/ml dengan p=0,034.

Kesimpulan : hasil penelitian ini menunjukkan ada hubungan yang bermakna antara kadar vitamin D serum dengan akne vulgaris. vitamin D serum.

 

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Acne vulgaris is a chronic inflammatory disease as a part of pilosebaceus. In general acne occurs during puberty, but it can also occur in young adults, and many occur in adolescents. Acne vulgaris affects 85% of young adults aged 12-25 years and consistently occupies "the top three most prevalence skin conditions" in the general population. One of the factors that influence acne vulgaris and which is still a debate pro and contra are nutritional factors. This study aims to find a relationship between vitamin D serum level and the degree of acne in adolescents. Previous researches that linked vitamin D levels with acne was not conclusive, especially in adolescents. This is a cross-sectional study that compares the mean values of serum vitamin D levels between two groups of acne levels in adolescents of high school students aged 15-18 years in the city of Depok. The total number of subjects was 60 people divided into 2 groups, 30 people in the group of mild acne vulgaris and 30 people with moderate-severe acne vulgaris. The mean of vitamin D level of the subject serum was 17.29 ± 6.77 ng / ml. The mean of vitamin D serum level in the mild group was 15.45 ± 6.7 ng / ml and moderate group was 19.13 ± 6.8 ng / ml with p = 0.034. A significant association was found between serum vitamin D levels and the degrees of acne vulgaris.

Conclusion: there is a significant relationship between serum vitamin D levels and degree of acne vulgaris. The mean of vitamin D level are lower in mild acne group than in moderate group

Abstrak :
[ABSTRAK
Latar belakang dan tujuan: Akne vulgaris (AV) adalah penyakit peradangan menahun unit pilosebasea yang bersifat swasirna, ditandai dengan lesi pleomorfik berupa papul, komedo, pustul, dan nodul. Pengobatan AV memerlukan waktu yang cukup lama. Penyakit menahun dengan waktu pengobatan yang lama, berdampak terhadap kepatuhan pasien. Kepatuhan pengobatan topikal lebih rendah daripada sistemik. Hanya akne vulgaris ringan (AVR) yang diterapi menggunakan obat-obatan topikal saja. Layanan pesan singkat merupakan salah satu cara yang praktis dan efisien dalam upaya meningkatkan kepatuhan pengobatan AV, dengan pertimbangan prevalensi AV lebih banyak pada usia remaja dan dewasa muda yang merupakan pengguna terbanyak layanan tersebut. Dengan layanan ini, diharapkan pasien tidak lupa menggunakan obat topikal pada AVR. Penelitian ini dilakukan untuk mengetahui efektivitas penggunaan pesan singkat elektronik terhadap kepatuhan pengobatan AVR.

Metode: Studi eksperimen dengan desain randomized controlled trial (RCT) terhadap pasien AVR usia 15-25 tahun yang berobat ke Poliklinik Ilmu Kesehatan Kulit dan Kelamin (IKKK) Rumah Sakit dr. Cipto Mangunkusumo (RSCM). Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat pesan singkat elektronik dan kelompok kontrol. Kedua kelompok diberi pengobatan tretinoin krim 0,05% dan/atau klindamisin gel 1,2% selama 6 minggu.

Hasil: Tidak terdapat perbedaan bermakna antara kepatuhan pengobatan AVR kelompok kontrol dengan kelompok intervensi pada minggu kedua (p=0,376) dan keempat (p=0,432). Namun pada minggu keenam, kelompok intervensi secara bermakna lebih patuh daripada kelompok kontrol (p=0,032).

Kesimpulan: Pesan singkat elektronik meningkatkan kepatuhan pengobatan AVR terutama pada minggu keenam di Poliklinik IKKK RSCM.

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ABSTRACT
Background and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy.

Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks.

Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032).

Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy. Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy. Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital., Background and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy. Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.]

