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"Latar belakang: Penyakit kusta adalah penyakit kulit yang disebabkan oleh Mycobacterium leprae yang dapat melibatkan organ mata. Kelainan mata pada kusta perlu dideteksi lebih dini untuk mencegah kebutaan. Alat deteksi dini kelainan mata yang tersedia bervariasi, sehingga perlu dikembangkan suatu instrumen daftar tilik yang valid dan sensitif untuk mempermudah deteksi kelainan mata pada kusta, yang disesuaikan dengan kompetensi dokter bukan spesialis mata yang menangani kusta. Tujuan: Uji validitas suatu instrumen daftar tilik untuk mempermudah deteksi dini kelainan mata pada kusta. Metode: Sebuah daftar tilik disusun berdasarkan tanda dan gejala kelainan mata pada kusta, sesuai dengan masukan ahli di bidang dermatovenereologi dan oftalmologi. Pasien kusta yang berobat di Poliklinik Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo, diperiksa mata dengan menggunakan instrumen daftar tilik tersebut oleh dokter bukan spesialis mata, kemudian dilanjutkan dengan pemeriksaan mata yang lebih lengkap oleh dokter spesialis mata, untuk konfirmasi hasil pemeriksaan sebagai baku emas. Data yang dihasilkan dianalisis untuk mendapatkan nilai validitas dan sensitivitas instrumen daftar tilik. Hasil: Daftar tilik pada penelitian ini memiliki validitas dan reliabilitas baik, dengan koefisien korelasi 0,664 p.

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Introduction: Leprosy is a disease caused by Mycobacterium leprae that affects peripheral nerve, skin, and other organs including eye. Ocular leprosy needs early detection to prevent blindness. Early detection tools for ocular leprosy varies, thus it is important to develop a valid and sensitive screening tool that can easily be used by general practitioner and doctor other that ophtalmologist who treat leprosy.

Purpose: This study aimed to test the validity of a checklist for early detection of eye involvement in leprosy.

Methods: A checklist was designed according to signs and symptoms of ocular leprosy, based on suggestion from dermatovenereologist and ophtalmologist. Leprosy patients in Dermatovenereology clinic of Cipto Mangunkusumo National General Hospital was examined by a general practitioner non ophtalmologist using the checklist as a screening tool, then those patients were re examined by an ophtalmologist as gold standard. Data were later analized to get the validity and sensitivity of the screening tool.

Results: This checklist had good validity and realibility with correlation value was 0,664 p "

"Psoriasis vulgaris merupakan penyakit inflamasi kronik kulit yang didasari oleh proses imunologi. Derajat keparahan psoriasis vulgaris dinilai secara klinis dengan penilaian body surface area (BSA) dan psoriasis area and severity index (PASI). Inflamasi kulit pada psoriasis vulgaris diperankan oleh berbagai sitokin inflamasi yang dapat meningkatkan inflamasi sistemik dan aktivasi trombosit. High sensitivity c-reactive protein (hs-CRP) sebagai penanda inflamasi sistemik serta mean platelet volume (MPV) sebagai penanda aktivasi trombosit diduga dapat dijadikan prediktor derajat keparahan psoriasis vulgaris. Penelitian ini berdesain observasional analitik potong lintang. Setiap subjek penelitian (SP) dengan psoriasis vulgaris yang memenuhi kriteria inklusi dan eksklusi dilakukan anamnesis, pemeriksaan fisik, dan perhitungan derajat keparahan psoriasis vulgaris dengan PASI dan BSA. Selanjutnya, dilakukan pemeriksaan kadar hs-CRP dan MPV. Dari 32 SP, didapatkan korelasi positif tidak bermakna antara hs-CRP dengan BSA (r=0,118; p=0,518) dan PASI (r=0,322; p=0,073). Korelasi negatif tidak bermakna ditunjukkan antara MPV terhadap BSA (r=-0,035; p=0,848)dan PASI (r=-0,035; p=0,848). Korelasi antara hs-CRP dengan MPV tidak bermakna (r=-0,178; p=0,329). Nilai hs-CRP dan MPV tidak memiliki korelasi bermakna terhadap PASI dan BSA sehingga tidak dapat digunakan sebagai prediktor yang spesifik untuk keparahan psoriasis vulgaris.

