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"[ABSTRAKLatar belakang dan tujuan: Akne vulgaris (AV) adalah penyakit peradangan menahun unit pilosebasea yang bersifat swasirna, ditandai dengan lesi pleomorfik berupa papul, komedo, pustul, dan nodul. Pengobatan AV memerlukan waktu yang cukup lama. Penyakit menahun dengan waktu pengobatan yang lama, berdampak terhadap kepatuhan pasien. Kepatuhan pengobatan topikal lebih rendah daripada sistemik. Hanya akne vulgaris ringan (AVR) yang diterapi menggunakan obat-obatan topikal saja. Layanan pesan singkat merupakan salah satu cara yang praktis dan efisien dalam upaya meningkatkan kepatuhan pengobatan AV, dengan pertimbangan prevalensi AV lebih banyak pada usia remaja dan dewasa muda yang merupakan pengguna terbanyak layanan tersebut. Dengan layanan ini, diharapkan pasien tidak lupa menggunakan obat topikal pada AVR. Penelitian ini dilakukan untuk mengetahui efektivitas penggunaan pesan singkat elektronik terhadap kepatuhan pengobatan AVR.Metode: Studi eksperimen dengan desain randomized controlled trial (RCT) terhadap pasien AVR usia 15-25 tahun yang berobat ke Poliklinik Ilmu Kesehatan Kulit dan Kelamin (IKKK) Rumah Sakit dr. Cipto Mangunkusumo (RSCM). Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat pesan singkat elektronik dan kelompok kontrol. Kedua kelompok diberi pengobatan tretinoin krim 0,05% dan/atau klindamisin gel 1,2% selama 6 minggu.Hasil: Tidak terdapat perbedaan bermakna antara kepatuhan pengobatan AVR kelompok kontrol dengan kelompok intervensi pada minggu kedua (p=0,376) dan keempat (p=0,432). Namun pada minggu keenam, kelompok intervensi secara bermakna lebih patuh daripada kelompok kontrol (p=0,032).Kesimpulan: Pesan singkat elektronik meningkatkan kepatuhan pengobatan AVR terutama pada minggu keenam di Poliklinik IKKK RSCM.

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ABSTRACTBackground and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks.Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032).Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital., Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.]"

"ABSTRAKLatar belakang dan tujuan: Xerosis atau kulit kering merupakan masalahkesehatan yang sering dijumpai pada usia lanjut. Prevalensi xerosis pada usialanjut berkisar antar 30 ? 58%. Salah satu faktor yang dijumpai pada kulit keringadalah penurunan ekspresi aquaporin-3 (AQP3). Bahan herbal pegagan atauCentella asiatica ekstrak etanol dalam nanopartikel kitosan (CAEENPK) secara invitro diketahui dapat meningkatkan ekspresi AQP3 pada keratinosit yang berperandalam hidrasi kulit. Penelitian ini bertujuan untuk membandingkan efektivitas dankeamanan krim pelembap yang mengandung Centella asiatica ekstrak etanoldalam nanopartikel kitosan 1%, Centella asiatica ekstrak etanol (CAEE) 1%, dankrim pelembap dasar pada populasi geriatri dengan kulit kering.Metode: Penelitian uji klinis acak tersamar buta ganda dilakukan pada 43 orangpenghuni panti werdha di Jakarta. Evaluasi skin capacitance (SCap), specifiedsymptom sum score (SRRC), derajat gatal, dan efek samping dilakukan pada awalterapi, minggu kedua, dan keempat. Setelah prakondisi selama satu minggu, setiapsubjek penelitian mendapatkan tiga pelembap yang berbeda secara acak pada tigalokasi di tungkai bawah.Hasil: Tidak didapatkan peningkatan nilai SCap yang berbeda bermakna antaraketiga kelompok pengobatan. Penurunan nilai SRRC setelah empat minggu tidakberbeda bermakna antara ketiga kelompok perlakuan. Derajat gatal pada minggukedua menurun pada ketiga kelompok, hingga menjadi tidak gatal pada seluruhSP (100%) setelah minggu keempat. Tidak ditemukan efek samping subjektif danobjektif pada ketiga kelompok perlakuan.Kesimpulan: Efektivitas krim pelembap yang mengandung CAEENPK 1% tidaklebih tinggi dibandingkan dengan krim pelembap yang mengandung CAEE 1%atau krim pelembap dasar, serta memiliki keamanan yang sama dalam mengatasikekeringan kulit pada populasi geriatri.Kata kunci: Centella asiatica, nanopartikel, aquaporin-3, hidrasi kulit, geriatri