Abstrak :
Latar Belakang: Akne vulgaris AV adalah peradangan kronis pilosebasea yang terutama dijumpai pada remaja dan dewasa muda. Peranan diet pada patogenesis AV terus menjadi perdebatan. Salah satu mikronutrien yang diduga berperan dalam patogenesis AV adalah vitamin A atau retinol. Tujuan: Mengetahui kadar retinol serum dan korelasinya dengan derajat keparahan AV, serta asupan vitamin A pasien AV. Metode: Studi potong lintang dengan 20 subjek penelitian SP yang direkrut secara consecutive sampling. Kadar retinol serum diukur menggunakan high performance liquid chromatography HPLC, sedangkan asupan vitamin A dinilai dengan metode food frequency questionnaire FFQ semikuantitatif. Hasil: Rerata kadar retinol serum kelompok AVR, AVS, dan AVB yaitu 0,962 SB 0,145 mol/L, 0,695 SB 0,054 mol/L, dan 0,613 SB 0,125 mol/L. Terdapat korelasi bermakna antara kadar retinol serum dengan derajat keparahan AV r = -0,798, p = 0,000. Rerata asupan vitamin A per hari pada kelompok AVR, AVS, dan AVB sebesar 476,21 SB 221,32 g, 823,71 SB 221,32 g, dan 780,99 SB 530,45 g. Simpulan: Kadar retinol serum ditemukan rendah pada kelompok AVS dan AVB. Hasil penelitian ini membuktikan semakin rendah kadar retinol serum, semakin berat derajat keparahan AV. Tidak terdapat perbedaan asupan vitamin A di antara ketiga kelompok. ...... Background: Acne vulgaris AV is a chronic inflammation of pilosebaceus that is primarily found in adolescents and young adults. The role of diet in the pathogenesis of AV continues to be a debate. One of micronutrients alleged in the pathogenesis of AV is vitamin A or retinol. Objective: This study aims to know the levels of serum retinol and its correlation with the degree of severity of the AV, as well as the patient 39 s intake of vitamin A. Method: This cross sectional study included 20 subjects divided into mild, moderate, and severe groups based on Lehman rsquo s classification. Serum retinol levels measured using high performance liquid chromatography, whereas the intake of vitamin A was assessed by semiquantitative food frequency questionnaire method. Results: The mean serum retinol levels of mild, moderate, and severe groups were respectively 0.962 SD 0.145 mol L, 0.695 SD 0.054 mol L, and 0.613 SD 0.125 mol L. There was significant correlation between serum retinol levels with the degree of severity of the AV r 0.798, p 0.000. The mean intake of vitamin A per day of mild, moderate, and severe groups were respectively 476.21 SD 221.32 g, 823.71 SD 221.32 g, and 780.99 SD 530.45 g. Conclusion: Levels of serum retinol found lower on the moderate and severe groups. The results has proven that the lower the levels of serum retinol, the more severe the degree of severity of the AV. There was no difference in vitamin A intake among the three groups.

