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Latar belakang: Skabies merupakan salah satu penyakit kulit yang paling sering ditemui di negara berkembang seperti Indonesia. Ukuran tungau Sarcoptes scabiei sangat kecil sehingga tidak dapat dilihat dengan kasat mata. Diagnosis definitif skabies adalah dengan identifikasi mikroskopis tungau, telur, atau feses tungau. Dermoskopi merupakan alat yang sangat bermanfaat dalam menegakkan diagnosis skabies, namun masih dibutuhan kajian mengenai akurasi dermoskopi di Indonesia terkait kelebihan dan kekurangan untuk penegakan diagnosis skabiesTujuan: Mengetahui sensitivitas dan spesifisitas pemeriksaan dermoskopi pada penegakan diagnosis skabiesMetode: Subjek penelitian adalah santri di Pondok Pesantren di Citeurerup, Bogor. Penelitian dibagi menjadi dua tahap, tahap pertama dilakukan uji inter-rater untuk memastikan peneliti kompeten dalam melakukan pemeriksaan dermoskopi. Tahap kedua menggunakan desain penelitian uji diagnostik potong lintang. Tahap kedua dilakukan satu minggu setelah tahap pertama dengan pengambilan sampel secara konsekutif.Hasil: Pada uji inter-rater antara peneliti dan Spesialis Kulit dan Kelamin SpKK pada 32 subjek penelitian SP didapatkan nilai kappa 0,5. Pada penelitian tahap ke-dua didaptkan hasil spesifisitas dermoskopi sangat baik 90,48 sedangkan sensitivitasnya rendah 44,29 . Nilai duga positif dermoskopi sangat baik 93,94 namun nilai duga negatifnya rendah 32,76 . Rasio kemungkinan positif dermoskopi adalah 4,65 IK 95 1,612-13,42 dan rasio kemungkinan negatif adalah 0,6158 IK 95 0,5793-0,6546 Simpulan: Dermoskopi dapat dijadikan sebagai salah satu pilihan alat yang baik dalam menegakkan diagnosis. Bila pada dermoskopi ditemukan gambaran a jet with contrail, diagnosis dapat langsung ditegakkan, namun bila tidak, perlu dilakukan pemeriksaan konfirmasi lainnya.

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ABSTRACT
Scabies occurs worldwide and can affect everyone. Scabies is one of the most common skin diseases in developing countries such as Indonesia. The size of the Sarcoptes scabiei mite is too small to be seen by the naked eye. The definitive diagnosis of scabies is by microscopic identification of mites, eggs, or scybala. Dermoscopy is a very useful tool in diagnosing scabies. Although there are few advantages and disadvantages to be considered in using dermoscopy to diagnose scabiesObjective To determine the sensitivity and specificity of dermoscopic examination in diagnosis of scabiesMethods The study design is using. Research subjects are students of Pondok Pesantren Al Hidayah. The research is divided into two stages, the initial stage is done inter rater test to ensure the researcher is competent in conducting dermoscopy examination. The second stage is a cross sectional diagnostic test with a consecutive sampling.The second stage is done one week after the first stage.Results The inter rater test between the researcher and dermatovenereologist with 32 subjects result in Kappa 0,5. Second stage with 95 subjects shows the specificity of dermoscopy is very good 90.48 while the sensitivity is low 44.29 . The dermoscopic positive predictive value was very good 93.94 but the negative predictive value is low 32.76 . Positive likelihood ratio of dermoscopy is 4,65 CI 95 1,612 13,42 and negative likelihood ratio of dermoscopy is 0,6158 CI 95 0,5793 0,6546 Conclusion Dermoscopy can be used as a good tool for diagnosis of scabies. If the dermoscopy shows a jet with contrail appearance, patient can be treated directly, but if its not found, examination should be followed by other diagnostic methods.