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ABSTRACTBackground and objectives: Xerosis or dry skin is a common health issue foundin the elderly. The prevalence rate of xerosis in the elderly ranges between 30 -58%. One of the factors found on dry skin is decreased expression of aquaporin-3(AQP3). The herbal plant Centella asiatica ethanol extract in chitosannanoparticle (CAEENPK) has been found to increase the expression of AQP3 onkeratinocytes in vitro which plays a role in skin hydration. This study aims tocompare the effectiveness and safety of moisturizing cream containing 1%Centella asiatica ehanol extract in chitosan nanoparticle, 1% Centella asiaticaethanol extract (CAEE), and moisturizing cream base in geriatric population withdry skin.Methods: A double-blind randomized controlled trial was conducted on 43residents of a nursing home in Jakarta. The evaluation of skin capacitance (SCap),specified symptom sum score (SRRC), pruritic degree, and side effects weremeasured at baseline, week-2, and week-4 after therapy. After a week ofpreconditioning, each test subject received three different randomizedmoisturizing creams to be applied on three separate locations on the lower limbs.Results: There was no significant increase in SCap value among the threetreatment groups. The decrease in SRRC value after four weeks did not differamong the three treatment groups. The pruritic degree decreased at the secondweek of treatment in all three groups and completely diminished after the fourthweek among all the test subjects (100%). No objective and subjective side effectswere found among the three treatment groups.Conclusion: The efectiveness of moisturizing cream containing 1% CAEENPK isnot higher when compared to moisturizing cream containing 1% CAEE ormoisturizing cream base. It is also as safe in treating dry skin of geriatricpopulation;;ABSTRAKLatar belakang dan tujuan: Xerosis atau kulit kering merupakan masalahkesehatan yang sering dijumpai pada usia lanjut. Prevalensi xerosis pada usialanjut berkisar antar 30 ? 58%. Salah satu faktor yang dijumpai pada kulit keringadalah penurunan ekspresi aquaporin-3 (AQP3). Bahan herbal pegagan atauCentella asiatica ekstrak etanol dalam nanopartikel kitosan (CAEENPK) secara invitro diketahui dapat meningkatkan ekspresi AQP3 pada keratinosit yang berperandalam hidrasi kulit. Penelitian ini bertujuan untuk membandingkan efektivitas dankeamanan krim pelembap yang mengandung Centella asiatica ekstrak etanoldalam nanopartikel kitosan 1%, Centella asiatica ekstrak etanol (CAEE) 1%, dankrim pelembap dasar pada populasi geriatri dengan kulit kering.Metode: Penelitian uji klinis acak tersamar buta ganda dilakukan pada 43 orangpenghuni panti werdha di Jakarta. Evaluasi skin capacitance (SCap), specifiedsymptom sum score (SRRC), derajat gatal, dan efek samping dilakukan pada awalterapi, minggu kedua, dan keempat. Setelah prakondisi selama satu minggu, setiapsubjek penelitian mendapatkan tiga pelembap yang berbeda secara acak pada tigalokasi di tungkai bawah.Hasil: Tidak didapatkan peningkatan nilai SCap yang berbeda bermakna antaraketiga kelompok pengobatan. Penurunan nilai SRRC setelah empat minggu tidakberbeda bermakna antara ketiga kelompok perlakuan. Derajat gatal pada minggukedua menurun pada ketiga kelompok, hingga menjadi tidak gatal pada seluruhSP (100%) setelah minggu keempat. Tidak ditemukan efek samping subjektif danobjektif pada ketiga kelompok perlakuan.Kesimpulan: Efektivitas krim pelembap yang mengandung CAEENPK 1% tidaklebih tinggi dibandingkan dengan krim pelembap yang mengandung CAEE 1%atau krim pelembap dasar, serta memiliki keamanan yang sama dalam mengatasikekeringan kulit pada populasi geriatri.Kata kunci: Centella asiatica, nanopartikel, aquaporin-3, hidrasi kulit, geriatri

