Search

Background: One of the most prevalent skin conditions worldwide is acne vulgaris (AV). Even mild forms of AV could have an adverse impact on psychological wellbeing. Purpose: To explore the profile of mild AV patients in a tertiary care facility in Surabaya, Indonesia. Method: This was a descriptive study conducted for eight weeks. Data regarding the patient's identity, history, skin type, and complaints related to AV or other complaints that arose were noted on the sample’s medical record and collected for analysis. The Lehmann classification was used to assess the AV degree. Result: A total of 34 patients were included. Gender equality was similar in our study, and late adolescence (17-25 years) is the most dominant age group (73.5%). Genetics plays the biggest precipitating factor (73.5%), followed by stress (70.6%). Most patients had an oily skin type (91.2%) with Fitzpatrick’s phototype 4 (85.3%). Comedone is the most prevalent lesion in our study (median = 10, range = 4-20). Conclusion: Most patients with mild AV had an oily skin type, and late adolescent is most dominant age group.

Background: Vitiligo is a long-term autoimmune disorder marked by the loss of melanocytes and the formation of white macules. Vitiligo can have an impact on the patient's look and quality of life. The Dermatology Life Quality Index (DLQI) is a questionnaire that analyzes the quality of life of skin patients in general, but it is not disease-specific. To assess the quality of life of vitiligo patients in Indonesia, a disease-specific instrument is required. Purpose: This study aims to analyze the validity and reliability of the Vitiligo Quality of Life (VitiQol) questionnaire in Indonesia and translate the VitiQol questionnaire into Indonesian. Methods: Using cross-sectional analytic observation, this study was performed on 39 participants with vitiligo at Dr. Soetomo Surabaya between December 2021 and January 2022. The investigation consisted of three phases: the Indonesian translation of VitiQol, testing for validity, and assessing reliability. Result: The VitiQol questionnaire is a valid and reliable questionnaire. Valid with a correlation coefficient between 0.40 and 0.80 and reliability close to perfection. There was a significant correlation between VitiQol and DLQI (r=0.511, p=0.001). Conclusion: According to the findings of this study, the Indonesian VitiQol is a valid and reliable instrument for measuring the life quality of vitiligo patients in Indonesia.

ABSTRACT Background: Lasers are one of the most important treatment modalities in dermatology. Lasers interact with chromophores through several mechanisms that depend on fluence and pulse durations. Early lasers worked by photothermal interaction with pulse durations of 1 microsecond to 1 second. A picosecond laser is developed to confine photothermal effects and produce photomechanical effects and plasma induction. Purpose: To understand the mechanism of action and application of picosecond lasers for dermatological disorders. Review: Non-fractional picosecond lasers work by photomechanical interaction. Photomechanical interaction happens when pulse duration is less than inertial confinement time, causing fractures of chromophores with lower energy, or “cold ablation”. Fractional picosecond lasers work by laser-induced optical breakdown (LIOB). In LIOB, accelerated seed electrons cause an electron avalanche that produce a collection of free electrons called plasma, which ablates tissues. LIOB in the skin is always followed by photodisruption. In LIOB, vacuoles and debris were eliminated transdermally and dermal collagen and elastin increased. Picosecond laser may be applied in disorders requiring destruction of chromophores and for collagen and elastin disorders. It is currently the first-line treatment for tattoo removal (Nevus of Ota and Acquired Bilateral Nevus of Ota-like macules, or ABNOM). It has good efficacy and safety for solar lentigines, freckles, and cafe-au-lait macules (CALM). It is an additional treatment for moderate to severe melasma and hypertrophic scars, in combination with other treatments. The fractional picosecond laser showed moderate improvement and low risk of postinflammatory hyperpigmentation (PIH) for atrophic acne scars and produced improvement in striae alba.

Background: Oral candidiasis (OC), frequently caused by Candida albicans, is the most common opportunistic infection in HIV/AIDS patients. Topical treatment for OC is limited. In vitro study revealed rosemary (Rosmarinus officinalis L.) essential oil has an antifungal effect. However, the essential oil is volatile and is not recommended to be applied to the skin and mucosa; therefore, emulsion gel (emulgel) is made. Purpose: This study was conducted to evaluate the antifungal activity of rosemary emulgel 6.25%, 25%, 37.5%, and 50% compared to nystatin. Methods: This study is an in vitro test using the disk diffusion method to d etermine the antifungal activity shown by the inhibitory zones of rosemary emulgel at 6.25%, 25%, 37.5%, and 50% compared to nystatin to stored isolates of C. albicans from HIV/AIDS patients with OC. Result: Rosemary emulgel 6.25% dan 25% did not show antifungal activity because no inhibitory zone was shown. The inhibitory zone diameter provided by rosemary emulgel 37.5%; 50%; and nystatin against C. albicans isolates were 3.17±3.763 mm; 7.00±4.107 mm; and 30.13±5.319 mm respectively. Significant differences in antifungal activity were shown by the inhibitory zone diameter provided between rosemary emulgel 37.5%, 50%, and nystatin (p

Background: Vitiligo is a depigmentation disorder characterized by the progressive loss of melanocytes from the epidermis and hair follicles. Vitiligo affects all age groups and is defined by acquired, idiopathic, progressive, different-sized, circumscribed, milky white depigmentation. Characteristics and clinical patterns of vitiligo will also help to understand the pathogenesis of the disease. Purpose: The aim of this study is to evaluate the characteristics profile and clinical features of vitiligo patients. Methods: The research material was taken from the medical record of vitiligo patients in the Division of Cosmetics Outpatient Clinic Dermatovenerelogy Dr. Soetomo General Hospital Surabaya from 2018-2020. Result: This study was obtained by a number of new vitiligo patients 115 (0.3%) of the total number of new outpatient clinic visits of Dermatovenereology Dr. Soetomo General Hospital Surabaya. The majority of the gender is female (53.9%), late adolescence (26.96%), students (25.22%), and the onset of vitiligo 1-5 years (30.43%). The most common risk factors were idiopathic (51.3%) and clinical types are non-segmental vitiligo (53.04%). Conclusion: Vitiligo predominantly affects in females with active age groups of 17-25 years old, and students.