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Latar belakang: Malassezia sp. berperan penting dalam patogenesis dermatitis seboroik DS . Pada penelitian di negara lain didapatkan M.globosa dan M.restricta sebagai spesies predominan pada lesi kulit kepala DS. Belum diketahui pola sebaran Malassezia pada kulit kepala pasien DS di Indonesia dan hubungannya dengan derajat keparahan DS. Tujuan: Mengetahui distribusi spesies Malassezia pada kulit kepala pasien DS serta hubungan antara derajat keparahan DS dengan spesies Malassezia yang ditemukan. Metode: Studi potong lintang dilakukan di Jakarta dengan cara consecutive sampling. Pada subjek dilakukan anamnesis, pemeriksaan fisis, dan pengambilan sisik dari kulit kepala, kemudian ditumbuhkan pada CHROMagar Malassezia, sub kultur pada agar SDA, Tween-60-esculin, dan reaksi katalase. Hasil : Dari 59 spesimen dengan kultur positif, terdapat 72,1 SP dengan DS ringan dan 27,7 dengan DS sedang-berat. Distribusi M.globosa sebesar 52,1 , M.dermatis 23,2 , M.japonica 7,2 , M.pachydermatis 7,2 , M.sympodialis 2,8 , serta M.obtusa dan M.furfur masing-masing 1,4 dari total 69 isolat. Terdapat 4,3 isolat yang tidak teridentifikasi. Tidak didapatkan hubungan antara derajat keparahan DS dengan spesies Malassezia. Simpulan: M.globosa merupakan spesies Malassezia terbanyak yang diidentifikasi pada pasien DS di Indonesia. Perbedaan hasil dengan negara lain diduga terjadi akibat perbedaan cara identifikasi dan lokasi geografis. Spesies Malassezia tidak mempengaruhi tingkat keparahan DS.

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ABSTRACT
Background Malassezia sp. plays an important role in the pathogenesis of seborrheic dermatitis SD . In some countries, M. restricta and M. globosa are considered the predominant organisms on SD scalp. There is no data about Malassezia sp. in Indonesian SD scalp and its relationship with severity of illness. Objective To identify the distribution of Malassezia sp. of SD scalp and correlation between severity of SD with the Malassezia sp. Methods This cross sectional study conducted in Jakarta, using consecutive sampling. Anamnesis, clinical examination, and scrapping from the scalp were done to subject. Scales inoculated on CHROMagar Malassezia, Saboraud Dextrose Agar SDA , Tween 60 esculin agar, and catalase reaction.Results There were 72,1 mild SD and 27,7 moderate to severe SD. M.globosa was identified in 52,1 , M.dermatis in 23,2 , M.japonica in 8,7 M.pachydermatis in 7,2 , M.sympodialis 2,8 , while M.obtusa and M.furfur contributes 1,4 out of 69 isolates from 59 specimens with positive cultures. There is 4,3 unidentified isolates. Malassezia species was not related to severity of SD. Conclusion M.globosa is the predominant Malassezia species in Indonesian SD patients. This difference may be attributable to the identification techniques and geographical differences. Malassezia species not related to severity of SD.

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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.

