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Abstrak :
Latar Belakang: Photoaging dapat mengakibatkan terjadinya penuaan kulit dini, kerutan kasar, hilangnya elastisitas dan kelenturan, tekstur kulit menjadi tidak rata, keratosis, serta perubahan pigmentasi kulit. Individu yang secara geografis tinggal di daerah sering terpajan sinar matahari lebih rentan mengalami photoaging, contohnya di area pesisir. Pengukuran photoaging menggunakan Skala Glogau, sedangkan pengukuran pajanan sinar matahari menggunakan sun index. Tujuan: Menganalisis profil photoaging berdasarkan skala Glogau dan korelasinya dengan riwayat pajanan matahari menggunakan sun index pada masyarakat pesisir. Metode: Merupakan studi deskriptif analitik dengan desain potong-lintang. Populasi target penelitian adalah orang berusia ≥20 tahun dengan kulit tipe Fitzpatrick III, IV, atau V, serta berisiko tinggi photoaging dengan rerata pajanan sinar matahari ≥ 3 jam perhari. Subjek penelitian (SP) diambil dengan metode consecutive sampling berdasarkan kriteria penerimaan dan penolakan. Analisis statistik dilakukan untuk membuktikan hipotesis penelitian. Nilai p<0,05 dianggap signifikan secara statistik. Hasil: Diantara 55 SP, 3 orang termasuk dalam Skala Glogau II, 42 orang dalam Skala Glogau III, dan 10 orang dalam Skala Glogau IV. Mayoritas memiliki kerutan yang tetap ada saat wajah tidak bergerak, paling banyak pada regio dahi 74,5%, nasolabial 70,9%, dan sudut mata 69,1%. Perubahan pigmentasi paling dominan ditemukan adaalah diskromnia (65,5%), serta tidak ditemukan keratosis aktinik pada mayoritas SP (98,2%). Diperoleh nilai median sun index sebesar 10,91, dan median BSA yang terpajan matahari sebesar 20,50%. Rerata total durasi pajanan matahari adalah 53,63 jam/minggu. Didapatkan korelasi lemah namun tidak bermakna secara statistik antara sun index dengan keparahan derajat photoaging berdasarkan Skala Glogau (r = 0,205; p = 0,134). Dari data tambahan didapatkan korelasi positif lemah yang bermakna antara lamanya pajanan matahari per minggu dan keparahan derajat photoaging berdasarkan Skala Glogau (r = 0,281; p = 0,038), serta didapatkan korelasi positif sedang yang bermakna antara usia dan derajat keparahan photoaging berdasarkan Skala Glogau (r = 0,631; p < 0,001). Didapatkan keratosis seboroik pada hampir seluruh SP, terutama pada kelompok Glogau tipe III (77,3%). Lebih banyak ditemukan SP yang tidak merokok pada Glogau II (100%) dan III (57,1%), sedangkan Glogau IV lebih banyak pada pasien merokok (80%). Didapatkan pula Glogau II dan III lebih banyak pada perempuan (100% dan 59,5%), sedangkan Glogau IV lebih banyak pada laki-laki (80%). Kesimpulan: Berdasarkan klasifikasi photoaging menurut Glogau, 3 orang termasuk dalam Skala Glogau II, 42 dalam Skala Glogau III, dan 10 dalam Skala Glogau IV. Tidak terdapat korelasi yang bermakna antara sun index dengan keparahan derajat photoaging berdasarkan Skala Glogau. ......Background: Photoaging can cause premature skin aging, coarse wrinkles, loss of elasticity, uneven skin texture, keratosis, and skin pigmentation changes. Individuals who geographically live in areas frequently exposed to sunlight are more susceptible to photoaging, for example in coastal areas. Photoaging was classified using Glogau scale and sun exposure was measured by sun index. Aim: To analyze the photoaging profile based on Glogau Scale and its correlation with the history of sun exposure using sun index in coastal population. Method: This is an analytic descriptive study witha cross-sectional design. The target population for this study were people aged ≥20 years with skin types Fitzpatrick III, IV, or V, and at high risk of photoaging with an average sun exposure of ≥ 3 hours per day. The research subjects were taken by consecutive sampling method based on acceptance and rejection criteria. Appropriate statistical analysis was performed to prove the research hypothesis. P value of <0.05 is considered statistically significant. Results: Among 55 subjects, 3 people are included in the Glogau II cathegory, 42 people in the Glogau III, and 10 people in the Glogau IV. Majority have wrinkles at rest, the most wrinkles were found in forehead region 74.5%, nasolabial 70.9%, and crow’s feet 69.1%. The most dominant pigmentation changes were dyschromia (65.5%), and no actinic keratosis was found in the majority subjects (98.2%). The median sun index value was 10.91, and the BSA median exposed to the sun was 20.50%. The average total duration of sun exposure was 53.63 hours/week. In additional data, there a was weak correlation but not statically significant between sun index and the severity of photoaging based on the Glogau Scale (r = 0.205; p = 0.134). A significant weak correlation was obtained between sun exposure per week and the severity of photoaging based on the Glogau Scale (r = 0.281; p = 0.038), and a significant moderate correlation was obtained between age and the severity of photoaging based on the Glogau Scale (r = 0.631; p < 0.001). Seborrheic keratosis was found in almost all subjects, especially in the Glogau type III group (77.3%). There were more non-smokers in Glogau type II (100%) and III (57,1%), while type IV was more common in smoking patients (80%). It was also found that type II and III Glogau were more common in women (100% and 59,5%), while type IV Glogau were more common in men (80%). Conclusion: Based on Glogau photoaging scale, 3 people are included in the Glogau II category, 42 people in the Glogau III, and 10 people in the Glogau IV. There was no significant correlation between sun index and the severity of photoaging based on the Glogau Scale.