Abstrak :
Latar belakang: Akne vulgaris AV adalah penyakit kulit yang ditandai dengan terjadinya sumbatan dan peradangan kronik pada unit pilosebasea. Penelitian sebelumnya tentang kadar lipid darah pada pasien AV menunjukkan hasil yang bervariasi. Lipid darah diduga memengaruhi aktivitas kelenjar sebasea. Tujuan: Mengetahui korelasi antara kadar lipid darah dan kadar sebum dengan derajat keparahan AV, serta mengetahui korelasi kadar lipid darah dengan kadar sebum kulit wajah. Metode: Studi potong lintang ini dilakukan terhadap 30 pasien AV non-obesitas, yang terbagi berdasarkan tiga derajat keparahan AV. Dilakukan pemeriksaan kolesterol total, trigliserida, LDL, HDL darah dan kadar sebum kulit wajah pada SP. Hasil: Terdapat korelasi yang bermakna antara kadar sebum dengan derajat keparahan AV r = 0,6689, p = 0,0001 . Tidak terdapat korelasi antara kadar kolesterol total, trigliserida, LDL, HDL darah dengan derajat keparahan AV. Tidak terdapat korelasi antara sebum kulit wajah dengan kadar kolesterol total, trigliserida, LDL, HDL darah. Kesimpulan: Hasil penelitian ini menunjukkan bahwa kadar lipid darah tidak memengaruhi keparahan AV dan kadar sebum, sedangkan peningkatan kadar sebum kulit wajah dapat meningkatkan keparahan AV. Kata kunci: akne vulgaris; kadar sebum; lipid darah. ...... Acne vulgaris is a common chronic skin disease involving blockage and inflammation of pilosebaceous units. Previous studies about blood lipids in acne patients revealed variable results. Blood lipids were considered affecting sebum production. Objective: To identify the correlation between blood lipids, sebum excretion rate and acne severity. This study also determines the correlation between blood lipids and sebum excretion rate. Methods: This study was conducted at Dr. Cipto Mangunkusumo Hospital in Jakarta. This was a cross sectional study with total of 30 non obese AV patients. The patients were divided into 3 groups based on the severity of AV. Total cholesterol, triglycerides, LDL, HDL serum and sebum excretion rate were measured. Results: The results revealed significant correlation between sebum excretion rate and severity of acne vulgaris r 0,6689, p 0,0001 . There were no correlation between total cholesterol, LDL, triglycerides, HDL and acne severity. Blood lipids had no correlation with sebum excretion rate. Conclusion: The results of this study has proven that blood lipids does not affect the severity of acne and sebum excretion rate. While increased sebum secretion would increase acne severity. Keywords acne vulgaris blood lipids sebum excretion.