Background: Psoriasis vulgaris can be diagnosed clinically. A biopsy is usually used to confirm non-classic cases. The findings of the histopathology feature are not usually present, thus clinical relevance is needed to confirm the diagnosis. Purpose: To describe the histopathology findings from tissue samples of histopathologically confirmed psoriasis vulgaris reported in the Department of Pathology and Anatomy of Dr. Soetomo General Hospital. Methods: A descriptive-retrospective study of pathology-ascertained tissue samples of histopathologically confirmed psoriasis vulgaris was reported in the Department of Pathology and Anatomy from patients who were also previously diagnosed clinically with psoriasis vulgaris in the Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Academic Hospital over a period of 2 years. Morphological parameters were observed after histopathology sections were stained with hematoxylin and eosin. Result: Thirty-three tissue samples were examined. Parakeratosis (86%) and hypogranulosis (70.3%) were the most observed findings. Club-shaped rete ridges, suprapapillary plate thinning, and spongiform pustules of Kogoj were the least observed findings (each by 2.7%). Three tissue samples (8.1%) showed only parakeratosis. Only 1 tissue sample (2.7%) showed 4 features (absence of the granular layer, parakeratosis, microabscess of Munro, and spongiform pustules of Kogoj). No tissue sample showed every histopathology finding of psoriasis vulgaris. Conclusion: All of the histopathology features of psoriasis vulgaris are rarely found in one tissue section. Albeit histopathology is believed to be the gold standard diagnosis of psoriasis vulgaris, relevance with clinical findings is still mandatory to support the diagnosis.

Background: Atopic Dermatitis (AD) is a common dermatosis in children, that includes skin architecture defects, immune dysregulation, and changes of skin flora. Several new drugs have been found to reduce the severity of AD. Vitamin D is one of the new therapies that is still controversial. The purpose of this research is to conclude the efficacy of vitamin D on atopic dermatitis severity in children aged 0-18 years old. Methods: A systematic search was conducted on the PubMed, Cochrane, ProQuest, Google Scholar, Clinical Trial website, and university repositories including studies published from January 2010 through October 2020. We compared populations, intervention, study design, and outcomes. Statistical analysis was done with Review Manager 5.4.1. Results: Eight articles met eligibility and inclusion criteria, four articles provided complete data and were analysed. Not all studies demonstrated the efficacy of vitamin D but a meta-analysis of four studies of vitamin D supplementation vs placebo found a mean difference of -0.93 (95%CI -1.76, to -0.11, p

Background: Acne vulgaris (AV) is not a deadly condition may affect one’s quality of life. Treatment of AV includes topical and oral, depending on the severity. Antibiotics as oral treatment should not be given alone because it can precipitate resistance. Purpose: To describe the clinical characteristics of AV in a tertiary hospital in Indonesia and evaluate the treatment given. Methods: This is a descriptive, retrospective study with a cross-sectional design. The study subject was classified based on severity according to Plewig and Kligman’s acne grading. Further evaluation was made according to the type of lesion, the risk factortopical and oral treatment in subjects with grades 2, 3, and 4. This research was conducted at the Cosmetic Medic Division, Dermatology and Venereology Outpatient Clinic at Dr. Soetomo General Academic Hospital Surabaya based on medical records from the period of 2017 to 2019. Result: From 2017 to 2019, there were 525 (1.1%) new AV patients out of a total of 45,754 new patients. AV was the major diagnosis in the Cosmetic Medic division. AV grades 2, 3, and 4 were found in 167 patients (32.0%). The most common lesion was papulopustular (75.4%) and the most common risk factor was hormonal (58.7%). All the patients received tretinoin, clindamycin gel 1.2%, and sunscreen for topical treatment. Doxycycline was the most common oral antibiotic used (98.2%) Conclusion: The most common AV grade in this study was mild AV. Oral antibiotics were given to moderate-to-severe AV patients in combination with topical treatment to prevent resistance.

Background: Syphilis infection and HIV are major health problems worldwide. Both of these diseases can be transmitted through sexual contact, so often a person suffers from both diseases at the same time. Purpose: To describe the risk factors of syphilis and HIV/AIDS coinfection in the Infectious Disease Intermediate Treatment Unit (UPIPI) inpatient and outpatient ward of Dr. Soetomo General Academic Hospital in 2019. Methods: The study design used in this study is a retrospective descriptive study aimed at evaluating sexual and non-sexual factors that cause syphilis and HIV coinfection. The research population was patients in the inpatient and outpatient rooms of UPIPI RSUD Dr. Soetomo Surabaya for the January-December 2019 period. The sampling technique was sourced from secondary data, namely medical record data from the inpatient and outpatient rooms of UPIPI RSUD Dr. Soetomo Surabaya for the period January-December 2019. The data in this study were obtained from medical records and patient biodata. Result: Based on the calculation results, it is known that age group (P=0.022>0.05), and gender (P=0.024>0.05) had no effect on the risk of syphilis and HIV coinfection, while marital status (P=0.048