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Psoriasis vulgaris is a chronic immunologic inflammatory skin disease. The severity of psoriasis vulgaris is clinically-assessed by using body surface area (BSA) and the psoriasis area and severity index (PASI). Skin inflammation in psoriasis vulgaris is played by various inflammatory cytokines that can perpetuate systemic inflammation and platelet activation. High sensitivity c-reactive protein (hs-CRP) as a marker of systemic inflammation and mean platelet volume (MPV) as a marker of platelet activation are thought to be predictors of psoriasis vulgaris severity.

This is a cross-sectional analytic observational study. Each subject with psoriasis vulgaris who met the inclusion and exclusion criteria underwent anamnesis, physical examination, and assessment of PASI and BSA, then examined for hs-CRP and MPV levels.

Among the 32 subjects, a weak insignificant positive correlation was found between hs-CRP and BSA (r=0.118; p=0.518)and PASI (r=0.322; p=0.073). A weak negative insignificant correlation was shown between MPV and BSA (r=-0.035; p=0.848) and PASI (r=-0.035; p=0.848). No significant correlation was found between hs-CRP and MPV (r=-0.178; p=0.329

The hs-CRP and MPV levels ​​do not have a significant correlation with PASI and BSA, therefore cannot be used as specific predictors of psoriasis vulgaris severity."

"ABSTRAKLatar belakang: Pruritus adalah keluhan subyektif terbanyak yang membuat pasien datang ke poliklinik kulit, dan dua pertiga di antaranya adalah pruritus kronik. Kuesioner 5-D Itch Scale 5DIS adalah alat pengukuran pruritus kronik yang memenuhi berbagai aspek alat pengukuran pruritus sesuai rekomendasi International Forum for the Study of Itch IFSI . Penelitian ini dilakukan untuk menguji validitas dan reliabilitas kuesioner 5DIS berbahasa Indonesia untuk menilai keluhan pruritus kronik di Indonesia.Metode: Naskah 5DIS asli berbahasa Inggris diterjemahkan ke bahasa Indonesia sesuai dengan pedoman adaptasi lintas budaya dari International Society for Pharmacoeconomics and Outcomes Research ISPOR . Tiga set kuesioner, yaitu skala gatal 5 dimensi, Dermatology Life Quality Index DLQI , dan Visual Analogue Scale VAS diberikan kepada pasien pruritus kronik di poliklinik IKKK RSUPNCM. Reliabilitas diuji menggunakan Cronbach a. Validitas konvergen dan konkuren diuji menggunakan korelasi Pearson dan Spearman.Hasil: Adaptasi lintas budaya 5DIS menghasilkan sebuah naskah skala gatal 5 dimensi. Ketiga set kuesioner diisi dengan lengkap oleh 34 orang. Rentang usia subjek penelitian SP adalah 18 hingga 83 tahun, dengan rerata usia 56,7 15,7 tahun. Nilai Cronbach a 0,679 untuk kelima ranah skala gatal 5 dimensi menunjukkan tingkat reliabilitas yang dapat diterima. Hasil uji validitas konvergen didapatkan korelasi yang kuat dan bermakna antara skor butir-butir dan skor total skala gatal 5 dimensi dengan nilai koefisien korelasi adalah 0,636-0,760. Hasil uji validitas konkuren didapatkan korelasi yang kuat dan bermakna antara skala gatal 5 dimensi dengan kuesioner DLQI dan skala VAS.Kesimpulan: Skala gatal 5 dimensi merupakan alat pengukuran yang valid dan reliabel untuk menilai keluhan pruritus kronik pada pasien dewasa dan lansia di Indonesia.Kata kunci: pruritus kronik, pengukuran, 5-D itch scale, skala gatal 5 dimensi, validitas, reliabilitas

