Cita Rosita Sigit Prakoeswa

Lactobacillus plantarum IS-10506 supplementation reduced SCORAD in children with atopic dermatitis

Lactobacillus plantarum IS-10506 is a novel probiotic isolated from dadih, an Indonesian traditional fermented buffalo milk. Its in vitro and in vivo probiotic properties have been assessed. Probiotic function has been shown in vivo by the suppression of allergic reactions in BALB/c mice through the action of T-regulatory cells cytokines by balancing Th1 and Th2 immune response. Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease characterised by the imbalance of Th1 and Th2. The aim of the study was to assess the probiotic function of L. plantarum IS-10506 in children with mild and moderate AD. A randomised double-blind placebo-controlled trial comparing microencapsulated L. plantarum IS-10506 (1010 cfu/day) and placebo (skim milk-Avicel) twice daily for 12 weeks was conducted in an outpatient clinic on children with mild and moderate AD. The trial included 22 AD children divided into intervention and control groups of n=12 and n=10 patients, respectively. Scoring Atopic Dermatitis Index (SCORAD) and serum immunoglobulin E (IgE), interleukin (IL)-4, interferon gamma (IFN-γ), forkhead box P3 (Foxp3+)/IL-10, and IL-17 levels were assessed. Demographic and baseline characteristics were not significantly different between the two groups. SCORAD and levels of IL-4, IFN-γ, and IL-17 were significantly lower in the probiotic group than those in the placebo group, while the IgE levels were not significantly changed. The ratio of Foxp3+ to IL-10 was significantly higher in the probiotic group than that in placebo group. Supplementation with the probiotic L. plantarum IS-10506 offered a potential treatment for children with AD. Further long-term studies with a larger sample size are required to confirm the therapeutic efficacy of L. plantarum IS-10506 in AD.

Effectiveness of 32 versus 20 weeks of prednisolone in leprosy patients with recent nerve function impairment: A randomized controlled trial

Background While prednisolone is commonly used to treat recent nerve function impairment (NFI) in leprosy patients, the optimal treatment duration has not yet been established. In this “Treatment of Early Neuropathy in Leprosy” (TENLEP) trial, we evaluated whether a 32-week prednisolone course is more effective than a 20-week course in restoring and improving nerve function. Methods In this multi-centre, triple-blind, randomized controlled trial, leprosy patients who had recently developed clinical NFI (<6 months) were allocated to a prednisolone treatment regimen of either 20 weeks or 32 weeks. Prednisolone was started at either 45 or 60 mg/day, depending on the patient’s body weight, and was then tapered. Throughout follow up, NFI was assessed by voluntary muscle testing and monofilament testing. The primary outcome was the proportion of patients with improved or restored nerve function at week 78. As secondary outcomes, we analysed improvements between baseline and week 78 on the Reaction Severity Scale, the SALSA Scale and the Participation Scale. Serious Adverse Events and the need for additional prednisolone treatment were monitored and reported. Results We included 868 patients in the study, 429 in the 20-week arm and 439 in the 32-week arm. At 78 weeks, the proportion of patients with improved or restored nerve function did not differ significantly between the groups: 78.1% in the 20-week arm and 77.5% in the 32-week arm (p = 0.821). Nor were there any differences in secondary outcomes, except for a significant higher proportion of Serious Adverse Events in the longer treatment arm. Conclusion In our study, a 20-week course of prednisolone was as effective as a 32-week course in improving and restoring recent clinical NFI in leprosy patients. Twenty weeks is therefore the preferred initial treatment duration for leprosy neuropathy, after which likely only a minority of patients require further individualized treatment.

Prevalence and characterisation of Staphylococcus aureus causing community-acquired skin and soft tissue infections on Java and Bali, Indonesia

To define the role of Staphylococcus aureus in community settings among patients with skin and soft tissue infections (SSTI) in Indonesia.

The Effects of Amniotic Membrane Stem Cell-Conditioned Medium on Photoaging

Abstract Background: Photoaging is a complex biologic process that affects various layers of the skin with the major damage seen in the connective tissue of the dermis. Although rarely fatal, photoaging can significantly contribute to a loss of quality of life; therefore, it deserves attention. Researchers are continually searching for new compounds to develop rejuvenation therapies. Nowadays, the stem cell population has been discovered, and it shows capability to rejuvenate the skin. Material and methods: This was an analytic experimental research conducted on a total of 48 women who were randomized into two groups: 24 women received amniotic membrane stem cell-conditioned medium (AMSC-CM) and the other 24 women received normal saline (NS). We applied the drug for three times with an interval of 2 weeks. Microneedling was used to enhance epidermal penetration. We evaluated the progression of photoaging on Weeks 0, 4, and 8, as well as the side effects. Results: The improvement in photoaging after treatment showed significant better effects with the AMSC-CM than with NS (p < .05). There were minimal transient side effects in either of the study groups. Conclusion: AMSC-CM has the capability to improve clinical photoaging and is a promising option for rejuvenation therapy.