Abstrak :
ABSTRAK
Latar belakang dan tujuan. Penggunaan antibiotik pada akne vulgaris (AV) saat ini dihadapi permasalahan resistensi Propionibacterium acnes (PA) dan bakteri lain yang berperan pada AV. Data pola resistensi AVS dan AVB di RS Cipto Mangunkusumo (RSCM) tahun 2006 menunjukkan adanya resistensi PA terhadap eritromisin (63,2%), klindamisin (57,9%), dan tetrasiklin (47,4%). Tidak ditemukan PA yang resisten terhadap doksisiklin maupun minosiklin. Penggunaan antibiotik pada AV dapat menyebabkan perubahan pola resistensi sehingga penelitian ini bertujuan memberikan data terbaru mengenai pola bakteri dan resistensinya terhadap antibiotik lini pertama pada AVS dan AVB di Departemen Ilmu Kesehatan Kulit dan Kelamin RSCM, yaitu tetrasiklin, doksisiklin, minosiklin, klindamisin dan eritromisin. Metode. Penelitian ini merupakan penelitian deskriptif dengan desain potong lintang. Spesimen untuk kultur dan uji resistensi didapatkan dari ekstraksi komedo tertutup yang selanjutnya dibiakkan secara aerob dan anaerob. Pemeriksaan uji resistensi dilakukan secara kuantitatif dengan menggunakan MIC strip test. Hasil. Dari 91 subjek, bakteri yang ditemukan terdiri atas PA 11,0%, Staphylococcus epidermidis (SE) 50,5%, Staphylococcus aureus (SA) 7,7% dan bakteri lain sebesar 40,7% (aerob) dan 19,8% (anaerob). Sebagian kecil PA (10%) resisten terhadap tetrasiklin, klindamisin, dan eritromisin. Tidak ditemukan PA yang resisten terhadap doksisiklin dan minosiklin. Bakteri SE resisten terhadap eritromisin (65,2%), klindamisin (52,2%), tetrasiklin (32,6%), dan doksisiklin (4,3%). Tidak ditemukan SE yang resisten terhadap minosiklin. Sebagian kecil SA resisten terhadap eritromisin (28,6%), doksisiklin (14,3%) dan klindamisin (14,3%). Tidak ditemukan SA yang resisten terhadap tetrasiklin dan minosiklin. Kesimpulan. Bakteri yang ditemukan pada pasien AVS dan AVB antara lain, Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, dan Staphylococcus aureus 7.7%. Bakteri paling banyak ditemukan resisten terhadap eritromisin dan ketiga bakteri tersebut seluruhnya masih sensitif terhadap minosiklin. ABSTRACT
Background and objective: The resistance of Propionibacterium acnes (PA) and other bacteria that implicated in acne vulgaris (AV), has been a problem in AV therapy. The latest data in the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin (63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance to doxycycline and minocycline. The use of antibiotics may cause changes in susceptibility. This study aimed to provide the latest bacterial profile and resistance pattern to first-line antibiotics used in moderate and severe AV: tetracycline, doxycycline, minocycline, clindamycin and erythromycin. Methods: This is a descriptive, cross-sectional study. Specimens were extracted from closed comedones and cultured in media for aerobic and anaerobic bacteria. Antibiotic resistance was measured quantitatively using MIC strip test. Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcus epidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and other bacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) was resistant to tetracycline, clindamycin, and erythromycin but not to doxycycline and minocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%), tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A small number of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) and clindamycin (14.3%) but not to tetracycline and minocycline. Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted of Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, and Staphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, but still completely sensitive to minocycline. ;Background and objective: The resistance of Propionibacterium acnes (PA) and other bacteria that implicated in acne vulgaris (AV), has been a problem in AV therapy. The latest data in the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin (63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance to doxycycline and minocycline. The use of antibiotics may cause changes in susceptibility. This study aimed to provide the latest bacterial profile and resistance pattern to first-line antibiotics used in moderate and severe AV: tetracycline, doxycycline, minocycline, clindamycin and erythromycin. Methods: This is a descriptive, cross-sectional study. Specimens were extracted from closed comedones and cultured in media for aerobic and anaerobic bacteria. Antibiotic resistance was measured quantitatively using MIC strip test. Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcus epidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and other bacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) was resistant to tetracycline, clindamycin, and erythromycin but not to doxycycline and minocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%), tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A small number of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) and clindamycin (14.3%) but not to tetracycline and minocycline. Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted of Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, and Staphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, but still completely sensitive to minocycline. ;Background and objective: The resistance of Propionibacterium acnes (PA) and other bacteria that implicated in acne vulgaris (AV), has been a problem in AV therapy. The latest data in the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin (63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance to doxycycline and minocycline. The use of antibiotics may cause changes in susceptibility. This study aimed to provide the latest bacterial profile and resistance pattern to first-line antibiotics used in moderate and severe AV: tetracycline, doxycycline, minocycline, clindamycin and erythromycin. Methods: This is a descriptive, cross-sectional study. Specimens were extracted from closed comedones and cultured in media for aerobic and anaerobic bacteria. Antibiotic resistance was measured quantitatively using MIC strip test. Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcus epidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and other bacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) was resistant to tetracycline, clindamycin, and erythromycin but not to doxycycline and minocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%), tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A small number of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) and clindamycin (14.3%) but not to tetracycline and minocycline. Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted of Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, and Staphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, but still completely sensitive to minocycline. ;Background and objective: The resistance of Propionibacterium acnes (PA) and other bacteria that implicated in acne vulgaris (AV), has been a problem in AV therapy. The latest data in the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin (63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance to doxycycline and minocycline. The use of antibiotics may cause changes in susceptibility. This study aimed to provide the latest bacterial profile and resistance pattern to first-line antibiotics used in moderate and severe AV: tetracycline, doxycycline, minocycline, clindamycin and erythromycin. Methods: This is a descriptive, cross-sectional study. Specimens were extracted from closed comedones and cultured in media for aerobic and anaerobic bacteria. Antibiotic resistance was measured quantitatively using MIC strip test. Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcus epidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and other bacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) was resistant to tetracycline, clindamycin, and erythromycin but not to doxycycline and minocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%), tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A small number of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) and clindamycin (14.3%) but not to tetracycline and minocycline. Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted of Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, and Staphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, but still completely sensitive to minocycline.