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ABSTRACTBackground and objectives: Xerosis or dry skin is a common health issue foundin the elderly. The prevalence rate of xerosis in the elderly ranges between 30 -58%. One of the factors found on dry skin is decreased expression of aquaporin-3(AQP3). The herbal plant Centella asiatica ethanol extract in chitosannanoparticle (CAEENPK) has been found to increase the expression of AQP3 onkeratinocytes in vitro which plays a role in skin hydration. This study aims tocompare the effectiveness and safety of moisturizing cream containing 1%Centella asiatica ehanol extract in chitosan nanoparticle, 1% Centella asiaticaethanol extract (CAEE), and moisturizing cream base in geriatric population withdry skin.Methods: A double-blind randomized controlled trial was conducted on 43residents of a nursing home in Jakarta. The evaluation of skin capacitance (SCap),specified symptom sum score (SRRC), pruritic degree, and side effects weremeasured at baseline, week-2, and week-4 after therapy. After a week ofpreconditioning, each test subject received three different randomizedmoisturizing creams to be applied on three separate locations on the lower limbs.Results: There was no significant increase in SCap value among the threetreatment groups. The decrease in SRRC value after four weeks did not differamong the three treatment groups. The pruritic degree decreased at the secondweek of treatment in all three groups and completely diminished after the fourthweek among all the test subjects (100%). No objective and subjective side effectswere found among the three treatment groups.Conclusion: The efectiveness of moisturizing cream containing 1% CAEENPK isnot higher when compared to moisturizing cream containing 1% CAEE ormoisturizing cream base. It is also as safe in treating dry skin of geriatricpopulation.Keywords: Centella asiatica, nanoparticle, aquaporin-3, skin hydration,geriatrics"

"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. "

"Latar belakang: Pitiriasis versikolor (PV) merupakan infeksi jamur superfisial kronik dengan prevalensi tinggi. Belum ada data yang membandingkan sampo SeS2 1,8% dengan ketokonazol 2% pada terapi PV. Tujuan: Mengetahui efikasi mikologis, keamanan, kekambuhan, dan efikasi biaya antara sampo selenium sulfida 1,8% dibandingkan dengan ketokonazol 2% pada PV. Metode: Uji klinis acak tersamar ganda terhadap pasien PV bulan September hingga Desember 2018, dengan terapi sampo SeS2 1,8% atau ketokonazol 2% sesuai dengan alokasi random. Dilakukan pemeriksaan fisik, uji provokasi skuama, lampu Wood, dan kalium hidroksida. Efikasi mikologis dianalisis dengan intention to treat dan kekambuhan dengan analisis per-protokol. Efikasi biaya dengan menghitung Incremental Cost-Effectiveness Ratio (ICER). Hasil: Efikasi mikologis lebih tinggi pada ketokonazol 2%, yaitu sebesar 94% vs 86%, tetapi tidak berbeda secara statistik (RR=2,3(95%IK0,6-8,5), p=0,182). Efek samping pada ketokonazol 2% lebih tinggi, yaitu 22% vs 8%. SeS2 1,8% lebih murah 14.880 rupiah, dengan risiko KOH masih positif sebesar 8% lebih tinggi dibanding ketokonazol 2%. Kekambuhan sebulan didapatkan lebih besar pada SeS2 1,8%, yaitu sebesar 8% vs 14%. Kesimpulan: Tidak terdapat perbedaan efikasi mikologis, efek samping, dan kekambuhan sebulan, antara SeS2 1,8% dengan ketokonazol 2%. Penggunaan SeS2 1,8% pada terapi PV lebih murah dengan risiko gagal terapi lebih tinggi dibandingkan ketokonazol 2%.