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Servisitis klamidia masih menjadi masalah kesehatan yang cukup signifikan di Indonesia karena sulitnya diagnosis pasti klamidia. Pemeriksaan penunjang yang mudah dan murah dilakukan yaitu pewarnaan Gram namun memiliki sensitivitas dan spesifisitas yang rendah. Pemeriksaan baku emas adalah polymerase chain reaction (PCR) namun membutuhkan biaya mahal dan membutuhkan fasilitas laboratorium lengkap. Dibutuhkan sebuah tes cepat untuk mendiagnosis klamidiosis dengan sensitivitas dan spesifisitas yang lebih baik dari pewarnaan Gram. Penelitian ini bertujuan menentukan nilai diagnostik dari QuickStripe™ Chlamydia rapid test (CRT) dalam mendiagnosis servisitis klamidia pada perempuan risiko tinggi di Jakarta. Studi potong lintang ini melibatkan perempuan risiko tinggi, baik simtomatik maupun asimtomatik, yang berada di Balai Rehabilitasi Sosial Eks Watunas Mulya Jaya selama bulan Juni hingga Juli 2020. Apusan endoserviks diambil dari tiap subjek dengan urutan acak untuk pemeriksaan QuickStripe™ CRT, pewarnaan Gram, dan real time PCR. Sebanyak 41 subjek berpartisipasi dalam penelitian ini. Sensitivitas dan spesifisitas QuickStripe™ CRT pada penelitian ini adalah 73,6% (IK 95%: 48,80% sampai 90,85%) dan 81,82% (IK 95%: 59,72% sampai 94,81%), dengan nilai duga positif dan negatif sebesar 77,78% (IK 95%: 58,09% sampai 89,84%) dan 78,05% (IK 95%: 62,39% sampai 89,44%). Proporsi servisitis klamidia berdasarkan real-time PCR pada penelitian ini adalah 46,3%. Sebuah studi menyatakan bahwa penggunaan rapid test dengan sensitivitas suboptimal pada populasi risiko tinggi dapat meningkatkan angka pengobatan dibandingkan penggunaan baku emas yang membutuhkan kunjungan ulang agar pasien mendapatkan pengobatan. Penelitian ini menyimpulkan bahwa QuickStripe™ CRT dapat menjadi alternatif dalam mendiagnosis servisitis klamidia pada perempuan risiko tinggi di Jakarta. .....Chlamydial cervicitis is one of health problems in Indonesia due to difficulty of definitive diagnosis for Chlamydia trachomatis. Gram staining is quick and affordable and usually done to make presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered gold standard but costly, technically demanding and difficult to be performed in low-resource settings. Thus, a rapid test with higher sensitivity and specificity is needed to aid chlamydial cervicitis. This study aims to determine the diagnostic value of QuickStripe™ Chlamydia rapid tests (CRT) in diagnosing chlamydial cervicitis among high-risk women in Jakarta. This cross-sectional study included symptomatic and asymptomatic high risk women in Balai Rehabilitasi Sosial Eks Watunas Mulya Jaya during June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ CRT, Gram staining, and real time PCR. A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48,80% to 90.85%) and 81.82% (95% CI: 59.72% to 94.81%). Positive and negative predictive value were 77.78% (95% CI: 58.09% to 89.84%) and 78.05% (95% CI: 62.39% to 89.44%). Chlamydial cervicitis proportion based on real-time PCR was 46.3% in this study. A modelling study stated that a rapid test with suboptimal sensitivity in a high risk setting can improve rates of treatment compared to a gold standard test that requires return visits for patients to receive results and treatment. We concluded that QuickStripe™ CRT may become alternative diagnostic test among high-risk women in Jakarta.

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Penelitian ini membandingkan efektivitas terapi topikal larutan KOH 10% dengan larutan kantaridin 0,7% terhadap moluskum kontagiosum pada anak, dilihat dari aspek medis dan efektivitas-biaya. Penelitian analitik dengan rancangan uji klinis acak terbuka dilakukan di Divisi Dermatologi Anak poliklinik Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit dr. Cipto Mangunkusumo Jakarta tahun 2012. Pembuatan larutan KOH 10% dilakukan di Departemen Farmasi Fakultas Kedokteran Universitas Indonesia. Hasil penelitian menunjukkan bahwa secara klinis efektivitas larutan KOH 10% lebih baik daripada larutan kantaridin 0,7% dan biaya keseluruhan yang diperlukan lebih rendah. Meskipun demikian, tidak ditemukan perbedaan bermakna secara statistik.

