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Abstrak :
Latar belakang: Hampir sebagian besar pasien kanker akan memiliki keluhan kulit, rambut, dan kuku (KRK) terkait efek samping kemoterapi yang diberikan. Antrasiklin merupakan kemoterapi yang banyak digunakan pada pasien kanker. Meskipun jarang mengancam nyawa, kelainan KRK dapat menyebabkan penurunan kualitas hidup. Berbagai faktor risiko berpengaruh terhadap kelainan tersebut. Waktu timbulnya manifestasi kelainan KRK pada pasien kanker yang menjalani kemoterapi berbasis antrasiklin juga beragam munculnya. Penelitian ini bertujuan untuk menganalisis hubungan antara usia, penyakit penyerta sistemik, status gizi, ECOG, dan anemia dengan manifestasi klinis KRK pada pasien kanker yang menjalani dua siklus kemoterapi berbasis antrasiklin. Metode: Penelitian ini merupakan penelitian deskriptif analitik dengan kohort prospektif yang diikuti dalam dua siklus pertama kemoterapi berbasis antrasiklin. Sebesar 65 pasien kanker berusia di atas 18 tahun yang mendapatkan kemoterapi siklus pertama berbasis antrasiklin di RSUPN dr. Cipto Mangunkusumo. Semua SP dilakukan anamnesis, pemeriksaan dermatovenereologikus, dan dokumentasi klinis sampai sebelum kemoterapi siklus ke-3. Pencatatan faktor risiko, jenis, dan waktu timbulnya kelainan dilakukan apabila ditemukan manifestasi KRK. Hasil: Kelainan kulit terbanyak berupa xerosis dan hiperpigmentasi. Anagen effluvium ditemukan pada 89,2% pasien kemoterapi. Melanonikia dan xanthonikia ditemukan pada 87,7% pasien. Xerosis ditemukan dengan median (minimum-maximum) 7 (2-56) hari, anagen effluvium timbul dalam median (minimum-maximum) 13(1-27 hari), dan melanonikia dengan median (minimum-maximum) 23(1-65) hari. Tidak terdapat hubungan antara usia, penyakit penyerta sistemik, status gizi, status performa ECOG, dan anemia dengan manifestasi KRK pada pasien kanker yang menjalani dua siklus kemoterapi berbasis antrasiklin. Kesimpulan: Semua pasien memiliki kelainan KRK. Kelainan yang paling cepat timbul adalah xerosis, diikuti anagen effluvium, dan melanonikia. Tidak ditemukan hubungan antara usia, penyakit penyerta sistemik, status gizi, status performa ECOG, dan anemia dengan manifestasi KRK pada pasien kanker yang menjalani dua siklus kemoterapi berbasis antrasiklin. ......Background: Nearly most cancer patients experience skin, hair, and nail complaints due to chemotherapy side effects. Anthracycline-based chemotherapy is widely utilized in cancer care. While rarely life-threatening, cutaneous, hair, and nail alterations can significantly impact quality of life. Several risk factors influence these disorders. The onset timing of skin, hair, and nail manifestations varies among cancer patients undergoing anthracycline-based chemotherapy. This study analyses the association between age, systemic comorbidities, nutritional status, ECOG performance status, and anaemia with clinical manifestations of skin, hair, and nails in cancer patients undergoing two cycles of anthracycline-based chemotherapy. Methods: This is an analytical descriptive study involving a prospective cohort followed during the first two cycles of anthracycline-based chemotherapy. A total of 65 cancer patients aged above 18, receiving the first cycle of anthracycline-based chemotherapy at RSUPN dr. Ciptomangunkusumo, were enrolled. All subjects underwent anamnesis, dermatovenereological examination, and clinical documentation before the third chemotherapy cycle. Risk factors, type, and onset time of abnormalities were recorded upon detection of skin, hair, and nail manifestations. Results: All patients presented with skin, hair, or nail abnormalities. The most rapidly occurring abnormalities were xerosis, followed by anagen effluvium and melanonychia. No correlation was found between age, systemic comorbidities, nutritional status, ECOG performance status, and anaemia with skin, hair, and nail manifestations in cancer patients undergoing two cycles of anthracycline-based chemotherapy. Conclusions: The most frequent skin abnormalities observed were xerosis and hyperpigmentation. Anagen effluvium was detected in 89.2% of chemotherapy patients. Melanonychia and xanthonychia were found in 87.7% of patients. Xerosis had a median (min-max) onset of 7 (2-56) days, anagen effluvium manifested within a median (min- max) of 13 (1-27) days, and melanonychia with a median (min-max) onset of 23 (1-65) days. There was no association found between age, systemic comorbidities, nutritional status, ECOG performance status, and anaemia with skin, hair, and nail manifestations in cancer patients undergoing two cycles of anthracycline-based chemotherapy.