Abstrak :
Latar belakang: Akne vulgaris (AV) merupakan kelainan kulit akibat peradangan kronik folikel pilosebasea yang sering dijumpai pada remaja dan dewasa muda. Pada pasien perempuan didapatkan prevalensi AV yang lebih tinggi dan dampak psikososial yang lebih berat. Beberapa studi meneliti terdapat hubungan antara peningkatan kadar homosistein dengan derajat keparahan AV, namun peran homosistein dalam patogenesis AV masih belum jelas. Kadar homosistein ditentukan oleh multifaktor sehingga temuan di Indonesia dapat berbeda dibandingkan penelitian terdahulu. Secara fisiologis, kadar homosistein pada perempuan lebih rendah dari laki-laki. Tujuan: Mendapatkan data kadar homosistein plasma pada pasien perempuan dengan AV ringan (AVR), AV sedang (AVS), dan AV berat (AVB) serta mengetahui korelasi kadar homosistein plasma dengan berbagai derajat keparahan AV. Metode: Studi potong lintang dilakukan terhadap 46 subjek penelitian (SP), direkrut secara consecutive sampling, yang terdiagnosis AV berdasarkan kriteria Lehmann pada bulan April-Juni 2019. Setiap SP akan diambil darahnya untuk dilakukan pemeriksaan kadar homosistein plasma dengan metode chemiluminescent microparticle immuno assay (CMIA). Hasil: Pada pasien perempuan dengan AV didapatkan rerata kadar homosistein plasma kelompok AVR, AVS, dan AVB yaitu 7,39 (1,84) μmol/L, 7,14 (1,73) μmol/L, dan 6,95 (1,14) μmol/L. Terdapat korelasi negatif lemah yang tidak bermakna antara kadar homosistein plasma dengan derajat keparahan AV (r=-0,0964, p=0,524). Kesimpulan: Kadar homosistein plasma ditemukan lebih rendah pada kelompok AVS dan AVB. Dari hasil penelitian didapatkan bahwa semakin rendah kadar homosistein plasma, maka semakin berat derajat keparahan AV. ......Background: Acne vulgaris (AV) is a skin disorder caused by chronic inflammation of pilosebaceus that is primarily found in adolescents and young adults. In female patient, there is a higher prevalence of AV and more severe psychosocial impact. Several studies have investigated association between the levels of serum homocysteine and severity of AV, but the role of homocysteine in AV is not clearly understood. Homocysteine levels are thought to be affected by varying factors, so it is assumed that homocysteine levels in Indonesian people will yield a different results. Physiologically, female has a lower homocysteine levels. Objective: This study aims to know the levels of homocysteine plasma in female patients suffering from mild, moderate, and severe AV, also its correlation with the degree of AV severity. Methods: This cross-sectional study included 46 subjects, recruited by consecutive sampling, who have been diagnosed with AV based on Lehmann criteria on April-June 2019. Blood sample will be taken from each subject to measure homocycsteine plasma levels by using chemiluminescent microparticle immuno assay method (CMIA). Results: In female patients, the mean plasma homocycteine levels of mild, moderate, and severe groups were respectively 7,39 (1,84) μmol/L, 7,14 (1,73) μmol/L, and 6,95 (1,14) μmol/L. There was no significant corelation between plasma homocysteine levels and the degree of acne severity (r=-0,0964, p=0,524). Conclusion: Levels of plasma homocysteine was found lower on moderate and severe AV groups. The lower the levels of plasma homocysteine, the more severe the the degree of acne severity.