Background: Skin aging is a physiological process that involves changes in skin cells and tissues due to abnormal mechanisms and decreased tissue function caused by both intrinsic and extrinsic factors. Skin aging has different clinical manifestations in each individual, which were classified using Glogau's photoaging classification. Purpose: The objective of this descriptive observational study is to evaluate the profile of skin aging patients at Dr. Soetomo General Hospital Surabaya from January – December 2019. Methods: This study utilized a total sampling technique from data obtained from the patients' medical records, which included age, gender, occupation, anamnesis, physical examination, diagnosis, and treatment received by patients. This research has been reviewed by the Ethics Committee at Dr. Soetomo General Hospital Surabaya (0438/KEPK/XII/2021). Result: Based on data obtained from medical records, 415 samples of skin aging patients were collected. The highest number of cases occurred among patients aged 45 - < 60 years. Most patients were female, and the majority of patients’ occupations were private employees. History taking findings include the most common complaint, namely dull skin, with the most precipitating factors discovered in patients, namely exposure to sunlight and pollution. Wrinkles were the most common physical examination finding in patients, with Glogau's photoaging III being the most common diagnosis. Most patients were treated with photoprotection in the form of sunscreen. Conclusion: With the increase of public awareness about appearance, as well as human health and quality of life, skin aging is receiving adequate attention nowadays, with sun exposure being the most common precipitating factor.

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Introduction: Keloid and hypertrophic scar are pathological scars resulting from excessive accumulation of collagen in wound healing process. Data about profiles of keloid and hypertrophic scar are rarely found in Indonesia. Therefore, it is necessary to conduct research related to keloid and hypertrophic scar. This study aimed to provide valuable data for further research. Methods: This was descriptive retrospective study evaluating 105 patients treated for keloid and hypertrophic scar from 2014 to 2017 using medical records of working-age patients. Results: Mostly in patients between 17-25 years old (40%). Comparison between male and female patients were 1.07:1 (keloid) and 1.09:1 (hypertrophic scar). As many as 10.71% of patients of keloid and 17.39% patients of hypertrophic scar were private employees. 23.21% patients with keloid and 23.91% patients of hypertrophic scar were Javanese. 14.29% patients of keloid and 19.57% patients of hypertrophic scar tend to have daily indoor activities. 17.86% patients of keloid and 26.09% patients of hypertrophic scar felt dark-skinned toned. Most keloid scars were caused by traumatic lesions (32.14%), located on the chest (19.54%), and treated by corticosteroid injection. Hypertrophic scar mostly caused by burn injury (54.35%), located on the face (29.55%), and treated by excision surgery. Conclusion: Both keloid and hypertrophic scars were mostly developed in 17-25 years old, male, private employees, Javanese ethnic, dark skin tone patients, with daily indoor activities, caused by traumatic lesion and located on the chest, earlobe, and hand, treated by corticosteroid injection (keloid). Meanwhile, hypertrophic scars are mostly caused by a burn injury on the face and treated by excision surgery.

Background: The damage of the peripheral nerves that occurs in Morbus Hansen (MH) patients can cause disability due to loss of sensory, motor and autonomic functions can cause wounds, infections, ulcers and disability. Ulcers are the most common cause of disability complications in MH patients and requires a certain time of healing. As many as 10-20% of MH patients experience ulcers on the soles. Tea Tree Oil (TTO) is extracted from steam distillation of the leaves and twigs of the Australian native shrub Melaleuca Alternifolia. In ulcers, TTO can work as an antimicrobial, anti-inflammatory, and antioxidant. TTO preparation in the form of hydrogel is believed to help the wound healing process. Purpose: To investigate the effect of TTO hydrogel 5% on the healing of Chronic Plantar Ulcer of Leprosy (CPUL). Methods: Tea tree oil hydrogel 5% was applied every 3 days for up to 8 weeks in 22 subjects with chronic MH plantar ulcers. Ulcer size, side effects, and possible side effects are evaluated weekly. Result: There were significant clinical and statistical differences in ulcer size (p = 0.000) and in ulcer depth (p = 0.000) after TTO hydrogel 5%. No side effects occurred in this study. The ulcer healed was 59%, the ulcer improved by 36.4%, the persistent ulcer was 4.6%, and there was no ulcer that got worse. Conclusion: TTO hydrogel 5% is effective in the healing process of chronic MH plantar pedis ulcers.

Background: Fractional Carbon Dioxide (CO2) LASER has better efficacy compared to conventional LASER in treating scar tissue such as acne scars, keloids, and striae albae. However, a population with darker skin has a higher risk of side effects, especially in post-inflammatory hyperpigmentation. Purpose: To evaluate the efficacy and side effects of fractional CO2 LASER in new patients with acne scars, keloids, and striae albae in the Dermatovenereology outpatient clinic. Methods: Retrospective analysis was done on 42 medical records of patients who met the inclusion criterion, which was those who have undergone fractional CO2 LASER treatments. The efficacy and side effects of the therapy were identified and analyzed using the Statistical Package for Social Sciences (SPSS) version 17 program. Result: A total of 42.9% of patients underwent fractional CO2 LASER treatments for acne scars, while 31% and 26.1% of patients received treatments for keloids and striae albae, respectively. There was a statistically significant decrease in the degree of acne scar (2.72 ± 0.83), keloid height (2.2 ± 0.405), and striae width (0.39 ± 0.02). The statistically significant side effects were hyperpigmentation (59.5%), crustae (26.2%), erythema ≥ for 4 days (19%), and new acne (19%). Conclusion: Fractional CO2 LASER was effective for treating scar tissue (acne scars, keloids, and striae albae) with a higher incidence of side effects in population with darker skin and post-inflammatory hyperpigmentation.

