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Latar Belakang: Melasma merupakan bercak hiperpigmentasi yang sebagian besar terdapat pada wajah. Penelitian sebelumnya menunjukkan bahwa kadar hormon tiroid secara bermakna lebih tinggi pada pasien melasma. Akan tetapi, belum terdapat penelitian yang menjelaskan perbedaan kadar hormon tiroid pada gradasi derajat keparahan melasma.

Tujuan: Mengetahui perbandingan kadar hormone tiroid pada derajat melasma yang berbeda yaitu pada melasma ringan atau sedang-berat yang dinilai dengan mMASI dan Janus II facial analysis system.

Metode: Empat puluh delapan perempuan disertakan sebagai subjek penelitian potong lintang ini. Sampel dipilih menggunakan metode consecutive sampling. Subjek dinilai derajat keparahan melasma secara subjektif menggunakan skor mMASI di Poliklinik Kulit dan Kelamin RSUPN Cipto Mangunkusumo setelah diagnosis ditegakkan. Pemeriksaan dikonfirmasi menggunakan alat Janus II facial analysis system di RSPAD Gatot Subroto. Subjek penelitian kemudian diperiksa hormon tiroid FT4 dan TSH.

Hasil: Berdasarkan skor mMASI, 24 pasien (50%) didiagnosis sebagai melasma derajat ringan dan 24 pasien (50%) didiagnosis sebagai melasma derajat sedang. Sebanyak 2 pasien (4%) juga didiagnosis dengan hipertiroid subklinis dan 1 pasien (2%) didiagnosis dengan hipotiroid subklinis. Tidak ditemukan hubungan yang bermakna antara derajat melasma berdasarkan mMASI dengan kadar TSH dan FT4 serum. Pemeriksaan Janus menggunakan modalitas cahaya polarisasi memiliki korelasi positif dengan kadar FT4 serum (r = 0,3, p = 0,039) dan skor mMASI (r = 0,314, p = 0,03).

Kesimpulan: Tidak terdapat perbedaan kadar TSH serum antar berbagai derajat melasma berdasarkan penilaian mMASI dan Janus II facial analysis system. Kadar FT4 serum memiliki korelasi positif dengan hasil penilaian Janus II facial analysis system menggunakan modalitas cahaya polarisasi.

 

 

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Background:

Melasma is characterized by hypermelanosis manifested mostly on facial area. Previous studies have shown that thyroid hormone level was significantly higher in melasma patient. However, no studies has defined comparison of thyroid hormone level on varying severity of melasma yet.

Aim

To study comparison of thyroid hormone level across varying severity of melasma, between mild and moderate-severe melasma, evaluated using mMASI and Janus II facial analysis system.

Metode:

Forty eight women included in this cross-sectional study. Samples were included using consecutive sampling method. The severity of melasma was measured subjectively using mMASI score in Dermatology and Venereology Outpatient Clinic of Cipto Mangunkusumo General National Hospital after the diagnosis of melasma has been made. The measurement was confirmed using Janus II facial analysis system in Gatot Subroto General Army Hospital. Lastly, we measured the level of FT4 and TSH of each patients.

Results:

Based on mMASI score, 24 patients (50%) were diagnosed as mild melasma and 24 patients (50%) were diagnosed as moderate-severe melasma. As many as two patients (4%) were also diagnosed with subclinical hyperthyroidism and one patient (2%) with subclinical hypothyroidism. There is no assosciation between severity of melasma and level of TSH and FT4. Janus examination using polarisasi light modalities has weak positive correlation with level of FT4 (r = 0,3, p – 0,039) and darkness score of mMASI (r = 0,3, p = 0,03).

Conclusion:

There is no association between TSH and varying severity of melasma. Using mMASI and Janus. FT4 level has weak positive correlation with Janus facial analysis system examiniton results on polarisasi light modalities.

 

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"[ABSTRAKLatar 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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ABSTRACTBackground 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]"

"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. 

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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."

"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

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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"

"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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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."