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Abstrak :
Latar Belakang: Hiperhomosisteinemia merupakan salah satu faktor risiko terjadinya penyakit kardiovaskular (PKV). Psoriasis vulgaris adalah penyakit kulit inflamasi kronis yang berhubungan dengan beberapa penyakit penyerta, misalnya aterosklerosis dan PKV. Defisiensi folat dapat terjadi pada pasien psoriasis, akibat utilisasi yang meningkat di kulit yang mengalami hiperproliferasi dan atau penyerapan oleh usus yang berkurang. Hal ini dapat mengakibatkan peningkatan kadar homosistein dalam darah. Penulis meneliti korelasi antara kadar homosistein serum dan derajat keparahan psoriasis vulgaris, yang diukur dengan metode psoriasis area severity index (PASI) dan luas permukaan tubuh (body surface area, BSA). Metode: penelitian ini menggunakan rancangan potong lintang, pada 36 pasien psoriasis vulgaris. Subyek terdiri dari16 perempuan dan 20 laki-laki. Kadar homosistein serum diukur dengan metode competitive immunoassay dan dikorelasikan dengan derajat keparahan psoriasis. Hasil: pada subyek psoriasis laki-laki, kadar homosistein serum berkorelasi positif dengan derajat keparahan penyakit yang diukur dengan PASI (korelasi Pearson, r = 0.615 , p < 0,05) dan BSA (korelasi Spearman , r = 0,476 , p < 0,05). Tidak ada korelasi antara kadar homosistein serum dengan PASI (korelasi Pearson , p > 0,05 ) dan BSA (korelasi Spearman, p > 0,05) pada subyek psoriasis perempuan. Kesimpulan: Terdapat korelasi positif yang signifikan secara statistik antara kadar homosistein serum dengan derajat keparahan psoriasis yang diukur dengan PASI dan BSA pada subyek psoriasis laki-laki. ......Background: hyperhomocysteinemia is an independent risk factor for the development of cardiovascular disease (CVD). Psoriasis vulgaris is a chronic inflammatory skin disease associated with several comorbidities, such as atherosclerosis and CVD. Psoriatic patients often presents low levels of folic acid as a result of an increasing vitamin utilization in the skin and/or reduced gut absorption. This may result in raised levels of homocysteine. The authors investigated the correlation between serum homocysteine levels and the severity of psoriasis vulgaris measured by psoriasis area and severity index (PASI) and body surface area (BSA). Method: we performed a cross-sectional study in 36 patients with psoriasis vulgaris. The subjects comprised 16 women and 20 men. The serum levels of homocysteine were measured by competitive immunoassay method and were correlated with the severity of psoriasis (PASI and BSA). Result: in male psoriasis subjects, serum homocysteine levels positively correlated with disease severity as measured by PASI (Pearson's correlation; r = 0.615, p < 0.05) and BSA (Spearman's correlation; r = 0.476, p < 0.05). There was no correlation between serum homocysteine levels with PASI (Pearson's correlation, p > 0.05) and BSA (Spearman's correlation, p > 0.05) in female psoriasis subjects. Conclusion: a significant correlation between serum homocysteine levels with disease severity measured by PASI and BSA in male psoriasis subjects was evidenced.

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ABSTRAK
Latar belakang: Melasma merupakan kelainan pigmentasi yang menyebabkan gangguan kosmetik serta berdampak negatif pada kualitas hidup, kesehatan emosi, dan interaksi sosial. Terdapat berbagai modalitas terapi melasma, namun efektivitas dan keamanan masing-masing terapi masih belum memuaskan. Asam traneksamat diketahui memiliki kemampuan menghambat inflamasi, faktor pertumbuhan melanosit, dan aktivitas tirosinase, sehingga dapat berperan dalam terapi melasma. Belum pernah dilakukan penelitian mengenai efektivitas asam traneksamat oral sebagai terapi melasma di Indonesia. Tujuan: Menilai efektivitas asam traneksamat oral dalam kombinasi terapi topikal pada tata laksana melasma.Metode: Uji klinis acak terkontrol tersamar ganda. Lima puluh subjek penelitian dibagi menjadi dua kelompok, satu kelompok mendapatkan intervensi terapi topikal melasma berupa krim hidrokuinon 4 dan tabir surya SPF 30 ditambah asam traneksamat oral, sedangkan kelompok lainnya mendapatkan terapi topikal melasma dan kapsul plasebo selama 3 bulan. Evaluasi dilakukan dengan menggunakan skor MASI modifikasi dan mexameter.Hasil: Nilai efektivitas kombinasi asam traneksamat dengan terapi topikal hidrokuinon dan tabir surya terhadap perbaikan klinis berdasarkan skor MASI dan mexameter berturut-turut sebesar 72 dan 52 sedangkan terapi topikal saja sebesar 4 dan 0 . Simpulan: Kombinasi asam traneksamat oral 500 mg dengan terapi topikal hidrokuinon 4 lebih efektif dibandingkan dengan terapi topikal saja untuk perbaikan klinis melasma.