Background: Photoaging is an early skin aging process caused by sun exposure. Sunscreen is effective as a primary photo-protection to protect the skin from the dangers of ultraviolet radiation (UV) sunlight. However, sunscreen is often used in the wrong manner, so that it can reduce the effectiveness of the work of sunscreen. Purpose: To describe the knowledge and the practice of sunscreen usage among medical students of Universitas Airlangga and find out the relationship between the knowledge and the practice of sunscreen usage. Methods: This study is an analytic-observational study. Data were collected through questionnaire sheets that distributed to medical students of Universitas Airlangga class of 2016, 2017, and 2018. The results were analyzed using the Spearman test with a significance level of 1%. Result: Obtained total respondents that fulfilled the inclusion criteria were 159 respondents, with 88.68% were female and 11.32% were male. Based on Fitzpatrick skin type, 55.97% respondents found with skin type-IV. There were 59.12% respondents got score of knowledge in the medium category and 64.78% respondents got score of practice also in the medium category. Based on analytic statistic correlation test between knowledge and practice of sunscreen usage, known that the significance value is equal to 0,006 with coefficient correlation is equal to 0.216. Conclusion: The knowledge and the practice of sunscreen usage among medical students of Universitas Airlangga is already in a fairly good range. There is a parallel relationship between the knowledge and the practice of sunscreen usage among medical students of Universitas Airlangga but with a low level of correlation strength.

Background: Acne Vulgaris (AV) is one of the most common diseases in the field of dermatology and ranks as the eighth most prevalent disease worldwide. Early management of this potentially deforming skin disease may reduce the pathophysiological burden and improve the quality of life of patients. Purpose: This study aimed to determine the pharmacotherapy for new patients with AV. Methods: This cross-sectional study used new patients with AV of the Cosmetic Division of the Outpatient Skin and Venereal Health Unit, Regional Public Hospital (RSUD) Dr. Soetomo, from January to December 2013 that were descriptively presented. The variable was the pharmacotherapy given. This study used secondary data collection by looking at the patients’ medical records. The variables studied were acne lesions and pharmacotherapy regimens, including the administration route and the medicine used. Results: The number of samples that met the inclusion criteria was 951 patients. Comedonal acne was most commonly given topical tretinoin. Papulopustular acne was most commonly given a topical combination of clindamycin and tretinoin, while acne conglobata was most commonly given a combination of topical clindamycin and tretinoin with oral doxycycline. Conclusion: The new patients with comedonal acne were mostly prescribed topical tretinoin pharmacotherapy. A pharmacotherapy combination of topical clindamycin and tretinoin was given to most new patients with papulopustular acne, whereas new patients with conglobata acne were given a pharmacotherapy combination of topical tretinoin and clindamycin with oral doxycycline.

Background: Gonorrhea refers to a set of clinical conditions involving infection with the sexually acquired bacterial pathogen, Neisseria gonorrhoeae. One of the simplest gonococcal infections in women involves mucosal surfaces of the endocervix that cause cervicitis, a frequently asymptomatic inflammatory condition that results in an abnormal mucopurulent discharge and cervical friability. Purpose: To report a case of cervicitis gonorrhea in a female patient whose sexual partner had a hisstory of unprotected promiscuous intercource with multiple sex worker. Case: A 24-year-old female patient presented with increased vaginal discharge for 4 days. Her husband had a history of having sexual intercourse with a sex worker 8 days before. Physical examination revealed mucopurulent exudate in the genitalia and endocervical canal. The Gram staining showed numerous leucocytes and Gram-negative intracellular diplococci, while the result of polymerase chain reaction (PCR) examination for Chlamydia trachomatis was negative. The patient was treated with single-dose cefixime 400 mg orally and doxycycline 100 mg orally twice a day for 7 days. Discussion: The present case report showed cervicitis gonorrhea co-infected with a nonspecific genital infection that was felt asymptomatic and unintentionally found when the patient accompanied her husband to Sexually Transmitted Infection (STI) clinic. The presumptive treatment of cervicitis directed against N. gonorrhoeae and C. trachomatis in this patient leads to a complete cure of the disease. Conclusion: It is important to treat the sexual partner of a patient with urethritis gonorrhea. The empiric treatment of cervicitis that is directed against N. gonorrhoeae and also against C. trachomatis is mandatory in preventing further possible complications.

Background: Chronic plantar ulcers in leprosy (CPUL) increase morbidity, increase medical costs, cause loss of productivity, and decrease quality of life. CPUL is a severe complication of leprosy disease with a 10-20% incidence. In general, CPUL consume a significant amount of time to heal. Green tea extract contains high amount of Epigallocatechin gallate (EGCG). EGCG functions as antiinflammatory, antimicrobial, and immunomodulator. This suggests that EGCG is effective for dermal wound treatment by facilitating reepithelialization. Purpose: To investigate the effect of topical EGCG 1% on the CPUL healing process. Methods: The topical EGCG 1% were applied every three days for eight weeks. Size of the ulcers, side effects and possible complications were monitored weekly. Result: There were significant clinical and statistical differences in the size and depth of the ulcers (p=0.000), as observed in the EGCG group. There was no side effect and complication found. Conclusions: Topical EGCG 1% was effective for CPUL healing. Sixty three point six percent of the ulcers were clinically healed, 31.8% demonstrated improvement, and 4.6% no effect was observed.