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ABSTRACT
This study compares the effectiveness between topical 10% potassium hydroxide solution and 0,7% cantharidin solution against molluscum contagiosum in children, viewed from the medical and cost-effectiveness aspects. The analytical open randomized clinical trial was conducted in Pediatric Dermatology Division, Dermatovenereology Clinic of dr. Cipto Mangunkusumo Hospital in 2012. The making of 10% potassium hydroxide solution was performed at the Department of Pharmacy Faculty of Medicine, University of Indonesia. Result shows that clinically, 10% potassium hydroxide solution is more effective than 0,7% cantharidin solution with less total cost. There were no statistically significant difference.

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[ABSTRAK
Latar belakang dan tujuan: efek samping radioterapi pada kulit, yang disebut dengan radiodermatitis, merupakan masalah bagi pasien keganasan kepala dan leher yang menjalani radioterapi. Efek samping yang terjadi dapat menurunkan kepatuhan pasien berobat, sehingga dapat meningkatkan angka putus terapi. Dua studi pendahulu telah mempelajari light emitting diode (LED) untuk mengurangi kejadian radiodermatitis dengan hasil yang berlawanan. Penelitian ini ingin mempelajari lebih lanjut mengenai efektivitas LED untuk menurunkan kejadian radiodermatitis. Metode: pada kelompok perlakuan, subjek penelitian (SP) mendapat tambahan fototerapi LED segera setelah radioterapi selesai. Fototerapi LED diberikan selama radioterapi berlangsung. Penilaian derajat radiodermatitis dilakukan oleh peneliti setiap lima kali radioterapi dijalani, menggunakan kriteria menurut Common Terminology Criteria for Adverse Event (CTCAE) yang dimodifikasi. Hasil: kejadian radiodermatitis antara kelompok kontrol dan perlakuan hampir sama dan tidak berbeda bermakna secara statistik. Berdasarkan analisis kecenderungan, terlihat bahwa terjadi peningkatan persentase jumlah SP dengan radiodermatitis pada kelompok kontrol sebesar dua kali lipat saat rerata dosis radiasi kumulatif 34 Gy, sedangkan pada kelompok perlakuan baru meningkat saat rerata dosis radiasi kumulatif 44 Gy. Rasa gatal, lesi eritematosa, dan hiperpigmentasi lebih dahulu dialami oleh kelompok kontrol. Pada pemantauan 2 minggu pasca radioterapi terlihat bahwa persentase SP dengan radiodermatitis menurun lebih cepat pada kelompok perlakuan. Kesimpulan: fototerapi LED tidak dapat menurunkan kejadian radiodermatitis pada pasien keganasan kepala dan leher, namun mempunyai kecenderungan untuk menurunkan kejadian radiodermatitis saat rerata dosis radiasi kumulatif 34 Gy hingga mencapai dosis 44 Gy. Fototerapi LED juga dapat menunda terjadinya rasa gatal, lesi eritematosa, dan hiperpigmentasi, serta mempercepat penyembuhan radiodermatitis. Diperlukan studi lebih lanjut untuk membuktikan hipotesis ini dengan memperhitungkan saran dari peneliti.