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ABSTRACT
Melasma is a pigmentary disorder that cause not only cosmetic impairment but also gives negative impact in the quality of life, emotional health and social interaction. There are different theurapeutic modalities for melasma, but none of those have the best satisfactory effectivity and safety yet. Tranexamic acid is known to have the abitily to inhibit inflamation, melanocyte growth factor, and tyrosinase activation, thus may have a role in the treatment of melasma. Until recently, there is no study about the effectiveness of oral tranexamic acid as a treatment of melasma in Indonesia. Objective To assess the effectiveness of oral tranexamic acid in combination with topical therapy in the treatment of melasma.Methods A double blinded controlled randomized clinical trial. Fifty subjects were divided into two groups, one group received a topical therapy of 4 hydroquinone and sunscreen SPF 30 with oral tranexamic acid, while the other group received topical therapy with placebo capsules for three months. Evaluation is done by using a modified MASI score and mexameter.Results The effectiveness of oral tranexamic acid in combination with topical hydroquinone and sunscreen for melasma clinical improvement based on the modified MASI score and mexameter respectively are 78 and 52 , whereas the topical therapy alone are 4 and 0 . Conclusion Combination of oral tranexamic acid 500 mg with topical 4 hydroquinone is more effective than topical therapy alone for clinical improvement of melasma.

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Latar Belakang: Akne vulgaris AV adalah peradangan kronis pilosebasea yang terutama dijumpai pada remaja dan dewasa muda. Peranan diet pada patogenesis AV terus menjadi perdebatan. Salah satu mikronutrien yang diduga berperan dalam patogenesis AV adalah vitamin A atau retinol. Tujuan: Mengetahui kadar retinol serum dan korelasinya dengan derajat keparahan AV, serta asupan vitamin A pasien AV. Metode: Studi potong lintang dengan 20 subjek penelitian SP yang direkrut secara consecutive sampling. Kadar retinol serum diukur menggunakan high performance liquid chromatography HPLC, sedangkan asupan vitamin A dinilai dengan metode food frequency questionnaire FFQ semikuantitatif. Hasil: Rerata kadar retinol serum kelompok AVR, AVS, dan AVB yaitu 0,962 SB 0,145 mol/L, 0,695 SB 0,054 mol/L, dan 0,613 SB 0,125 mol/L. Terdapat korelasi bermakna antara kadar retinol serum dengan derajat keparahan AV r = -0,798, p = 0,000. Rerata asupan vitamin A per hari pada kelompok AVR, AVS, dan AVB sebesar 476,21 SB 221,32 g, 823,71 SB 221,32 g, dan 780,99 SB 530,45 g. Simpulan: Kadar retinol serum ditemukan rendah pada kelompok AVS dan AVB. Hasil penelitian ini membuktikan semakin rendah kadar retinol serum, semakin berat derajat keparahan AV. Tidak terdapat perbedaan asupan vitamin A di antara ketiga kelompok. ...... Background: Acne vulgaris AV is a chronic inflammation of pilosebaceus that is primarily found in adolescents and young adults. The role of diet in the pathogenesis of AV continues to be a debate. One of micronutrients alleged in the pathogenesis of AV is vitamin A or retinol. Objective: This study aims to know the levels of serum retinol and its correlation with the degree of severity of the AV, as well as the patient 39 s intake of vitamin A. Method: This cross sectional study included 20 subjects divided into mild, moderate, and severe groups based on Lehman rsquo s classification. Serum retinol levels measured using high performance liquid chromatography, whereas the intake of vitamin A was assessed by semiquantitative food frequency questionnaire method. Results: The mean serum retinol levels of mild, moderate, and severe groups were respectively 0.962 SD 0.145 mol L, 0.695 SD 0.054 mol L, and 0.613 SD 0.125 mol L. There was significant correlation between serum retinol levels with the degree of severity of the AV r 0.798, p 0.000. The mean intake of vitamin A per day of mild, moderate, and severe groups were respectively 476.21 SD 221.32 g, 823.71 SD 221.32 g, and 780.99 SD 530.45 g. Conclusion: Levels of serum retinol found lower on the moderate and severe groups. The results has proven that the lower the levels of serum retinol, the more severe the degree of severity of the AV. There was no difference in vitamin A intake among the three groups.