Abstrak :
Akne vulgaris (AV) adalah suatu penyakit peradangan kronik folikel pilosebasea dengan gambaran klinis berupa komedo, papul, pustul, nodus, kista, dan jaringan parut. Akne vulgaris merupakan masalah kulit tersering di dunia dan dapat mengenai 85% orang pada kelompok usia 12-24 tahun.2 Walaupun AV bukan merupakan penyakit yang mengancam jiwa serta sebagian besar dapat mengalami resolusi spontan, namun AV dapat menimbulkan gejala sisa berupa jaringan parut yang akan membuat pasien merasa tidak percaya diri, marah, bahkan depresi. Berdasarkan data rekam medis Paliklinik Divisi Dermatologi Kosmetik Departemen Ilmu Kesehatan Kulit & Kelamin Rumah Sakit dr. Cipto Mangunkusumo (IKKK RSCM), terdapat kenaikan insidens AV tipe ringan dari 18,11% pada tahun 2003 menjadi 38,26% pada tahun 2004, AV tipe sedang 28,45% tahun 2003 menjadi 50% tahun 2004, dan AV tipe berat dari 4,23% pada tahun 2003 menjadi 9,14% pada tahun 2004. Sampai saat ini etiologi AV belum diketahui.3.7 Beragam faktor diduga sebagai etiologi penyakit ini.8 Akne vulgaris merupakan penyakit multifaktorial yang gambaran klinisnya bergantung pada interaksi banyak faktor.9 Empat faktor kunci yang diduga berperan dalam patogenesis AV adalah hiperproliferasi dan hiperkeratinisasi folikular, peningkatan produksi sebum, proliferasi mikroorganisme serta proses inflamasi. Mikroorganisme yang diduga terlibat dalam patogenesis AV adalah Propionibacterium aches (PA), Staphylococcus epidermidis (SE), dan Malassezia furfur (MF). Propionibactenum acnes merupakan mikroorganisme yang paling dominan dan berperan penting menimbulkan inflamasi pada AV dengan menghasilkan enzim dan faktor kemotaktik serta dapat menstimulasi aktivasi komplemen melalui jalur klasik dan alternatif. Proporsi kepositivan kuman PA pada pasien AV tipe sedang dan berat sampai saat ini belum diketahui. Pemberian antibiotik oral bertujuan untuk menurunkan jumlah PA serta menurunkan produksi enzim dan faktor kemotaktik oleh PA, sehingga menurunkan kemungkinan terjadi inflamasi. Antibiotik juga dapat berperan sebagai anti-inflamasi. Antibiotik oral biasanya diberikan pada pasien AV tipe sedang dan berat menurut kiasifikasi yang diadopsi oleh Regional Consensus on Acne Management pada tahun 2003 di Ho Chi Minh City dari artikel yang ditulis Lehmann dkk. (2002). Beberapa antibiotik oral yang digunakan dalam terapi AV adalah tetrasiklin, eritromisin, klindamisin, azitromisin, doksisiklin, minosiklin, siprofloksasin serta kotrimoksasoi.