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ABSTRACT
Background and objectives: radiation dermatitis remains a common problem in patients with head and neck cancer. This side effect causes discomfort, pain, and may lead to treatment delay. Two previous studies using light emitting diode (LED) phototherapy to prevent radiation dermatitis have been reported, with a completely different result. This study sought to further evaluate the effectiveness of LED phototherapy in lessening radiation dermatitis. Method: in the LED treatment group, all subjects with head and neck cancer received LED phototherapy after each radiation treatment. Reactions were evaluated every five treatments by the author, using the modified Common Terminology Criteria for Adverse Event (CTCAE) criteria. Results: instances of radiodermatitis amongst the control and the treated group has no clinical or statistical differences. Based on trend analysis, the fourth week of the study (mean cumulative radiation dose 34 Gy) shows a two-fold increase in the number of subject developing radiodermatitis in the control group. On the other hand, the treated group experiences an increase in the number of subject developing radiodermatitis on the fifth week (mean cumulative radiation dose 44 Gy). The control group experiences itching sensation, erythematous and hyperpigmented lesion sooner than the treated group. Two weeks after radiation therapy, the percentage of subject experiencing radiodermatitis decreases faster. Conclusions: LED phototherapy did not reduce the incidence of radiation dermatitis, but there is a patterned trend which show LED phototherapy may reduce radiation dermatitis when the mean cumulative radiation dose 34 Gy until it reaches 44 Gy. LED phototherapy tend to delay development of itching sensation, erythematous and hyperpigmented lesion, also accelerate radiodermatitis healing process. Further study needed to prove this hypothesis.;Background and objectives: radiation dermatitis remains a common problem in patients with head and neck cancer. This side effect causes discomfort, pain, and may lead to treatment delay. Two previous studies using light emitting diode (LED) phototherapy to prevent radiation dermatitis have been reported, with a completely different result. This study sought to further evaluate the effectiveness of LED phototherapy in lessening radiation dermatitis. Method: in the LED treatment group, all subjects with head and neck cancer received LED phototherapy after each radiation treatment. Reactions were evaluated every five treatments by the author, using the modified Common Terminology Criteria for Adverse Event (CTCAE) criteria. Results: instances of radiodermatitis amongst the control and the treated group has no clinical or statistical differences. Based on trend analysis, the fourth week of the study (mean cumulative radiation dose 34 Gy) shows a two-fold increase in the number of subject developing radiodermatitis in the control group. On the other hand, the treated group experiences an increase in the number of subject developing radiodermatitis on the fifth week (mean cumulative radiation dose 44 Gy). The control group experiences itching sensation, erythematous and hyperpigmented lesion sooner than the treated group. Two weeks after radiation therapy, the percentage of subject experiencing radiodermatitis decreases faster. Conclusions: LED phototherapy did not reduce the incidence of radiation dermatitis, but there is a patterned trend which show LED phototherapy may reduce radiation dermatitis when the mean cumulative radiation dose 34 Gy until it reaches 44 Gy. LED phototherapy tend to delay development of itching sensation, erythematous and hyperpigmented lesion, also accelerate radiodermatitis healing process. Further study needed to prove this hypothesis., Background and objectives: radiation dermatitis remains a common problem in patients with head and neck cancer. This side effect causes discomfort, pain, and may lead to treatment delay. Two previous studies using light emitting diode (LED) phototherapy to prevent radiation dermatitis have been reported, with a completely different result. This study sought to further evaluate the effectiveness of LED phototherapy in lessening radiation dermatitis. Method: in the LED treatment group, all subjects with head and neck cancer received LED phototherapy after each radiation treatment. Reactions were evaluated every five treatments by the author, using the modified Common Terminology Criteria for Adverse Event (CTCAE) criteria. Results: instances of radiodermatitis amongst the control and the treated group has no clinical or statistical differences. Based on trend analysis, the fourth week of the study (mean cumulative radiation dose 34 Gy) shows a two-fold increase in the number of subject developing radiodermatitis in the control group. On the other hand, the treated group experiences an increase in the number of subject developing radiodermatitis on the fifth week (mean cumulative radiation dose 44 Gy). The control group experiences itching sensation, erythematous and hyperpigmented lesion sooner than the treated group. Two weeks after radiation therapy, the percentage of subject experiencing radiodermatitis decreases faster. Conclusions: LED phototherapy did not reduce the incidence of radiation dermatitis, but there is a patterned trend which show LED phototherapy may reduce radiation dermatitis when the mean cumulative radiation dose 34 Gy until it reaches 44 Gy. LED phototherapy tend to delay development of itching sensation, erythematous and hyperpigmented lesion, also accelerate radiodermatitis healing process. Further study needed to prove this hypothesis.]