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ABSTRACTBackground Pruritus is a major subjective complaint in dermatology clinic, two thirds of them are chronic pruritus. International Forum for the Study of Itch recommends 5 D Itch Scale 5DIS as a multidimensional measurement tools for chronic pruritus assessment. The objective of this study is to test the validity and reliability of 5DIS in Indonesian language for chronic pruritus symptoms in Indonesia.Method The original 5DIS was translated into Indonesian language using cross cultural adaptation guideline from International Society for Pharmacoeconomics and Outcomes Research ISPOR . Three sets of questionnaire 5DIS in Indonesian language, Dermatology Life Quality Index DLQI , and Visual Analogue Scale VAS , were administered to chronic pruritus patients in dermatovenereology clinic of Dr. Cipto Mangunkusumo Hospital. Reliability was tested using Cronbach rsquo s a. Convergent and concurrent validity was tested using Pearson correlation and Spearman rsquo s rho.Result Cross cultural adaptation resulted a 5DIS in Indonesian language. All questionnaires were completed by 34 people between 18 to 83 years old mean 56.7 15.7 years old . Cronbach rsquo s a for five domains of 5DIS was 0,679. There was significant strong correlation between items scores and total scores of 5DIS r 0.636 to 0.760 . There was significant strong correlation between 5DIS in Indonesian language and DLQI, also between 5DIS in Indonesian language and VAS.Conclusion 5DIS in Indonesian language is a valid and reliable instrument to assess chronic pruritus symptoms on adult and geriatric patients in Indonesia.Keywords chronic pruritus, measurement, 5 D itch scale in Indonesian language, validity, reliability "

"Latar belakang: Subepidermal low echogenic band (SLEB) adalah gambaran USG berupa area hipoekhoik pada lapisan dermis, tepatnya subepidermal, yang merupakan suatu proses elastosis sebagai penanda dari photoaging.Tujuan: Menilai perbedaan rasio ketebalan SLEB dengan dermis antara kelompok perempuan pra dan pascamenopause dengan menggunakan USG general purpose frekuensi 18 MHz.Metode: Penelitian ini merupakan studi potong lintang komparatif menggunakan data primer dan data sekunder. Data primer diperoleh melalui pengukuran langsung di pipi kanan dan kiri dengan menggunakan USG general purpose frekuensi 18 MHz. Data sekunder diperoleh dari penelitian sebelumnya.Hasil: Rerata usia subjek pramenopause sebesar 29,6 tahun dan rerata usia subjek pascamenopause sebesar 55,7 tahun. Rerata tebal dermis dan rerata tebal SLEB didapatkan lebih tebal pada kelompok pramenopause dibandingkan kelompok pascamenopause. Rasio SLEB – dermis pada kelompok pramenopause didapatkan lebih tebal dibandingkan kelompok pascamenopause.Kesimpulan: Rasio tebal SLEB terhadap tebal dermis pada kelompok pramenopause didapatkan lebih tebal dibandingkan pada kelompok pascamenopause. USG general purpose dapat digunakan dalam menilai tebal dermis dan tebal SLEB, namun diperlukan studi lebih lanjut dalam menilai faktor – faktor lain yang mempengaruhi rasio tebal SLEB terhadap tebal dermis.

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Background: Subepidermal low echogenic band (SLEB) is an ultrasound image in the form of a hypoechoic area in the dermis layer – subepidermal, to be precise, which is an 2 elastotic process as a marker of photoaging. Objective: Assessing difference in ratio of SLEB to dermis thickness between the premenopausal and postmenopausal groups using the 18 MHz general-purpose ultrasound frequency.

Method: This research is a comparative cross-sectional stuy using primary data and secondary data. Primary data were obtained through direct measurements on the right and left cheeks using general purpose ultrasound with a frequency of 18 MHz. Secondary data was obtained from previous studies.

Result: The mean age of premenopausal subjects was 29.6 years and the average age of postmenopausal subjects was 55.7 years. The mean dermis thickness and mean SLEB thickness were found to be thicker in the premenopausal group than the postmenopausal group. The SLEB – dermis ratio in the premenopausal group was found to be thicker than the postmenopausal group.

Conclusion: The ratio of SLEB thickness to dermis thickness in the premenopausal group was found to be thicker than in the postmenopausal group. General purpose ultrasound can be used in assessing dermis thickness and SLEB thickness, but further studies are needed in assessing other factors that affect the ratio of SLEB thickness to dermal thickness."