Background: Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids. Topical steroids in Indonesia are often used without prescription. The misuses of steroids has led to the emergence of TI. Clinical diagnosis of TI is still a challenge even by dermatologists, thus lead to a delay treatment. Purpose: To report a case of TI in child. Case: A 10-year-old girl presented with itchy ill defined erythematous patches on the face. The patch had appeared since 2 months before. The patient had already got topical and systemic corticosteroid but there were no improvement. Physical examination showed multiple papules on ill defined scaly erythematous patches on facial region. Potassium hydroxide examination revealed arthroconidia and septate hyphae, while from culture isolation Microsporum gypseum were identified. Diagnosis of TI was successfully made and the patient was treated with griseofulvin two times 125 mg per day orally for four weeks. The patient showed good result. Discussion: TI lesions usually lose their classic annular appearance thus the disease is likely to be confused with other diseases. It is important for dermatologist to consider fungal infection as differential diagnosis of prolong erythematous scaly lesions unresponsive to steroids or calcineurin inhibitors, and encourage of laboratory tests for mycological evaluation. Conclusion: Discontinuance of steroid and adminisration antifungal therapy promoted lesions improvement clinically and mycologically. It is important to regulate the topical steroid distribution and to educate primary care doctors about superficial dermatophytosis to reduce the increasing case of TI.

Latar Belakang: Akne vulgaris (AV) adalah penyakit inflamasi kronik yang menyerang unit pilosebasea yang paling banyak menyerang pasien dewasa muda di hampir seluruh negara. Pasien dengan akne vulgaris dapat mengalami tekanan psikologis sehingga memengaruhi kualitas hidup pasien. Tujuan: Mengevaluasi kualitas hidup pasien akne vulgaris derajat sedang. Metode: Merupakan penelitian potong lintang observasional dengan menggunakan kuesioner yang melibatkan pasien AV derajat sedang yang mendapatkan terapi AV standar dan penambahan fototerapi sinar biru pada periode Desember 2017 hingga Februari 2018 di Divisi Kosmetik Medik Unit Rawat Jalan Kesehatan Kulit dan Kelamin RSUD Dr.Soetomo Surabaya. Hasil: Sejumlah 40 pasien berusia 16 – 25 tahun dengan rata-rata 19,22 ± 2,76 tahun. Subjek merasakan AV berefek berat terhadap kualitas hidupnya (65%), diikuti dengan yang merasakan berefek sedang (20%), berefek ringan (10%), berefek sangat berat (2,5%), dan tidak ada efek terhadap kualitas hidup (2,5%). Skor total kuesioner Dermatology Life Quality Index (DLQI) dianalisis korelasi dengan variabel lama sakit dan usia subjek menggunakan uji Spearman’s rho. Analisis tersebut menunjukkan adanya korelasi yang bermakna antara skor DLQI total dengan lamanya subjek menderita AV (p = 0,037; CI 95%). Kekuatan korelasi antar kedua variabel (r) negatif lemah. Hal tersebut berarti semakin lama durasi menderita AV maka semakin kecil skor DLQI total. Skor DLQI total dikatakan tidak berkorelasi dengan usia subjek (p = 0,318; CI 95%). Simpulan: Penelitian ini menunjukkan penurunan kualitas hidup pada pasien akne derajat sedang, dan kualitas hidup berkorelasi dengan lama durasi menderita AV.

Latar Belakang: Vitiligo adalah penyakit depigmentasi yang paling sering dijumpai dengan manifestasi klinis berupa makula berwarna putih susu berbatas tegas, patogenesis kompleks yang belum dipahami dengan baik sehingga evolusi penyakit tidak dapat diprediksi. Peran kemokin CXCL 10 pada vitiligo masih belum banyak diketahui dan dipelajari. Penelitian mengenai kadar CXCL 10 serum pada vitiligo belum pernah dilakukan di Indonesia. Tujuan: Untuk mengetahui profil kadar CXCL 10 serum pada pasien vitiligo. Metode: Rancangan penelitian ini deskriptif cross-sectional yang bertujuan untuk mengevaluasi kadar CXCL 10 serum pada pasien vitiligo, 16 sampel yang didiagnosis vitiligo dilakukan pengambilan darah pada pasien untuk mengukur kadar serum CXCL 10. Hasil: Kadar CXCL 10 serum pada penelitian ini lebih tinggi pada pasien vitiligo, tidak ada perbedaan bermakna antara laki laki dan perempuan dan distribusi proporsi tipe vitiligo tertinggi adalah generalisata. Simpulan: Profil kadar serum CXCL 10 pada pasien vitiligo berdasarkan jenis kelamin, usia, dan lama menderita vitiligo.

Latar Belakang: Dermatitis atopik (DA) adalah penyakit kompleks dengan gejala klinis berspektrum luas. Penyakit ini ditandai dengan gejala gatal yang dominan sampai dapat mengganggu kualitas tidur, dan dapat menyebabkan infeksi sekunder. Patogenesis DA meliputi gangguan sawar kulit, faktor lingkungan, agen infeksius, dan abnormalitas sistem imun. Gangguan sawar kulit menjadi faktor utama yang harus diperbaiki salah satunya dengan pemberian pelembap seawal mungkin. Tujuan: Membandingkan efikasi pelembap yang mengandung seramid, mentol, dan polidokanol dengan jeli petrolatum pada pasien DA derajat ringan. Metode: Penelitian ini merupakan penelitian eksperimental analitik dengan menggunakan metode uji klinis acak terkontrol tersamar tunggal, membandingkan terapi pelembap yang mengandung seramid, polidokanol, dan mentol dengan pelembap jeli petrolatum pada pasien DA anak dan dewasa dengan derajat keparahan ringan yang dinilai melalui indeks scoring of atopic dermatitis (SCORAD). Hasil: Penghitungan nilai SCORAD sebelum dan sesudah intervensi pada kelompok perlakuan atau kontrol memiliki perbedaan yang tidak signifikan dengan nilai p>0,05. Simpulan: Pemberian kedua jenis pelembap dapat menurunkan derajat keparahan SCORAD pada pasien DA.