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[ABSTRAK
Latar belakang dan tujuan: Keloid merupakan pertumbuhan berlebih dari kolagen dermis yang dapat menimbulkan masalah fisis dan psikis bagi penderitanya. Berbagai pilihan terapi telah digunakan untuk pengobatan keloid. Penelitian ini membandingkan efikasi dan efek samping antara kombinasi triamsinolon asetonid (TA) dan 5-fluorouracil (5-FU) dengan TA intralesi pada terapi keloid. Metode: Studi eksperimen dengan desain single blind randomized controlled trial (RCT) terhadap pasien keloid. Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat kombinasi 5-fluorourasil dan triamsinolon asetonid intralesi, dan kelompok kontrol yang mendapat terapi tunggal triamsinolon asetonid intralesi. Kedua kelompok diberi pengobatan 1 kali perminggu selama 8 minggu dan lesi keloid diukur tinggi dan volume. Hasil: Penurunan tinggi dan volume terjadi pada kedua kelompok. Pada penurunan tinggi, respons baik terjadi pada 75% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,403). Sedangkan pada penurunan volume, respons baik terjadi pada 58,3% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,713). Sebanyak 5 dari 24 SP pada kelompok intervensi mengalami efek samping berupa gatal, nyeri ringan, ulkus dangkal, dan telangiektasi. Sedangkan pada kelompok kontrol terdapat 7 dari 22 SP yang mengeluh gatal, nyeri ringan, dan telangiektasi. Kesimpulan: Secara umum, efikasi dan efek samping kombinasi TA dan 5-FU intralesi sebanding dengan TA saja.

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ABSTRACT
Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid. Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume. Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis. Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid. Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume. Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis. Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid. Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume. Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis. Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone, Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid. Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume. Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis. Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone]

Abstrak :
Latar belakang: Untuk menghasilkan rambut dan kulit kepala yang sehat, produk perawatan harus digunakan dengan frekuensi tepat. Perempuan berhijab semakin umum dijumpai di Indonesia. Saat ini belum ada kesepakatan mengenai frekuensi keramas yang paling tepat pada perempuan berhijab. Oleh karena itu dibutuhkan penelitian yang membandingkan pengaruh frekuensi keramas berbeda terhadap nilai transepidermal water loss (TEWL) dan hidrasi kulit kepala perempuan berhijab. Tujuan: Mengetahui hubungan antara frekuensi keramas dengan nilai TEWL dan hidrasi kulit kepala perempuan yang menggunakan hijab. Metode: Sebanyak 60 perempuan sehat usia reproduksi berhijab menjadi subjek penelitian dan dibagi menjadi dua kelompok, yaitu 30 subjek pada kelompok A (keramas sering, setiap 1-2 hari sekali) dan 30 subjek pada kelompok B (keramas jarang, setiap 3-5 hari sekali). Dilakukan pengukuran nilai TEWL dan hidrasi kulit kepala pada baseline, hari ke-14, dan hari ke-28. Uji kemaknaan perbedaan nilai TEWL dan hidrasi kulit kepala antara kedua kelompok dilakukan menggunakan analisis Mann-Whitney. Hasil: Median nilai TEWL kulit kepala hari ke-14 kelompok A adalah 20,07 g/m2/h dan kelompok B adalah 17,05 g/m2/h (p<0,05). Median nilai TEWL kulit kepala hari ke-28 kelompok A adalah 20,87 g/m2/h dan kelompok B adalah 17,67 g/m2/h (p<0,01). Median nilai hidrasi kulit kepala hari ke-14 kelompok A adalah 8,18 AU dan kelompok B adalah 12,52 AU (p>0,05). Median nilai hidrasi kulit kepala hari ke-28 kelompok A adalah 11,48 AU dan kelompok B adalah 12,77 AU (p>0,05). Kesimpulan: Terdapat hubungan antara frekuensi keramas dengan nilai TEWL kulit kepala perempuan berhijab. Frekuensi keramas yang sering dapat meningkatkan nilai TEWL kulit kepala perempuan berhijab secara bermakna, tetapi tidak terdapat hubungan antara frekuensi keramas dengan nilai hidrasi kulit kepala perempuan berhijab ......Background: To obtain healthy hair and scalp, care product should be used in the right frequency. Women wearing hijab are becoming more common in Indonesia. There is no unified consensus regarding the correct frequency of hair washing in women wearing hijab. Therefore, research is needed to compare the influence of different hair wash frequencies on the scalp skin transepidermal water loss (TEWL) and hydration in women wearing hijab. Objective: To assess the correlation between hair wash frequency with scalp skin TEWL and hydration in women wearing hijab. Methods: Sixty healthy women in reproductive age are recruited and allocated into two groups, 30 subjects in group A (frequent hair wash, every 1-2 days) and 30 subjects in group B (infrequent hair wash, every 3-5 days). Measurements of scalp skin TEWL and hydration was performed on baseline, day-14, and day-28. Significance test of the difference in scalp skin TEWL and hydration scores between groups was done using Mann-Whitney analysis. Results: The day-14 median value of scalp skin TEWL was 20,07 g/m2/h in group A and 17,05 g/m2/h in group B (p<0,05). The day-28 median value of scalp skin TEWL was 20,87 g/m2/h in group A and 17,67 g/m2/h in group B (p<0,01). The day-14 median value of scalp skin hydration was 8,18 AU in group A and 12,52 AU in group B (p>0,05). The day-28 median value of scalp skin hydration was 11,48 AU in group A and 12,77 AU in group B (p>0,05). Conclusion: There is a correlation between hair wash frequency and scalp skin TEWL score in women wearing hijab. Frequent hair wash may significantly increase scalp skin TEWL score in women wearing hijab. However, there is no correlation between hair wash frequency and scalp skin hydration in women wearing hijab