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Background: Pityriasis versicolor (PV) is a chronic superficial fungal infection which highly prevalent. There is no data comparing SeS2 1.8% with 2% ketoconazole shampoo in the treatment of PV. Objective: To assess the mycological efficacy, safety, relaps, and cost-efficacy of SeS2 1.8% and ketoconazole 2% shampoo for the treatment of PV. Methods: A double blind randomized controled trial was performed in patients with PV during September-December 2018, based on block randomization. Physical examinations, scale provocation test, Woods lamp and potassium hydroxide examination were conducted. Intention to treat analysis was performed to evaluated mycological efficacy and per-protocol analysis to evaluated relaps. Cost-efficacy was analyzed by calculating the Incremental Cost-Effectiveness Ratio (ICER). Result: The mycological efficacy, side effect and relaps were higher in the ketoconazole group; 94% vs 86% (RR=2.3(95%CI 0.6-8.5), p= 0.182), 22% versus 8%, and 14% versus 8%. We found lesser cost for SeS2 1.8% of about 14.880 rupiah with risk of persistent positive KOH smear is 8% higher than ketoconazole. Conclusion: There were no significant differences of mycological efficacy, side effect, and relaps, between both arms. The cost-efficacy revealed a lesser cost for SeS2 1.8% with higher risk of persistent positive KOH as compared to ketoconazole."

"Latar belakang: Proporsi lansia diperkirakan akan terus meningkat. Salah satu masalah utama pada kesehatan kulit lansia adalah xerosis cutis atau kekeringan kulit. Tata laksana xerosis cutis yang tidak adekuat dapat menimbulkan komplikasi dan menurunkan kualitas hidup lansia. Pelembap merupakan tata laksana utama xerosis cutis. Jarak waktu pemakaian ulang yang tepat berbagai jenis pelembap perlu diketahui dasar ilmiahnya.Tujuan: Mengetahui status hidrasi dan sawar kulit setelah aplikasi tunggal vaselin album, lanolin 7,5% dalam vaselin album, krim urea 10%, dan krim pelembap yang mengandung seramid pada lansia dengan xerosis cutis.Metode: Sebuah penelitian dengan pre dan post-experimental design, tersamar ganda pada lansia dengan xerosis cutis. Jumlah SP adalah 15 orang dan pemilihan SP dilakukan secara berurutan (consecutive sampling). Satu SP mendapat empat perlakuan, dua pelembap dioleskan di tungkai bawah kanan dan dua pelembap di tungkai bawah kiri. Penentuan lokasi pengolesan pelembap menggunakan metode randomisasi sederhana. Penilaian status hidrasi dan sawar kulit dinilai menggunakan skor SRRC sebelum dan 12 jam setelah pengolesan pelembap, sedangkan nilai SCap dan TEWL diperiksa setiap 3 jam selama 12 jam.Hasil: Terdapat penurunan skor SRRC yang bermakna 12 jam setelah pengolesan keempat jenis pelembap (p<0,001). Peningkatan tertinggi nilai SCap pada 3 jam setelah pengolesan vaselin album sebesar 12 AU (p<0,001) dan lanolin 7,5% dalam vaselin album sebesar 13,96 AU (p<0,001). Peningkatan tertinggi nilai SCap pada 6 jam setelah pengolesan krim urea 10% sebesar 14,43 AU (p<0,001) dan krim yang mengandung seramid sebesar 7,57 AU (p=0,002). Terdapat peningkatan nilai SCap yang bermakna sejak pada 3-12 jam pada seluruh kelompok pelembap. Penurunan bermakna nilai TEWL hanya pada 3 jam setelah pengolesan krim urea 10% sebesar 1,44 g/h/m2 (p=0,006).Kesimpulan: Terdapat perbaikan skor SRRC yang bermakna pada seluruh kelompok pelembap. Terdapat perbaikan nilai SCap yang bermakna sejak 3-12 jam setelah pengolesan keempat jenis pelembap. Penurunan bermakna nilai TEWL hanya terdapat pada 3 jam setelah pengolesan krim urea 10%. Berdasarkan hasil penelitian ini, jarak waktu ideal pemakaian ulang vaselin album dan lanolin 7,5% dalam vaselin album adalah setiap 3 jam, sedangkan jarak waktu ideal pemakaian ulang krim urea 10% dan krim yang mengandung seramid adalah setiap 6 jam. Dengan mempertimbangkan biaya dan efektivitas pelembap dalam meningkatkan hidrasi kulit, pengulangan pemakaian pelembap masih dapat dilakukan setiap 12 jam.