"ABSTRAKLatar belakang : Gonore masih menjadi masalah kesehatan yang cukup signifikan terutama padalaki-laki dengan perilaku seksual risiko tinggi. Pemeriksaan baku emas untuk diagnosis gonoreadalah biakan dan tes amplifikasi asam nukleat. Namun, kedua tes tersebut sulit dilakukan padatempat dengan keterbatasan fasilitas serta sumber daya manusia. ENCODETM gonorrhea rapidtest (GRT) merupakan salah satu point of care test (POCT) yang relatif mudah untuk digunakandan dapat memberikan hasil dalam waktu singkat. Jenis POCT ini diperkirakan dapat menegakkandiagnosis gonore lebih praktis, cepat, dan akurat di Indonesia.Tujuan : Mengetahui sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif dariGRT dalam diagnosis gonore pada duh tubuh uretra laki-laki risiko tinggi di JakartaMetode : Penelitian ini merupakan studi potong lintang terhadap laki-laki risiko tinggi dengankeluhan duh tubuh uretra yang mengunjungi dua klinik IMS di Jakarta selama Bulan September-November 2018. Jenis POCT gonore yang digunakan adalah ENCODETM GRT untuk mengujisensitivitas, spesifisitas, nilai prediksi negatif dan positifnya. Pemeriksaan baku emas yangdigunakan adalah biakan.Hasil : Telah berhasil diseleksi sebanyak total 54 subyek penelitian. Sensitivitas dan spesifisitasGRT diperoleh sebesar 96,77% (95% IK 83,3-99,92%) dan 82,6% (95% IK 61,22-95,05%).Nilai prediksi positif didapatkan sebesar 88,24% (95% IK 75,43-94,82%) sedangkan nilaiprediksi negatif sebesar 95% (95% IK 73,25-99,25%).Kesimpulan : ENCODETM GRT menunjukkan sensitivitas dan spesifisitas yang cukup baikuntuk diagnosis gonore pada laki-laki risiko tinggi dengan keluhan duh tubuh uretra.Pengunaannya cukup praktis, sehingga dapat disarankan untuk tempat dengan keterbatasanfasilitas.

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ABSTRACTBackground : Gonorrhea still becomes a significant health problem especially in men with highrisksexual activities. The gold standard diagnostic tests are culture and nucleic acid amplificationtest. However, both of the tests were difficult to perform in the setting of limited resources. Othertests require trained analyst to perform, which may also not available in rural areas. ENCODEgonorrhea rapid test (GRT) is a point of care test (POCT) which is relatively easy to use and canprovide result quickly. This POCT may provide more practical, faster, and more accuratediagnosis of gonorrhea in Indonesia.Objective : To know the sensitivity, specificity, positive predictive value, negative predictivevalue of gonorrhea rapid test in diagnosing gonorrhea urethritis on high risk men in Jakarta.Methods : This is a cross-sectional study including men with symptomatic gonococcal urethritiswho visited two STI clinics in Jakarta during September-November 2018. ENCODETM GRT wasperformed to evaluate its sensitivity, specificity, positive and negative predictive value. The goldstandard diagnostic test was culture.Result : There were 54 men recruited in this study. The sensitivity and specificity for ENCODEgonorrhea rapid test are 96.77% (95% CI 83.3-99.92%) and 82.6% (95% CI 61.22-95.05%).Positive and negative predictive values respectively are 88.24% (95% CI 75.43-94.82%) and95% (95% CI 73.25-99.25%).Conclusion : ENCODE GRT has a good sensitivity and specificity rates for diagnosing gonorrheain high risk men with urethral discharge. Its use is recommended especially in rural areas or areaswith limited resources due to its practicality."

"[ABSTRAKLatar belakang. Rekomendasi Global Alliance dalam penanganan AVS meliput antibiotik, asam retinoat, dengan atau tanpa BPO. Resistensi obat menjadi perhatian utama pada penggunaan antibiotik jangka panjang dalam terapi akne vulgaris sedang. Kombinasi antibiotik dan BPO direkomendasikan untuk mengatasi masalah tersebut. Pada tipe kulit IV-V hiperpigmentasi pasca akne merupakan masalah yang sering dikeluhkan. Tujuan. Membandingkan efektivitas, efek samping dan kejadian hiperpigmentasi pasca inflamasi penggunaan BPO sebagai paduan terapi lini pertama AVS pada tipe kulit IV-V Fitzpatrick. Metode. Penelitian analitik dengan desaain uji klinis acak tersamar ganda membandingkan dua sisi wajah. Subyek diberikan paduan terapi lini pertama. Sisi wajah perlakuan diberikan gel BPO 2,5% sedangkan kelompok kontrol gel plasebo. Hasil. Pada minggu ke-2,4,6,8 didapatkan penurunan persentase total lesi sebesar 51,47%, 71%, 75%, 82,84% pada kelompok BPO dan 30%, 53,75%, 62,28, 71% pada kelompok plasebo (p<0,001 .) Efek samping dan kejadian HPI pada minggu ke 2,4,6 dan 8 tidak berbeda bermakna. Kesimpulan. Penggunaan BPO sebagai bagian dari paduan terapi lini pertama AVS lebih efektif, tidak meningkatkan efek samping ataupun kejadian HPI.Kata kunci. akne vulgaris, gel BPO 2,5%,