Abstrak :
ABSTRAK
Latar belakang: Erupsi obat alergik EOA tipe sindrom Stevens-Johnson dan nekrolisis epidermal toksik SSJ/NET adalah EOA berat yang jarang terjadi namun dapat mengancam nyawa. Tata laksana utama EOA tipe SSJ/NET saat ini adalah menghentikan pajanan obat penyebab. Di beberapa negara Asia, polimorfisme gen HLA-B telah digunakan sebagai metode skrining pada pemberian obat berisiko tinggi. Tujuan: Mengetahui sebaran obat penyebab dan polimorfisme gen HLA-B pada pasien EOA tipe SSJ/NET di Jakarta. Metode: Studi potong lintang ini dilakukan pada bulan April ndash; Juni 2017 di RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, dan RSUD Tarakan. Pemilihan sampel dilakukan secara total sampling pada pasien EOA tipe SSJ/NET di 5 RS tersebut selama 2 tahun. Dilakukan anamnesis dan penentuan obat dengan algoritma ALDEN dan pemeriksaan typing gen HLA-B dengan metode PCR ndash;SSOP. Hasil: Didapatkan 22 subjek dengan median usia 45,5 tahun dan sebagian besar perempuan. Obat penyebab tersering yang ditemukan adalah karbamazepin. Pada subjek, alel HLA-B yang tersering adalah HLA-B 15:02 dan HLA-B 18:01. Alel HLA-B 15:02 ditemukan pada lima 72 dari tujuh SP dengan obat penyebab karbamazepin. Simpulan: Obat penyebab EOA tipe SSJ/NET yang paling sering ditemukan pada SP adalah karbamazepin, dengan 5 dari 7 SP memiliki gen HLA-B 15:02.