Abstrak :
Latar belakang: Keratosis seboroik (KS) merupakan salah satu tumor jinak epidermis yang paling sering ditemukan. Pada penelitian baru mengenai KS, vitamin D berperan melalui banyak mekanisme nongenomik, termasuk ekspresi protein dan mutasi gen FGFR3. Defisiensi vitamin D mengakibatkan gangguan proliferasi dan diferensiasi, sehingga mempengaruhi jumlah dan ukuran lesi KS. Di sisi lain pajanan matahari juga merupakan faktor yang mempengaruhi baik kadar serum 25-hydroxyvitamin D (25(OH)D) maupun terhadap munculnya lesi KS. Pengukuran pajanan sinar matahari dapat dilakukan dengan berbagai cara, salah satunya dengan menggunakan sun index. Sampai saat ini belum ada penelitian mengenai hubungan antara kadar serum 25(OH)D dan sun index dengan jumlah dan ukuran lesi KS. Tujuan: Mengetahui hubungan kadar serum 25-Hydroxyvitamin D dan sun index (indeks pajanan matahari) dengan jumlah dan ukuran lesi keratosis seboroik pada wajah di Poliklinik Kulit dan Kelamin, RSUPN Dr. Cipto Mangunkusumo Metode: Penelitian potong lintang ini melibatkan 50 pasien KS yang direkrut secara consecutive sampling pada bulan Desember 2018 hingga Mei 2019. Pasien yang memenuhi kriteria akan dilakukan anamnesis dan pengisian kuesioner sun index, pemeriksaan fisis, penilaian jumlah dan ukuran terbesar lesi KS di wajah dengan FotoFinder® dan dermoskopi, serta pemeriksaan laboratorium kadar serum 25(OH)D. Dilakukan analisis data untuk mengetahui korelasi kadar serum 25(OH)D dan sun index dengan jumlah dan ukuran terbesar lesi KS pada wajah dengan uji Pearson jika sebaran data normal atau uji Spearman jika sebaran data tidak normal. Hasil: Median kadar serum 25(OH)D SP sebesar 10,3 (3,9-24,2) ng/mL. Median nilai sun index adalah 1,3 (0,3-16,2). 94% SP mengalami defisiensi kadar serum 25(OH)D dan 6% mengalami insufisiensi kadar serum 25(OH)D. Terdapat korelasi bermakna dengan kekuatan sedang antara kadar serum 25(OH)D dengan sun index (p=0,009, r=0,367). Median jumlah lesi KS pada wajah sebesar 28 (8-87) lesi dan meningkat sesuai dengan peningkatan kelompok usia. Median ukuran terbesar lesi KS sebesar 3,5(1-9,5) mm dan meningkat sesuai dengan peningkatan kelompok usia. Tidak terdapat korelasi antara kadar serum 25(OH)D dengan jumlah dan ukuran terbesar lesi KS pada wajah (p=0,178, r=0,194 dan p=0,164, r=0,2). Terdapat korelasi bermakna antara sun index dengan jumlah dan ukuran terbesar lesi KS pada wajah (p<0,001, r=0,517 dan p<0,001, r=0,451) Kesimpulan: Kadar serum 25(OH)D ditemukan di bawah nilai normal (defisiensi dan insufisiensi) pada seluruh SP. Hasil penelitian membuktikan bahwa semakin tinggi kadar serum 25(OH)D, tidak menyebabkan semakin sedikit jumlah dan semakin kecil ukuran lesi KS di wajah. Namun semakin tinggi nilai sun index, maka akan menyebabkan semakin banyak jumlah dan semakin besar ukuran lesi KS di wajah ......Background: Seborrheic keratoses (SK) is one of the most common benign epidermal tumors. Recent study on SK, vitamin D is involved through many nongenomic interactions, including changes in protein and mutations in the FGFR3 gene. Decreased on vitamin D causes disorder of proliferation and differentiation, thus affecting the number and size of SK lesions. On the other hand, sun exposure is also a factor that affects the levels of 25-hydroxyvitamin D (25(OH)D) as well as the SK lesions. Measurement of sunlight exposure can be done in various ways, one of them is by using the sun index. Until now there has been no research on the relationship between 25(OH)D serum and sun index with the number and size of SK lesions. Objective: To assess the relationship of 25-hydroxyvitamin D levels and sun index (sun exposure index) with number and size of seborrheic keratoses lesions on the face in Dermatovenereology Clinic , Dr. Cipto Mangunkusumo National General Hospital. Methods: This cross-sectional study involved 50 SK patients that recruited by consecutive sampling in December 2018 to May 2019. Patients who met the criteria will be analyzed and filled in with the sun index questionnaire, physical examination, assessment of the number and size of SK lesions on the face with FotoFinder® and dermoscopy, and laboratory tests for 25(OH)D serum levels. Data analysis was performed to determine the correlation of serum 25 (OH) D and sun index levels with the number and size of SK lesions on the face with Pearson test if the data distribution is normal or Spearman test if the data distribution is not normal. Result: The median 25(OH)D serum level is 10.3 (3.9-24.2) ng/mL. The median sun index value is 1.3 (0.3-16.2). 