Abstrak :
Latar Belakang: Prevalensi akne vulgaris (AV) pada perempuan dewasa tinggi dengan morbiditas psikososial bermakna. Akne vulgaris yang timbul saat remaja dan berlanjut hingga umur lebih dari 25 tahun disebut sebagai AV menetap (AVM). Hormon androgen memiliki peranan terpenting dalam patogenesis AVM. Indeks Androgen Bebas (IAB) adalah metode yang bagus untuk mengevaluasi kadar hormon androgen. Perbedaan ras berpengaruh pada variasi kadar hormon androgen antara individu. Tujuan: Untuk mengetahui perbandingan nilai IAB dalam darah pada perempuan dewasa dengan AVM dan tanpa AV. Metode: Penelitian kasus kontrol. Hasil: Nilai IAB dalam darah pada perempuan dewasa dengan AVM memiliki median 1,93 (minimum 0,46 - maksimum 9,88). Nilai IAB dalam darah pada perempuan dewasa tanpa AV memiliki median 1,05 (minimum 0,24 - maksimum 2,42). Nilai IAB dalam darah pada perempuan dewasa dengan AVM lebih tinggi dibandingkan tanpa AV, dengan perbedaan yang bermakna secara statistik (p=0,014). Kesimpulan: Nilai IAB dalam darah pada perempuan dewasa dengan AVM lebih tinggi dibandingkan tanpa AV. ...... Background: The prevalence of acne vulgaris (AV) in adult women is high with significant psychosocial morbidity. Acne vulgaris which occur in adolescence and continue until age more than 25 years is mentioned as persistent acne vulgaris (PAV). Androgen hormone has the most important role in PAV pathogenesis. Free Androgen Index (FAI) is a good methode to evaluate androgen hormone level. Race difference influent the variation of androgen hormone level between individual. Objective: To investigate the comparison of blood FAI in adult women with PAV and without AV. Methods: Case control study. Result: The blood FAI in adult women with PAV has median 1,93 (minimum 0,46 - maksimum 9,88). The blood FAI in adult women without AV has median 1,05 (minimum 0,24 - maksimum 2,42). The blood FAI in adult women with PAV is higher than without AV, with difference which is statisticaly significant. (p=0,014). Conclusion: The blood FAI in adult women with PAV is higher than without AV.

Abstrak :
Latar belakang: Akne vulgaris AV adalah penyakit kulit yang ditandai dengan terjadinya sumbatan dan peradangan kronik pada unit pilosebasea. Penelitian sebelumnya tentang kadar lipid darah pada pasien AV menunjukkan hasil yang bervariasi. Lipid darah diduga memengaruhi aktivitas kelenjar sebasea. Tujuan: Mengetahui korelasi antara kadar lipid darah dan kadar sebum dengan derajat keparahan AV, serta mengetahui korelasi kadar lipid darah dengan kadar sebum kulit wajah. Metode: Studi potong lintang ini dilakukan terhadap 30 pasien AV non-obesitas, yang terbagi berdasarkan tiga derajat keparahan AV. Dilakukan pemeriksaan kolesterol total, trigliserida, LDL, HDL darah dan kadar sebum kulit wajah pada SP. Hasil: Terdapat korelasi yang bermakna antara kadar sebum dengan derajat keparahan AV r = 0,6689, p = 0,0001 . Tidak terdapat korelasi antara kadar kolesterol total, trigliserida, LDL, HDL darah dengan derajat keparahan AV. Tidak terdapat korelasi antara sebum kulit wajah dengan kadar kolesterol total, trigliserida, LDL, HDL darah. Kesimpulan: Hasil penelitian ini menunjukkan bahwa kadar lipid darah tidak memengaruhi keparahan AV dan kadar sebum, sedangkan peningkatan kadar sebum kulit wajah dapat meningkatkan keparahan AV. ...... Background: Acne vulgaris is a common chronic skin disease involving blockage and inflammation of pilosebaceous units. Previous studies about blood lipids in acne patients revealed variable results. Blood lipids were considered affecting sebum production. Objective: To identify the correlation between blood lipids, sebum excretion rate and acne severity. This study also determines the correlation between blood lipids and sebum excretion rate. Methods: This study was conducted at Dr. Cipto Mangunkusumo Hospital in Jakarta. This was a cross sectional study with total of 30 non obese AV patients. The patients were divided into 3 groups based on the severity of AV. Total cholesterol, triglycerides, LDL, HDL serum and sebum excretion rate were measured. Results: The results revealed significant correlation between sebum excretion rate and severity of acne vulgaris r 0,6689, p 0,0001 . There were no correlation between total cholesterol, LDL, triglycerides, HDL and acne severity. Blood lipids had no correlation with sebum excretion rate. Conclusion: The results of this study has proven that blood lipids does not affect the severity of acne and sebum excretion rate. While increased sebum secretion would increase acne severity.