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Background: The proportion of elderly is expected to increase continuously. One of the main problems in elderly skin health is xerosis cutis. Inadequate management of xerosis cutis in the elderly can cause complications and reduce the quality of life. Moisturizers is the main management of xerosis cutis. The evidences base of the interval reapplication time in various types of moisturizers need to be known.

Objectives: To determine the hydration and skin barrier status after a single application of vaseline albumin, lanolin 7.5% in vaseline album, urea 10% cream, and ceramide cream in elderly with xerosis cutis.

Methods: This was a study with a pre and post-experimental design, double-blinded. A total of 15 elderly subjects with xerosis cutis were choosen with consecutive sampling. Every subject received four treatments, two moisturizers on the right leg and two moisturizers on the left leg. The location of moisturizers application was determined by using a simple randomization method. Assessment of hydration and skin barrier status was assessed using the SRRC score before and 12 hours after application, while the SCap and TEWL value were examined every 3 hours for 12 hours.

Results: There was a significant decrease in SRRC scores 12 hours after application of all types moisturizers (p<0.001). The highest increase in SCap at 3 hours after the application of vaseline album was 12 AU (p<0.001) and lanolin 7.5% in vaseline album was 13.96 AU (p<0.001). The highest increase in SCap at 6 hours after the application of urea 10% cream was 14.43 AU (p<0.001) and ceramide cream was 7.57 AU (p=0.002). There was a significant increase of SCap from 3 to 12 hours in all four types moisturizers. The significant decrease in TEWL only at three hours after the use of urea 10% cream was 1.44 g/h/m2 (p=0.006).

Conclusion: There was a significant decrease in SRRC scores in all four types of moisturizers. There was a significant increase in the value of SCap from 3 to 12 hours after application of all moisturizers. The significant decrease in TEWL was only 3 hours after application of urea 10% cream. Based on the results, the ideal reapplication time of vaseline album and lanolin 7.5% in vaseline album is every 3 hours, while for urea 10% cream and ceramide cream is every 6 hours. Considering the cost and effectiveness of moisturizers in hydrating the skin, reapplication of moisturizers every 12 hours still would be effective."