Latar Belakang: Rosasea adalah penyakit inflamasi kulit kronis yang biasanya terdapat pada bagian tengah wajah, termasuk pipi, hidung, dagu, dan dahi. Area yang terlibat tidak hanya wajah, tetapi juga daerah sekitarnya seperti leher, dada, punggung, dan kulit kepala serta mata. Tujuan: Mengevaluasi gambaran umum dan evaluasi pasien baru rosasea di Divisi Kosmetik Medik Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya periode tahun 2013-2015. Metode: Penelitian retrospektif dengan meneliti catatan medik pasien rosasea di Divisi Kosmetik Medik URJ Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya selama Januari 2013 sampai Desember 2015. Hasil: Jumlah kunjungan pasien baru rosasea selama periode 2013-2015 sebesar 24 pasien. Sebagian besar pasien adalah wanita. Usia terbanyak adalah 25-44 tahun. Keluhan utama terbanyak adalah jerawat atau bintil serta kemerahan di wajah. Subtipe rosasea yang paling banyak ditemukan adalah subtipe eritematotelangiektasis sebesar 37,5%. Terapi yang terbanyak untuk pengobatan topikal adalah metronidazol dan pengobatan sistemik adalah doksisiklin. Sebesar 75% pasien melakukan kunjungan ulang. Simpulan: Terdapat penurunan jumlah pasien rosasea. Subtipe rosasea yang banyak ditemukan adalah subtipe eritematotelangiektasis dan subtipe papulopustular, subtipe phymatous hanya sedikit, sedangkan subtipe okular tidak ditemukan.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder, recurrent lesion with a distinctive and specific distribution of lesions according phases. Patients with allergic diseases have been known to have a variety of patterns of cortisol. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and the role of cortisol has been studied in patients with DA. Free cortisol adrenal cortex is considered biologically active, which passively diffuses into all body fluids including saliva. Another advantage is the saliva examination is non-invasive, stress free and easy to do anywhere. Purpose: To analyze the correlation between levels of serum cortisol and salivary cortisol in patients with AD. Methods: Analytical, observational, cross-sectional study of the 29 AD patients who underwent blood and saliva samples by the method of "passive drooling" conducted on the hour 8:00 to 9:00 to see the levels of serum cortisol and salivary cortisol. Results: Twenty-nine subjects revealed mean serum cortisol levels 6,703,82g/dL, mean salivary cortisol levels was 1,430,96g/dL. Equation of salivary cortisol = 0,471+0,142*serum cortisol 2 (R=28,5%). Conclusions: The increasing of serum cortisol level of AD patients will result in increased levels of cortisol in saliva. Saliva collection methods by “passive drooling” were able to describe the serum cortisol levels at 28,5%. Key words: atopic dermatitis, serum cortisol, salivary cortisol.

Background: Atopic dermatitis is a chronically and relapsing inflammatory skin disease affecting individuals with atopic history or their families. Atopic dermatitis affects all ageswith percentage 15-30% in children and 1-2% in adults. Chronic pruritus, skin infection, sleep disorder, and growth disorder are signs and symptomps commonly found in childhood atopic dermatitis. Evaluation of the profile and management of DA were needed to improve the management of atopic dermatitis. Purpose:To evaluate the profile of childhood atopic dermatitis. Methods: A retrospective study of all new cases of childhood atopic dermatitis who visited the Pediatric Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya from January 2007 to Desember 2011. Results: Numbers of chilhood atopic dermatitis increased from 2007 to 2011. Itchy was the main complaint of DA, but redness patches (32,3%) and xerosis cutis (9,1%) were also found. Atopic history in patients and or their families were found in 842 patients (74,3%). Treatment was antihistamin in 879 patients (77,5%). Conclusions: Chilhood atopic dermatitis are still increasing by years. Determining and avoiding trigger factors are education for DA's patients and their families in preventing it recurrency. Key words: atopic dermatitis, childhood, retrospective study.

Background: Acne Vulgaris (AV) is a chronic and obstructive inflammatory skin disease of the pilosebaceous unit. Testosterone is main androgen hormone that have a role in the pathogenesis of AV. Pevious researches have shown controversial results regarding serum testosterone levels in AV. Purpose: To evaluate the association of serum testosterone levels with AV severity in adult women in Dermatovenereology Outpatient Clinic of Dr. Soetomo General Hospital Surabaya. Methods: This is an analitic observational study, with 37 patients based on the inclusion and exclusion criteria. Results: Mean serum testosterone level in mild AV group was 39.16 + 24.18µg/dL, moderate AV group was 39.75 + 23.75 µg/dL, and severe AV group was 52.46 + 24.00 µg/dL. These results indicate that serum testosterone level in severe AV group was higher than moderate and mild AV groups. But there was no statistically significant correlation between serum testosterone levels and the severity of AV. Conclusions: Serum testosterone levels in patients with severe AV was higher than moderate and mild AV. No correlation between serum testosterone levels with AV severity in adult women. Further research ruled out confounding factors is needed to determine hormonal role in the pathogenesis of AV.