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ABSTRACTBackground. Global alliance recommendation for moderate acne treatment are antibiotic, retinoic acid with or without benzoyl peroxide. Drug resistance become the most common problem due to longterm use of antibiotic in acne treatment. Combination of antibiotic and BPO is recommeded to overcome this problem. In patient with skin type IV-V post acne hyperpigmentation is one of the most significant complaint. Aim. To compare efectivity, side effect and post inflammatory hyperpigmentation of BPO 2,5% gel as a part of first line therapy regiment in patient with skin type IV-V. Method. This is an analytic study with randomized control trial design comparing both half-face (split-face). Subjects were given first line therapy regiment. Half-face was given BPO 2,5% gel twice daily while other half face with placebo. Result. Total lesions reduction in BPO group on week 2,4,6,8 were 51,47%, 71%, 75%, 82,84% respectively and 30%, 53,75%, 62,28, 71% in placebo group respectively. Conclusion. BPO as a part of first line therapy regiment for moderate acne is more effective, with no increase of side effect nor post inflammatory hyperpigmentation compared to placebo., Background. Global alliance recommendation for moderate acne treatment are antibiotic, retinoic acid with or without benzoyl peroxide. Drug resistance become the most common problem due to longterm use of antibiotic in acne treatment. Combination of antibiotic and BPO is recommeded to overcome this problem. In patient with skin type IV-V post acne hyperpigmentation is one of the most significant complaint. Aim. To compare efectivity, side effect and post inflammatory hyperpigmentation of BPO 2,5% gel as a part of first line therapy regiment in patient with skin type IV-V. Method. This is an analytic study with randomized control trial design comparing both half-face (split-face). Subjects were given first line therapy regiment. Half-face was given BPO 2,5% gel twice daily while other half face with placebo. Result. Total lesions reduction in BPO group on week 2,4,6,8 were 51,47%, 71%, 75%, 82,84% respectively and 30%, 53,75%, 62,28, 71% in placebo group respectively. Conclusion. BPO as a part of first line therapy regiment for moderate acne is more effective, with no increase of side effect nor post inflammatory hyperpigmentation compared to placebo.]"

"Latar belakang: Air mempunyai peran yang sangat penting bagi kehidupan manusia. Asupan air yang tidak adekuat, dapat menimbulkan berbagai masalah pada manusia. Dehidrasi paling sering terjadi pada lanjut usia (lansia) yang menyebabkan kulit kering dan berbagai masalah kulit. Kulit memiliki peran penting dalam mencegah kekeringan pada tubuh manusia. Air mendominasi kulit sekitar 30% dan berkontribusi pada kekenyalan, elastisitas, dan ketahanan kulit. Saat ini belum terdapat cukup data untuk membuktikan hubungan antara asupan cairan dengan peningkatan hidrasi kulit.Metode: Penelitian ini merupakan deskriptif analitik potong lintang yang dilakukan pada lansia berusia 65-80 tahun di panti Tresna Werdha Budi Mulia 3. Pengukuran dilakukan dengan menilai asupan cairan selama 7 hari. Pada hari ke-9 dilakukan penilaian status hidrasi melalui Urine Specific Gravity (USG), kekeringan kulit melalui Specified Symptom Sum Score (SRRC), dan karakteristik sawar kulit melalui Transepidermal Water Loss (TEWL) dan Skin Capacitance (SCap).Hasil: Sebanyak 67 SP mengikuti penelitian ini dengan median usia 70 tahun. Terdapat korelasi negatif lemah bermakna antara status hidrasi dengan asupan cairan (nilai p <0,0001). Terdapat korelasi negatif lemah bermakna antara asupan cairan pada lansia dengan SRRC (p<0,0001). Tidak terdapat korelasi antara asupan cairan pada lansia dengan TEWL dan SCap (p = 0.613 and p = 0.060).Kesimpulan: Asupan cairan yang adekuat dapat meningkatkan kelembapan kulit. Rekomendasi asupan cairan dari Kementerian Kesehatan Indonesia dapat dianjurkan pada lansia.