"Proses penuaan kulit secara ekstrinsik dipengaruhi oleh radiasi UV, merokok, gizi buruk, polusi udara, dan stres fisik. Dermoscopic photoaging scale (DPAS) adalah metode non-invasif untuk menilai penuaan foto. Penelitian ini bertujuan untuk mengevaluasi prevalensi penuaan kulit akibat paparan sinar UV pada personel militer pria berusia 30-42 tahun, dengan membandingkan kelompok infanteri dan administrasi yakni kelompok kesehatan militer (CKM) menggunakan DPAS. Selain itu, hubungan antara prevalensi penuaan, konsumsi alkohol, dan kebiasaan merokok akan diteliti. Penelitian ini adalah penelitian deskriptif analitik dengan desain potong lintang. Kriteria penuaan foto dinilai berdasarkan DPAS. Hasil dari penelitian ini yaitu sebanyak 40 subjek penelitian, semuanya memiliki skor DPAS total > 1, dengan kriteria yang paling sering ditemukan adalah ephelides/lentigines, yellow papules, dan superficial wrinkles. Tidak ada hubungan yang signifikan secara statistik antara kebiasaan merokok dan skor DPAS di setiap wilayah wajah. Setelah melakukan penelitian, peneliti memiliki kesimpulan bahwa berdasarkan metode DPAS, tidak ada perbedaan prevalensi penuaan foto di kedua kelompok. Namun, skor total DPAS (StDPAS) infanteri lebih tinggi daripada StDPAS kelompok CKM, dengan perbedaan signifikan pada skor DPAS di wilayah pipi kanan dan pipi kiri dibandingkan dengan wilayah wajah lainnya.

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The extrinsic process of skin aging influenced by UV radiation, smoking, poor nutrition, air pollution, and physical stress. Dermoscopic photoaging scale (DPAS) is a non-invasive method to assess photoaging. This study aims to evaluate the prevalence of UV-induced skin aging in male military personnel aged 30-42, comparing infantry and administration groups in this research represented by military medical service group using DPAS. Additionally, the relationship between aging prevalence, alcohol consumption, and smoking habits will be examined. This is a descriptive analytic research with cross-sectional design. Photoaging criteria was assessed based on DPAS. The results of this research are a total of 40 research subjects, all had a total DPAS score > 1, with the most frequently found criteria being ephelides/lentigines, yellow papules, and superficial wrinkles. There was no statistically significant association between smoking habits and DPAS scores in each facial region. After doing this research, the writer concludes that based on DPAS method, there is no prevalence difference of photoaging in both groups. But the infantry's DPAS total score (TsDPAS) was greater than military medical service’s TsDPAS, with a significant difference in the DPAS score in the right and left cheek regions compared to other facial regions."

"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"

"Salah satu faktor penyebab kulit kering pada lanjut usia adalah penurunan konsentrasi asam hialuronat pada epidermis dan dermis. Asam hialuronat berat molekul kecil dianggap lebih efektif melembapkan kulit dibandingkan asam hialuronat berat molekul besar. Penelitian ini merupakan uji klinis acak terkontrol tersamar ganda yang dilakukan pada 36 orang berusia 60-80 tahun dengan kulit kering di Panti Sosial Tresna Werdha Budi Mulia 3. Setelah prakondisi selama satu minggu, setiap subjek penelitian mendapatkan tiga pelembap yang berbeda secara acak pada tiga lokasi di tungkai bawah, yang dioleskan dua kali sehari. Penilaian skin capacitance (SCap), transepidermal water loss (TEWL), dan skor SRRC dilakukan pada minggu ke-0, 2, dan 4. Nilai SCap lebih tinggi pada area pengolesan asam hialuronat berat molekul kecil dibandingkan dengan asam hialuronat berat molekul besar (56,37 AU vs 52,37 AU, p=0,004) dan vehikulum (56,37 AU vs 49,01 AU, p<0,001). Tidak terdapat perbedaan nilai TEWL dan skor SRRC yang bermakna antara ketiga kelompok perlakuan. Tidak ditemukan efek samping subjektif dan objektif pada ketiga kelompok perlakuan. Pelembap yang mengandung asam hialuronat berat molekul kecil meningkatkan SCap lebih tinggi secara bermakna daripada asam hialuronat berat molekul besar dan vehikulum serta memiliki keamanan yang sama dalam mengatasi kulit kering pada populasi lansia.