Background: Plantar ulcer is a physical disability that most often occurs in approximately 10-20% of leprosy patient. Conventional therapies such as dressings, surgical debridement, and skin graft can not provide satisfactory improvement. Platelet rich plasma (PRP) has a variety of growth factors required in ulcer wound healing. Purpose: To prove the effect of PRP topical gel to the size of wound, macrophage activation, neovascularization, fibrosis, and formation of granulation tissue on chronic plantar ulcer healing in leprosy patients. Methods: The analytic cohort study of 20 leprosy patients with chronic plantar ulcer in Morbus Hansen Division, Dermatology and Venereology Outpatient Clinic, Dr. Soetomo Hospital Surabaya. Biopsies were performed before and after PRP topical gel treatment on leprosy patient with chronic plantar ulcers. Results: After two doses of PRP topical gel, wound size of 9 patients (45%) was reduced

Phaeohyphomycosis is a rare fungal infection caused by melanized fungi which usually involve the skin and subcutaneous tissue. It is an infrequent cause of infection in human beings. Common clinical manifestations are subcutaneous cystic swellings, which is localized, characterized by subcutaneous asymptomatic nodular lesions that develop after traumatic implantation of fungus from contaminated soil, thorns or wood splinters, especially on extremities. We report a case of subcutaneous phaeohyphomycosis presenting as multiple cystic swellings over the left lower leg with unknown predisposing factors. At first, the patient was misdiagnosed as soft tissue tumor and subcutaneous tuberculosis, then got surgical and anti-tuberculosis therapy respectively, but there was no improvement. Further investigation revealed granulomatous inflammation on histopathology examination and black-coloured colonies identifed as Exophiala dermatitidis on fungal culture. This case of phaeohyphomycosis was successfully treated by itraconazole monotherapy without surgical excision and still under follow-up.

Melatonin an important immunomodulatory molecule in allergic diseases. Melatonin also plays a role in several body systems including to regulate circadian rhythms because of its role to cause drowsiness. Research shows in the case of atopic dermatitis (AD) circadian production of melatonin is reduced compared to healthy controls. This study aimed to investigate the differences of urinary melatonin levels between children with AD and healthy controls, and its relationship with disease severity. A cross sectional study was conducted in pediatric dermatology division of our outpatient clinic. Severity of AD was determined by using the instruments Scoring Atopic Dermatitis (SCORAD). Urinary melatonin levels were measured by Enzyme-linked immunosorbent assay (ELISA). The urinary melatonin levels in AD group were not significantly lower than in healthy controls (P =0.98 P 0.05) but there’s a tendency of decreased urinary melatonin with increased the severity of AD.

Background: Acne vulgaris (AV) is a chronic inflammatory multifactorial disease that involves the pilosebaceous unit. The lesions of acne may be either non-inflammatory (comedones, which are blackheads or whiteheads) or inflammatory lesions (papules, nodules or pustules). The effects of diet and cosmetics on acne are still inconclusive. The objective of this study was to analyse the relationship between diet, cosmetics and the degree of AV. Methods: This was a hospital-based, analytic observational study with cross-sectional design. The subjects were patients from the Outpatient Clinic of Dermatovenereology Department of Dr. Soetomo General Hospital. The questionnaire was filled by the respondents and the degree of AV was graded by the specialist. Results: Among the types of diet, white bread (p=0.039), chocolate (p=0.044) and oily food (p=0.013) are significantly associated with the degree of AV. However, white rice, potatoes and milk were insignificantly related to degree of AV (p>0.05). No significant association was found in cosmetics (cleanser, moisturizer, facial protection, exfoliators and decorative cosmetics) with the degree of AV (p>0.05). Conclusions: The factors that have an influence on the degree of AV are white bread, chocolate and oily food intake.

Background: Atopic Dermatitis (AD) is a chronic inflammatory relapsing skin disorder along with itchy sensation. Etiopathogenesis DA remains unclear, however in common are caused by impaired epidermal barrier function of the skin and immune system that tend to ensue infection. Vitamin D is an immunomodulator and plays an important role in the pathogenesis of DA through improving the integrity of skin barrier permeability, expression of antimicrobial peptide (AMP), which inhibit infection, and reduce inflammation. Deficiency of vitamin D may increase the development risk of DA lesion. Purpose: To evaluate the serum levels of vitamin D (25[OH]D) in patients with DA. Methods: A descriptive observational cross-sectional study, in 34 DA patients at Dermatology and Venereology Outpatient Clinic of Dr. Soetomo Hospital Surabaya. Subjects were enrolled through consecutive sampling, serum vitamin D levels were measured using enzyme-linked immunosorbent assay (ELISA) method. Results: Serum levels of vitamin D (25[OH]D) in DA patients was 22.72±14.55 ng/mL. Serum levels of vitamin D based on the severity DA: mild (30.86±22.66 ng/mL); moderate (20.42±10.13 ng/mL); and severe (18.84±8.22 ng/mL). Conclusion: Deficiency of vitamin D can occur in DA patient with low level of serum vitamin D (25[OH]D), but the relationship with the severity of DA remains to be done further research. Key words: atopic dermatitis, vitamin D (25[OH]D).