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Background: Water plays a crucial role in human life. Inadequate water intake can result in various issues in humans. Dehydration most commonly occurs in the geriatric, leading to dry skin and various skin problems. The skin plays a vital role in preventing bodily desiccation. Water constitutes around 30% of the skin and contributes to its resilience, elasticity, and durability. Currently, there is insufficient data to establish a definitive relationship between fluid intake and improved skin hydration.

Methods: This study is a cross-sectional analytical descriptive study conducted on elderly individuals aged 65-80 years at the Tresna Werdha Budi Mulia 3 nursing home. Measurements were performed by assessing fluid intake over a 7-day period. On the 9th day, assessments were conducted for hydration status using Urine Specific Gravity (USG), skin dryness through the Specified Symptom Sum Score (SRRC), and skin barrier characteristics using Transepidermal Water Loss (TEWL) and Skin Capacitance (SCap).

Results: Sixty-seven subjects participated in this study, with a median age 70 years. There was a statistically significant weak negative correlation between hydration status and fluid intake (p-value < 0.0001). Additionally, other parameters also showed significant weak negative correlations between hydration status and SRRC with p-values of <0.0001. Nevertheless, there was no significant difference observed in the correlation between fluid intake and both TEWL and SCap value (p = 0.613 and p = 0.060).

Conclusion: Adequate fluid intake can enhance skin moisture. The recommendations of fluid intake from the Indonesian Ministry of Health can be advised for the geriatric population."

"Later belakang: Atlet renang berlatih di ruang terbuka terpajan sinar matahari dan dapat mengalami sunburn yang dapat dicegah dengan penggunaan tabir surya. Namun, aktivitas fisik dapat mengganggu efektivitas tabir surya, menurunkan kadar sun protection factor (SPF). Tabir surya diklasifikasikan menjadi inorganik dan organik. Tabir surya organik bertahan lebih lama, tetapi tabir surya inogranik memiliki spektrum luas, lebih fotostabil, dan jarang menimbulkan alergi.

Tujuan: Mengetahui ketahanan SPF 30 tabir surya inorganik dan organik setelah digunakan berenang 1,5 jam.

Metode: Penelitian merupakan uji klinis acak tersamar ganda dengan metode split body. Setiap subjek menerima dua perlakuan dengan randomisasi alokasi dan perlakuan. Perbedaan SPF kedua tabir surya dinyatakan tidak berbeda bila nilai p untuk uji berpasangan >0.05 dan batas atas interval kepercayaan tidak melebihi 4 SPF.

Hasil: Tidak ada perbedaan bermakna SPF kedua tabir surya sebelum berenang (p=0,220). Setelah berenang, terdapat penurunan SPF tabir surya inorganik, median 27 (23-47) menjadi 12,3 (8-19); dan organik, median 30 (24-47) menjadi 9,9 (6-19) yang bermakna secara statistik (p<0.0001). Setelah berenang, terdapat perbedaan penurunan SPF kedua kelompok yang bermakna secara statistik (p=0,017).

Kesimpulan: Terdapat penurunan SPF tabir surya inorganik dan organik setelah digunakan berenang 1,5 jam dengan ketahanan tabir surya inorganik lebih baik dibandingkan tabir surya organik.

Background: Outdoor swimmers are exposed to sun exposure, causing sunburn which is preventable by using sunscreen. However, physical activities interfere with sunscreen efficacy, decreasing its sun protection factor (SPF). Sunscreens are classified as inorganic and organic. Organic sunscreen last longer, however, inorganic sunscreen is broad-spectrum, more photostable, and less allergenic.

Objective: To determine SPF 30 persistence between inorganic and organic sunscreen after 1,5 hours swimming.

Methods: This is a randomized, split-body, double-blind, clinical trial. Each subject received two treatments. Subject allocation and treatment were randomized. The difference between sunscreens SPF is no different if p-value for paired test is >0.05 and the upper limit of confidence interval do not exceed 4 SPF.

Results: There was no significant difference between SPF before swimming (p=0.220). After swimming, there was a decrease in inorganic sunscreen SPF, median 27 (23-47) to 12.3 (8-19), and organic, median 30 (24-47) to 9.9 (6-19) which was statistically significant (p<0.0001). When compared, there was statistically significant difference in the decrease of SPF between the two groups (p=0.017).

Conclusion: There is a decrease in SPF of inorganic and organic sunscreen after 1.5 hours swimming with a better persistence of inorganic sunscreen compared to organic sunscreen."