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 :
Latar belakang: Skabies adalah penyakit kulit akibat infestasi ektoparasit berupa tungau Sarcoptes scabiei var hominis. Transmisi terjadi melalui kontak kulit secara langsung dan kontak dengan fomite. Risiko penularan skabies tinggi di komunitas yang tinggal bersama, contohnya asrama, pondok pesantren, panti jompo, dll. Prinsip tata laksana skabies meliputi penggunaan skabisid untuk pasien dan narakontak secara serempak. Sediaan permetrin merupakan pilihan utama, dengan tingkat kesembuhan 61,1% pada hari ketujuh. Blacksoap® adalah produk sabun yang diakui sebagai pendamping terapi skabies. Sampai saat ini belum ada penelitian mengenai efektivitas dan efek samping penggunaan Blacksoap®. Tujuan: Membandingkan proporsi kesembuhan skabies dan efek samping pada kelompok yang mendapatkan kombinasi krim permetrin dan Blacksoap® dan kelompok yang mendapatkan kombinasi krim permetrin dan sabun bayi; membandingkan skor VAS gatal dan TEWL sebelum dan sesudah pemberian terapi pada kedua kelompok. Metode: Sebuah uji klinis acak tersamar tunggal dilakukan di Pondok Pesantren Al Islami, Cibinong, Bogor pada September hingga Oktober 2018. Terdapat 78 orang santri yang memenuhi kriteria penelitian, tetapi hanya 69 subjek penelitian (SP) menyelesaikan penelitian. Alokasi kelompok dilakukan secara cluster randomization berdasar tempat tinggal. Kelompok intervensi mendapatkan krim permetrin 5% dan Blacksoap®, sedangkan kelompok kontrol mendapatkan krim permetrin 5% dan sabun bayi. Dilakukan pemeriksaan kerokan kulit, skor VAS gatal dan TEWL. Subjek penelitian kemudian di follow-up pada minggu ke-1 dan minggu ke-4 untuk menilai kesembuhan, skor VAS gatal, TEWL, dan efek samping pengobatan.  Hasil: a minggu pertama lebih rendah dibanding kelompok kontrol (75% vs. 81,1%), proporsi kesembuhan kelompok intervensi pada minggu ke-4 lebih tinggi dibanding kelompok kontrol (96,9% vs. 91,9%). Tidak terdapat perbedaan bermakna skor VAS gatal pada kelompok intervensi dan kontrol pada minggu ke-1 (p=0,793) dan minggu ke-4 (p=0,123). Tidak terdapat perbedaan bermakna median dan perubahan skor TEWL pada kelompok kontrol dan intervensi pada minggu ke-1 dan minggu ke-4.  Tidak terdapat perbedaan efek samping bermakna pada kedua kelompok. Kesimpulan: Efektivitas pengobatan skabies sebanding antara penambahan atau tanpa Blacksoap®. Perbaikan skor VAS dan TEWL, serta efek samping penambahan Blacksoap® sebanding dengan tanpa Blacksoap®. ......Background: Scabies is a skin disease due to ectoparasitic infestation in the form of Sarcoptes scabiei var hominis. Transmission occurs through direct skin contact and contact with fomite. The transmission risk is high among communities living together, such as dormitories, boarding schools, nursing homes, etc. The principles of scabies management include the use of scabicide for patients and close contact simultaneously. Permethrin cream is the first line therapy, with a cure rate of 61.1% on the seventh day. Blacksoap® is a soap product which is recognized as an adjuvant to scabies therapy. Until now there has been no research on the effectiveness and side effects of using Blacksoap®. Objectives: To compare the cure rate of scabies treatment with standard therapy with and without Blacksoap®, to compare itch intensity using visual analogue scale (VAS) score and transepidermal water loss (TEWL) score before and after receiving therapy between two groups, and to evaluate the side effects of the therapy. Methods: A single-blind randomized controlled trial was conducted in Cibinong, Bogor, from September to October 2018. A total of 78 students were eligible for the study's criteria. In the end, there were only 69 samples finished the study. Cluster randomization was done to allocate the samples. Intervention group obtained standard therapy and Blacksoap®, meanwhile control group obtained standard therapy and baby soap. Skin scrapings, pruritus VAS score and TEWL score were assessed. Follow up was done on 1st and 4th week to assess the cure rate, pruritus VAS score, TEWL score and the side effect of therapy. Results: The cure rate of intervention group was lower compared to that of control group on the first week (75% vs. 81,1%). The cure rate of intervention group is higher compared to that of control group on the fourth week (96,9% vs. 91,9%).  There is no significant difference of pruritus VAS score and TEWL score between two groups on the first and fourth week. There is no significant difference of side effects between two group on the first and forth week. Conclusion: The effectiveness of scabies treatment was similar between standard therapy with or without Blacksoap®. Decrease of VAS, TEWL score and side effects were similar between two groups on the first and fourth week.