Background: Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels and the most common type of vasculitis in children. Vesicles and haemorrhagic bullae were thought to be rare in HSP and maybe difficult to diagnose. Purpose: To describe the rare case of haemorrhagic bullous lesion in HSP. Case: A 15-year-old Javanese girl was admitted to Dr. Soetomo General Hospital Surabaya with one week history of multiple haemorrhagic blisters on her extremities, accompanied with joint pain, abdominal pain, and severe nausea. Firstly, it’s only a few redness patches then become numerous and changed to haemorrhagic blisters. A dermatological examination shown multiple bullae and vesicles on multiple palpable erythematous purpura. There were hypokalemia on laboratory examination and histopathological examination concluded a leukocytoclastic vasculitis. Discussion: Fluid balance, oral corticosteroid, oral antihistamine, antiemetic injection, and potassium correction were administered to the patient. Dexamethasone was discontinued because there was a presence of melena. Symptomatic treatment was given and significantly improvement was achieved in one month after treatment. Conclusion: Henoch-Schonlein purpura is diagnosed based on history, physical, clinical, and histopathological examination. Vesicles and haemorrhagic bullae are rare in HSP, and it does not seem to have any prognosis value in the outcome of HSP. Key words: Henoch-Schonlein purpura, haemorrhagic bullous lesion, small vessel vasculitis.

Background: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) is rare, but threaten the patient's life. Purpose: To evaluate management of SJS and TEN. Methods: A retrospective study to patient with SJS and TEN in 2011-2014, data regarding the prevalent of patients, history of patients, etiology, clinical manifestation, supporting of examination, therapy, complication, mortality, follow up, and duration of treatment patients recorded from medical report. Result: Total patient with SSJ and NET were 37 patients. Most patients were female (73%) with majority age range 25-44 years (48.6%), epilepsy is the most comorbidities (27%), the main etiology the use of drug (62.1%), the highest class of drugs is analgesic drugs (38.6%), 37 patients using corticosteroid for therapy (100%), skin is the most complication (50.9%), and death rate was zero (0%). Conclusion: Management of patients with SJS and TEN gives complete recovery. Key words: Stevens-Johnson syndrome, toxic epidermal necrolysis, management.

Background: Acne is a disorder of pilosebasea unit, that mostly affect an adolesecent, caused by hormonal changing. Dietary is one factor that was thought to induce acne. But the association between diet and acne are still controversial. Purpose: Review the role of some diets for acne Review: Acne is multifactorial disease, whereas diet is one of many factors that excarcerbate acne. Some dietaries are thought have some roles in acne, including carbohidrate, milk, chocolate, fatty acid, zinc-iodine, vitamin A, and antioxidant. Some research has proved the relationship between diets and acne but there are still few limitations. Conclusion: Relationship between diets and acne still need more research with better methods. Key words: acne, diet, glicemic index.

Background: Photoaging is premature skin aging that is caused by sun exposure in long periode. Glycolic acid peel is one of photoaging treatment that improve skin at epidermal layer. Improper patient selection and irregular follow-up may become factors of unsuccessful treatment. Purpose: To evaluate gycolic acid peel treatment for photoaging for improvement of medical service in the future. Methods: A retrospective study to photoaging patiens that were managed with glicolyc acid peel in Medical Cosmeutic Division Dermatology and Venereology Departement Dr. Soetomo General Hospital Surabaya on period from January 2011 to December 2013. The data were collected from medical record, Results: New patient of photoaging is 455 patients in Medical Cosmetic Division, 15.8% patients were treated with glycolic acid peel. Diagnosis classification were using Glogau classification. Thirty six point one percent of patient did not undergo follow up and 47.1% of patient’s interval of follow up were more than 4 weeks. Majority of patient (37.5%) have no improvement. Conclusion: Education to photoaging patient that undergo glycolic acid peel need to be improved. Clinical worsening and no improvement in some patients may be caused by irregular follow up. Key words: photoaging, retrospective study, glycolic acid peel.

Background: Atopic Dermatitis (AD) is a common dermatosis in children, that includes skin architecture defects, immune dysregulation, and changes of skin flora. Several new drugs have been found to reduce the severity of AD. Vitamin D is one of the new therapies that is still controversial. The purpose of this research is to conclude the efficacy of vitamin D on atopic dermatitis severity in children aged 0-18 years old. Methods: A systematic search was conducted on the PubMed, Cochrane, ProQuest, Google Scholar, Clinical Trial website, and university repositories including studies published from January 2010 through October 2020. We compared populations, intervention, study design, and outcomes. Statistical analysis was done with Review Manager 5.4.1. Results: Eight articles met eligibility and inclusion criteria, four articles provided complete data and were analysed. Not all studies demonstrated the efficacy of vitamin D but a meta-analysis of four studies of vitamin D supplementation vs placebo found a mean difference of -0.93 (95%CI -1.76, to -0.11, pp=0.008) in vitamin D supplementation groups compared to placebo groups. Conclusions: Vitamin D supplementation in paediatric atopic dermatitis patients could offer improvement of disease severity but the recommended dose and duration of administration cannot be concluded yet.

Background: Atopic Dermatitis (AD) is a common dermatosis in children, that includes skin architecture defects, immune dysregulation, and changes of skin flora. Several new drugs have been found to reduce the severity of AD. Vitamin D is one of the new therapies that is still controversial. The purpose of this research is to conclude the efficacy of vitamin D on atopic dermatitis severity in children aged 0-18 years old. Methods: A systematic search was conducted on the PubMed, Cochrane, ProQuest, Google Scholar, Clinical Trial website, and university repositories including studies published from January 2010 through October 2020. We compared populations, intervention, study design, and outcomes. Statistical analysis was done with Review Manager 5.4.1. Results: Eight articles met eligibility and inclusion criteria, four articles provided complete data and were analysed. Not all studies demonstrated the efficacy of vitamin D but a meta-analysis of four studies of vitamin D supplementation vs placebo found a mean difference of -0.93 (95%CI -1.76, to -0.11, pp=0.008) in vitamin D supplementation groups compared to placebo groups. Conclusions: Vitamin D supplementation in paediatric atopic dermatitis patients could offer improvement of disease severity but the recommended dose and duration of administration cannot be concluded yet.