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ABSTRACT
Background Stevens Johnson syndrome and toxic epidermal necrolysis is a very rare but life threatening type of cutaneous drug eruption. The principle management of SJS TEN is withdrawal of causative drug and preventing reexposure to said drug. In other countries in Asia, spesific HLA B allele has already been utilized as a screening method to prevent SJS TEN. Objective to acquire data regarding causative drugs and HLA B allele polymorphism in SJS TEN patient in Jakarta. Method This cross sectional study was performed in RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, and RSUD Tarakan from April to June 2017. The sampling method is total sampling of all patient in all five hospital from March 2015 to March 2017. Subject fulfilling the inclusion and exclusion criteria was interviewed and their blood sample was taken for DNA extraction. The DNA was examined with PCR SSOP and Luminex technology for high resolution HLA B typing. Results We studied 22 subjects. The median age was 45,4 years old 14 74 and female gender predominate. The most common causative drug in this study is carbamazepine. HLA B 15 02 and HLA B 18 01 were the most common allele in all subjects. HLA B 15 02 was found in five 72 out of seven subjects whose condition was caused by carbamazepine. Conclusion The most common causative drug of SJS TEN in five hospitals in Jakarta is carbamazepine, with five 72 out seven subjects had HLA B 15 02 allele.

Abstrak :
Lesi psoriasis pada kulit kepala, wajah, lipatan, kelamin, telapak tangan/kaki, dan kuku sering terlambat terdiagnosis, sulit diterapi, dan menyebabkan disabilitas. Predileksi ini disebut sebagai area yang sulit diobati (hard-to-treat /HTT). Meski lesi pada area HTT umumnya kecil, namun berisiko komorbiditas. Sindrom metabolik (SM) merupakan komorbiditas utama psoriasis. Keparahan psoriasis dinilai dengan Psoriasis Area Severity Index(PASI). Tujuan penelitian ini untuk mengetahui hubungan antara derajat keparahan psoriasis yang memiliki lesi HTT dengan kejadian SM. Penelitian ini merupakan studi observasional analitik dengan disain potong lintang secara multicenter. Dari 84 SP, sebanyak 42 orang memiliki skor PASI<10 (derajat ringan-sedang) dan 42 orang dengan skor PASI >10 (derajat berat). Prevalensi SM ditemukan sebesar 64,3%. Pasien psoriasis HTT derajat berat berisiko 3,6 kali lebih besar untuk mengalami SM dibandingkan dengan derajat ringan-sedang (78,6% vs 50%, OR 3,667; IK 95% 1,413-9,514; p=0,006). Terdapat perbedaan kejadian hipertensi (p=0,028), penurunan kadar high density lipoprotein/HDL (p=0,01), rerata kadar gula darah puasa (p=0,018), dan trigliserida (p=0,044) antara kedua kelompok. Prevalensi SM pada psoriasis HTT derajat berat lebih besar dan secara statistik bermakna dibandingkan dengan derajat ringan-sedang. Proporsi kriteria SM dari yang terbesar secara berturutan adalah obesitas sentral, penurunan kadar HDL, hipertensi, hiperglikemia, dan hipertrigliseridemia.  ......Psoriatic lesions on the scalp, face, intertriginous, genitals, palms, soles, and nails (hard-to-treat/HTT areas) are often delay diagnosed, hard to treat, and cause disability. Despite the small surface of HTT areas, it has risks of comorbidities. Metabolic syndrome (MS) is one of the main comorbidities of psoriasis. The severity of psoriasis was measured by Psoriasis Area Severity Index (PASI). This study aims to assess the association of psoriasis severity that has HTT lesions with the prevalence of SM. It is an analytic observational, multicenter study with a cross-sectional design. From 84 patients, 42 had a PASI score <10 (mild-moderate) and 42 had a PASI score >10 (severe). The prevalence of SM is 64.3%. Patients with severe HTT psoriasis were 3,6 times more likely to have SM compare to mild-moderate group (78.6% vs 50%, OR 3.667; 95% CI 1.413-9.514; p=0.006). The incidence of hypertension (p=0.028), decreased in high density lipoprotein/HDL (p=0.01), mean fasting blood sugar (p=0.018), and triglycerides levels (p=0.044) between two groups were significantly different. Severe HTT psoriasis has higher prevalence of MS and statistically significant compared to mild-moderate group. The highest proportion of SM criteria respectively are central obesity, low levels of HDL, hypertension, hyperglycemia, and hypertriglyceridemia.