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Latar belakang: Frambusia atau yaws merupakan penyakit akibat infeksi Treponema pallidum subspecies pertenue yang menahun dan terutama mengenai kulit serta tulang. Penegakkan diagnosis berdasarkan klinis dan serologis. Program temuan kasus frambusia didasarkan atas temuan klinis menurut World Health Organization WHO , kemungkinan terdapat frambusia tanpa lesi klinis yang tidak terdiagnosis masih belum dapat disingkirkan. Belum ada penelitian proporsi di suatu desa yang dinyatakan endemis. Tujuan: Mengetahui proporsi kasus frambusia berdasarkan kriteria klinis WHO dan pemeriksaan serologis di desa Sei Berombang pada anak usia 1-12 tahun periode 22-27 Agustus 2016. Metode: Studi potong lintang ini dilakukan pada tanggal 22-27 Agustus 2016 di desa Sei Berombang, Sumatera Utara. Pemilihan sampel dilakukan secara consecutive sampling. Subjek kemudian dilakukan anamnesis, pemeriksaan fisis, dan pemeriksaan rapid diagnostic test RDT . Hasil : Didapatkan total 129 subjek dengan median usia 9 tahun termuda 1 tahun dan tertua 12 tahun . Sebanyak 14 anak dengan lesi klinis suspek frambusia, sedangkan 4 anak dengan RDT yang positif. Hanya 3 anak dari RDT yang positif memiliki temuan klinis. Lesi klinis suspek frambusia yang paling banyak ditemukan adalah makula hipopigmentasi dan skar atrofik, sedangkan lokasi tersering adalah tungkai bawah. Simpulan: Ditemukan proporsi suspek frambusia berdasarkan klinis adalah 10,85 , sedangkan proporsi frambusia konfirmasi berdasarkan klinis dan serologis adalah 2,33 . Dua subjek didiagnosis frambusia laten, sedangkan satu subjek didiagnosis sebagai frambusia primer. Kata kunci: frambusia, proporsi, anak

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ABSTRACT
Background Yaws is a chronic infectious disease caused by Treponema pallidum subspecies pertenue, mainly affecting skin and bone. Diagnosis of yaws is based on clinical manifestation and serologic test. According to WHO, yaws detection program is focused on clinical manifestation. Thus, it is possible that latent yaws without any clinical manifestation is still under diagnosed. Until recently, there is no proportion study performed in remote endemic village.Objective To determine the proportion of yaws based on WHO clinical criteria and serologic test in children age 1 12 years old in Sei Berombang village.Methods This cross sectional study was conducted on 22nd 27th August 2016 in Sei Berombang village, North Sumatra. We recruited the subjects consecutively and performed anamnesis, clinical examination, and rapid diagnostic test RDT .Results A total of 129 subjects were examined with median age of 9 years old 1 12 years old . Yaws was suspected in 14 subjects, but only 4 subjects were reactive to RDT. Three subjects had clinical manifestation and RDT reactive. Hypopigmentation patch and atrophic scar were the most common clinical findings in this study. Most lesions were found in lower extremities. Conclusion Proportion of suspected yaws based on clinical manifestation is 10,85 in this study. Proportion of confirmed yaws based on clinical manifestation and serology is 2,33 . Two subjects diagnosed with latent yaws and one subject was diagnosed with primary yaws.