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"Berbagai molekul bioaktif yang terdapat dalam sekretom mayoritas merupakan molekul dengan ukuran >20 kDa sehingga sulit untuk melewati epidermis dan menimbulkan efek farmakologis. Metode aplikasi sekretom diduga memiliki peranan terhadap efektivitas sekretom sehingga perlu dilakukan suatu uji klinis untuk membandingkan efektivitas aplikasi sekretom terhadap fungsi sawar kulit yang didahului dengan metode microneedling dan laser fraksional CO₂. Penelitian ini merupakan uji klinis acak terkontrol tersamar tunggal dengan metode split-face yang dilakukan pada wanita berusia 35-59 tahun di Poliklinik Madya, RSUPN dr. Cipto Mangunkusumo. Penilaian transepidermal water loss (TEWL), dan skin capacitance (SCap) dilakukan pada minggu ke-0, 2, dan 4. Pada minggu ke-0 dan ke-2 semua subjek dilakukan microneedling dan laser fraksional CO₂ yang diikuti dengan aplikasi konsentrat sekretom. Sebanyak 12 SP mengikuti penelitian ini dengan rerata usia 46,2 ± 6,45 tahun. Terdapat penurunan kadar TEWL yang bermakna pada kelompok laser fraksional CO₂ (p-value 0,002) dan microneedling (p-value 0,002). Pada analisis lebih lanjut penurunan TEWL bermakna terdapat pada minggu ke-4. Tidak terdapat perubahan kadar TEWL yang signifikan pada kelompok laser fraksional CO₂ dibandingkan dengan microneedling. Terdapat peningkatan kadar SCap pada kelompok laser fraksional CO₂ dan microneedling namun tidak bermakna secara statistik. Tidak terdapat perbedaan perubahan nilai SCap yang signifikan pada sisi laser fraksional CO₂ dibandingkan dengan microneedling. Prosedur laser fraksional CO₂ dan microneedling sebelum pemberian konsentrat sekretom memiliki efektivitas yang serupa dalam memperbaiki fungsi sawar kulit. 

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Most of the various bioactive molecules present in the secretome are molecules with a size of >20 kDa, making it difficult to pass through the epidermis and cause pharmacological effects. Secretome application method is thought to have an important role in the effectiveness of the secretome, so a clinical trial is needed to compare the effectiveness of the secretome application on the skin barrier function which is preceded by the microneedling method and fractional CO₂ laser. A single-blind, randomized split-face was conducted on women aged 35-59 years at Madya Clinic, dr. Cipto Mangunkusumo Hospital. Transepidermal water loss (TEWL) and skin capacitance (SCap) assessments were carried out at weeks 0, 2, and 4. At weeks 0 and 2 all subjects underwent microneedling and fractional CO₂ laser followed by application of secretome concentrate. Twelve participants took part in this study with an average age of 46.2 ± 6.45 years. There was a significant decrease in TEWL levels in the fractional CO₂laser (p-value 0,002) and microneedling (p-value 0,002) groups. Significant decreases in TEWL were found at week 4. There was no significant change in TEWL levels in fractional CO₂ laser group compared to microneedling. There was an increase in SCap levels in fractional CO₂ laser and microneedling groups but it was not statistically significant. There was no significant difference in SCap value changes on the CO₂ fractional laser side compared to microneedling. Fractional CO₂ laser and microneedling procedures prior to administration of secretome concentrate have similar effectiveness in improving skin barrier function"

"ABSTRAKLatar Belakang. Dermatitis pada tangan akibat kerja DTAK bersifat kronis, memiliki prognosis buruk, dan berdampak signifikan terhadap aspek psikososial dan pekerjaan. Prevalensi dermatitis kontak pada tenaga kerja bongkar muat TKBM Pelabuhan Sunda Kelapa Jakarta adalah sebesar 24,3 , dengan lesi di tangan 47,1 . Penggunaan alat pelindungdiri APD masih belum cukup untuk mengatasi masalah ini, sehingga dibutuhkan intervensi lain. Penggunaan pelembap untuk memperbaiki sawar kulit dipertimbangkan efektif untuk mencegah keparahan DTAK.Metode. Penelitian ini adalah kuasi eksperimental satu kelompok. Intervensi dilakukan dengan menggunakan gliserin 10 dalam vaselin album sekali sehari setelah bekerja selama 14 hari.Hasil. Rerata nilai transepidermal water loss TEWL setelah intervensi 11,4 3,8 g/m2/jam lebih rendah dibandingkan rerata nilai TEWL awal 14,2 4 g/m2/jam , dengan perbedaan rerata nilai TEWL sebesar 2,8 2,9 g/m2/jam p= 0,000 95 CI 1,5-4,1 . Median nilai hand eczema severity index HECSI setelah intervensi 9,5 3-34 lebih rendah dibandingkan median skor HECSI awal 29,5 6-80 , dengan perbedaaan rerata skor HECSI sebesar 19,5 -2-46 p= 0,000 . Korelasi antara perubahan nilai TEWL dan perubahan skor HECSI tidak bemakna p= 0,476 dengan kekuatan korelasi sangat lemah r= 0,160 . Variabel exposure rating tahunan debu semen berhubungan dengan perubahan skor HECSI p= 0,002 . Setelah intervensi seluruh lesi di jari-jari, telapak tangan, punggung tangan dan pergelangan tangan mengalami perbaikan yang bermakna.

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ABSTRACT

Background. Occupational hand dermatitis OHD is chronic, has a poor prognosis, and significantly affects psychosocial and occupational aspects. The prevalence of contact dermatitis of loading dockworkers at Port Sunda Kelapa Jakarta was 24,3 and 47,1 lesion was on the hands. The use of personal protective equipment PPE is deemed inadequate to solve this problem, thus requiring other intervention. Using moisturizer for improvement of skin barrier is considered to be effective for preventing severity of occupational hand dermatitis.Method. The study design was quasi experimental one group pre and post test design. The 14 days intervention was performed on the loading dockworkers by instructing them to apply 10 glycerin in vaseline album on their hands once daily after working.Result. The mean value of transepidermal water loss TEWL after intervention 11.4 3.8 g m2 hour was lower than the mean value of TEWL before the intervention 14.2 4 g m2 hour . The TEWL mean difference was 2.8 2.9 g m2 hour p 0.000 95 CI 1.53 4.1 . The median value of hand eczema severity index HECSI after intervention 9.5 3 34 was lower than the median value of HECSI before the intervention 29,50 6 80 . The HECSI mean difference was 19.5 2 46 p 0,000 . The correlation between TEWL changes and HECSI changes was not significant p 0.476 and the correlation strength was very weak r 0.160 . Annual exposure rating of cement dust associated with the HECSI changes p 0,002 . After intervention, all lesions on the fingers, palms, back of hand and wrist were significantly improved p 0,05 , except for the finger tips. Additional analysis showed that the commonly found morphology of the lesion was infiltrate papule, scaling and erythema. After intervention, the severity score of the morphology lesions was also significantly decreased p 0,05 .Conclusion. Once daily application of 10 glycerin in vaseline album for 14 days could improved skin barrier function and the severity of OHD, thus can be advised for loading dockworkers with high annual exposure rating of cement dust. "