94% of SP had deficiencies and 6% experienced insufficiency of serum 25(OH)D levels. There was a significant correlation with moderate strength between 25(OH)D serum levels and sun index (p = 0.009, r = 0.367). The median number of SK lesions on the face was 28 (8-87) lesions and increased according to the increase in age groups. The median largest size of SK lesions was 3.5 (1-9.5) mm and increased according to the increase in age groups. There is no correlation between 25(OH)D serum levels and the largest number and size of SK lesions on the face (p = 0.178, r = 0.194 and p = 0.164, r = 0.2). There is a significant correlation between the sun index and the largest number and size of SK lesions on the face (p <0.001, r = 0.517 and p <0.001, r = 0.451) Conclusion: 25(OH)D serum levels were found below normal (deficiency and insufficiency) in all subject. The results showed that the higher 25(OH)D serum levels did not cause the smaller the number and the smaller the size of KS lesions on the face. But higher sun index value correlate on the number and size of SK lesions on the face.

Abstrak :
Keratosis Seboroik (KS) merupakan salah satu tumor jinak epidermis dengan faktor risiko utama pajanan matahari yang berlebihan. Selain pajanan matahari, defisiensi vitamin D diduga berperan pada patogenesis KS. Defisiensi vitamin D dapat disebabkan pajanan matahari yang kurang maupun kurangnya asupan vitamin D. Daerah pesisir memiliki karakteristik pajanan matahari yang tinggi. Oleh karena itu, diperlukan penelitian yang menilai hubungan kadar vitamin D (kalsidiol serum) pasien KS di daerah pesisir dengan pajanan matahari (sun index) dan asupan vitamin D. Penelitian ini bersifat deskriptif-analitik dengan desain potong lintang. Dilakukan wawancara dengan menggunakan kuesioner sun index, food frequency questionnaire semikuantitatif vitamin D, pemeriksaan fisis dan dermoskopi untuk menilai ukuran terbesar lesi KS, serta pengukuran kadar kalsidiol serum pada 39 individu usia 19-59 tahun di Kecamatan Cilincing, Jakarta Utara. Median ukuran lesi KS adalah 2 mm; median nilai sun index adalah 3,95; median kadar kalsidiol serum sebesar 14,3 ng/ml, dan median asupan vitamin D adalah 4,3 mcg/hari. Tidak ditemukan korelasi yang bermakna antara sun index dan kadar kalsidiol dengan ukuran lesi KS, serta sun index dan asupan vitamin D dengan kadar kalsidiol pada masyarakat pesisir tersebut. ......Seborrheic keratosis (SK) is a benign epidermal tumor with high sun exposure as a major risk factor. In addition, vitamin D deficiency is thought to play a role in the pathogenesis of SK. Vitamin D deficiency can be caused by insufficient sun exposure or a lack of vitamin D intake. Coastal areas are characterized by high sun exposure. Therefore, research assessing the relationship of vitamin D levels of SK patients living in a coastal area with sun exposure and vitamin D intake needs to be done. This is an analytic-descriptive cross-sectional study. We performed interview using sun index questionnaire; semi quantitative food frequency questionnaire for vitamin D; physical examination and dermoscopy to determine the largest diameter of SK lesions; and measurement of serum calcidiol levels in 39 individuals with 19-59 years age living in Cilincing District, North Jakarta. The Spearman correlation test was used to assess the relationship between variables. Median of the largest SK lesions size, sun index, serum calcidiol, and vitamin D intake were 2 mm, 3.95, 14.3 ng/ml, and 4.3 mcg/day, respectively. There were no significant correlations between sun index and calcidiol level with SK lesion size, as well as sun index and vitamin D intake with calcidiol level in this coastal population.