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A contributing cause to dry skin is a reduced concentration of hyaluronic acid (HA) in both the epidermis and dermis. Low molecular weight HA (LMWHA) is believed to be more effective in replenishing skin hydration in aging skin compared to High Molecular Weight HA (HMWHA). A double-blind, randomized controlled trial was conducted on 36 residents of a nursing home in Jakarta, aged 60 and 80 years with dry skin. Following a week of preconditioning, each test subject was administered three distinct, randomized moisturizing lotions, to be topically applied to three separate sites on the leg. Skin capacitance (SCap), transepidermal water loss (TEWL), and SRRC scores were measured at weeks 0, 2, and 4. After four weeks of therapy, area that was treated with LMWHA showed greater SCap values compared to the area treated with HMWHA (56.37 AU vs 52.37 AU, p=0.004) and vehicle (56.37 AU vs 49.01 AU, p<0.001). All groups did not show any significant differences in TEWL and SRRC scores. No side effects were found in all groups. The application of a moisturizer containing LMWHA to the dry skin of elderly resulted in significant improvements in skin hydration compared to moisturizers containing HMWHA and vehicle. Furthermore, these moisturizers demonstrated similar safety in treating dry skin in the elderly."

"Latar belakang : Reaksi ENL disebabkan oleh ketidakseimbangan imunitas selular dan humoral. Kortikosteroid merupakan obat standar yang digunaktapi dapat menimbulkan efek samping pada berbagai organ. Sehubungan dengan itu perlu dipikirkan terapi ajuvan yang efektif untuk reaksi ENL. Seng merupakan mikronutrien yang berperan penting pada berbagai fungsi enzimatik, aktivasi sel T, efek antiinlamasi, menghambat pembentukan kompleks imun, dan mempunyai efek antioksidan, dipikirkan dapat digunakan sebagai terapi ajuvan untuk terapi reaksi ENL. Tujuan : Menilai perbandingan perbaikan klinis reaksi ENL pada pasien kusta yang diberikan ajuvan seng dengan yang diberikan plasebo. Metode : Penelitian ini merupakan suatu uji klinis acak tersamar ganda menggunakan plasebo dengan desain paralel. Dilakukan randomisasi blok untuk membagi subyek menjadi dua kelompok, yaitu kelompok perlakuan dan kelompok plasebo. Evaluasi dilakukan tiap dua minggu selama enam minggu. Hasil : Pada akhir perlakuan, perbaikan klinis kelompok perlakuan adalah 79,2% dan kelompok plasebo adalah 72,7%. Perbedaan tersebut tidak bermakna secara statistik. Kesimpulan : Tidak terdapat perbedaan bermakna pada perbaikan klinis reaksi ENL antara pasien kusta yang diberikan ajuvan seng dengan yang diberikan plasebo.

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Background : ENL reaction is caused by imbalance of cellular and humoral immunity. Corticosteroid is the standard drug used to treat ENL, but can cause serious side effects in multiple organs. There for, it is needed to find effective adjuvant drug for ENL. Zinc is essential micronutrient for various enzymatic proceses, T cell activation, antiinflamation effect, inhibiting the formation of immune complexes, and has the effect of antioxidant. Several studies have shown the benefit of addition zinc for ENL reaction.

Objective : To assess the comparative clinical improvement ENL reaction in leprosy patients given adjuvant zinc with placebo.

Methods : Randomized double-blind clinical trial using placebo with parallel design. Block randomization divided the subjects into two groups, namely the treatment group and the placebo group. The evaluation was performed every two weeks for six weeks.

Result : At the end of treatment, the clinical improvement ENL reaction obtained was 79,2% treatment group and the placebo group was 72,7%. The differences were not statistically significant.

Conclusion : There were no significant differences in clinical improvement ENL reaction in leprosy patient treated with adjuvant zinc compared to placebo."