The efficacy of topical human amniotic membrane-mesenchymal stem cell-conditioned medium (hAMMSC-CM) and a mixture of topical hAMMSC-CM + vitamin C and hAMMSC-CM + vitamin E on chronic plantar ulcers in leprosy:a randomized control trial

Abstract Background: Healing of chronic plantar ulcers in leprosy (CPUL) typically takes a long time due to impaired neurological function, thereby reducing the levels of growth factors and cytokines. Cytokines can be found in metabolite products from amniotic membrane stem cells. Chronic ulcers are frequently characterized by high levels of reactive oxygen species. Vitamin E (α-tocopherol) is widely used in skin lesions, owing to its antioxidant and anti-inflammatory properties. Vitamin C also has antioxidant, anti-inflammatory, and collagen synthesis properties which are useful in wound healing. Herein, we compared the effects of topical human amniotic membrane-mesenchymal stem cell-conditioned medium (hAMMSC-CM) alone and with vitamins C and E on healing of CPUL. Methods: In this randomized controlled trial, topical agents were applied every 3 days for up to 8 weeks. Ulcer size, side-effects, and possible complications were monitored weekly. Results: Healing percentage increased each week in all groups. Mean difference in ulcer size was highest in the hAMMSC-CM + vitamin E group, implying better progress of wound healing. There were no side-effects or complications. Conclusions: hAMMSC-CM + vitamin E is best for healing of CPUL.

EFFECTS OF BLUE LIGHT EMITTING DIODE (LED) AND DOXYCYCLINE TO SEBACEOUS GLAND IN ACNE VULGARIS

Acne vulgaris (AV) is an inflammation of pilosebaceous unit especially in young adult. The pathophysiology is the elevation of sebum production, keratinization of abnormal pilocebaseous follicles, and inflammation caused by immune response to Propionibacterium acnes. Therapy combination of oral antibiotics (doxycycline) and physical therapy (blue light) in moderate-severe acne is one option to reduce antibiotic resistance. Doxycycline is a commonly antibiotic used. The effects of photosensitive can increase the penetration of blue light by sebaceous glands. There was a total decrease in sebum and clinical improvement of combination therapy of blue light and doxycycline in seven patients. The combination therapy has been shown to improve its therapeutic effect, but more clinical trials are needed to prove the effectiveness of blue light with doxycycline than without blue light.

Uji Tempel Pasien Dengan Riwayat Dermatitis Kontak Alergi Kosmetik di URJ Kesehatan Kulit Dan Kelamin RSUD Dr. Soetomo Surabaya

Latar belakang: Akne vulgaris (AV) merupakan penyakit yang banyak diderita remaja, sekitar 85% remaja terkena dengan tingkat keparahan tertentu. Penyebab AV adalah multifaktorial. Faktor pencetus yang berperan antara lain faktor genetik, lingkungan, hormonal, stres emosi, makanan, trauma, kosmetik, dan obat-obatan. Tujuan: Mengidentifikasi faktor pencetus AV pada pasien di Divisi Kosmetik Medik Unit Rawat Jalan Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya. Metode: Studi retrospektif terhadap rekam medis tentang gambaran umum, faktor pencetus, diagnosis, dan penatalaksanaan pasien baru AV periode 2008-2010. Hasil: Jumlah pasien baru AV tahun 2008-2010 adalah 3448 pasien. Penderita AV perempuan (79,4%) lebih banyak daripada laki-laki. Kelompok umur terbanyak menderita AV adalah 15-24 tahun (64,3%), jenis pekerjaan pasien AV terbanyak adalah pelajar/mahasiswa (39,1%). Sebagian besar pasien menderita AV selama 1-5 tahun (46,5%). Faktor pencetus AV tersering adalah hormonal (55,6%). Tipe lesi AV terbanyak adalah papulopustular (75,6%). Terapi yang terbanyak adalah kombinasi doksisiklin oral, tretinoin dan klindamisin topikal. Simpulan: Faktor pencetus timbulnya AV pada wanita tersering adalah hormonal dan kosmetik, sedangkan pada laki-laki adalah makanan dan stres. Kata kunci: akne vulgaris, faktor pencetus, retrospektif.Latar belakang: Dermatitis seboroik (DS) dan psoriasis sering sulit dibedakan baik secara klinis maupun secara histopatologi. Anamnesis yang tepat dengan memperhatikan usia, riwayat keluarga, dan pemeriksaan klinis yang teliti serta ditunjang dengan pemeriksaan histopatologi, dapat menentukan diagnosis yang tepat. Tujuan: Mengevaluasi perbedaan DS dan psoriasis supaya klinisi dan patolog bisa membuat diagnosis yang benar.Telaah kepustakaan: Secara epidemiologi, terdapat berbagai perbedaan antara DS dan psoriasis. Hal itu bisa dilihat dari usia saat timbulnya lesi, jenis kelamin, ras, maupun genetik. Lokasi lesi dan manifestasi klinis juga mempunyai ciri yang berbeda. Biopsi kulit dibutuhkan untuk membantu menegakkan diagnosis yang tepat.Gambaran histopatologi DS bervariasi sesuai dengan perjalanan penyakitnya: akut, sub-akut, dan kronis, sedangkan psoriasis mempunyai ciri khas berupa pemanjangan rete ridges, abses Munro atau adanya abses Kojog. Simpulan: Terdapat beberapa perbedaan antara DS dan psoriasis dari usia pertama kali muncul lesi, lokasi lesi, manifestasi klinis dan gambaran histopatologi.Kata kunci: dermatitis seboroik, psoriasis, manifestasi klinis, gambaran histopatologi.Latar belakang: Kasus dermatitis kontak alergi kosmetik (DKAK) relatif signifikan, diperkirakan 10% dari seluruh kasus dermatitis kontak di RSUD Dr. Soetomo Surabaya cenderung meningkat. Tahun 2008 ditemukan 24 (6%) penderita DKAK dari 267 pasien DKA, sedangkan tahun 2009 ditemukan 36 (15%) dari 230 pasien DKA yang datang berobat. Tujuan: Mengetahui bahan kosmetik penyebab dermatitis kontak akibat kosmetik dan mengetahui relevansi klinis hasil uji tempel. Metode: Penelitian retrospektif terhadap 30 sampel dengan riwayat DKAK periode November 2010 – November 2011 di Divisi Alergi Imunologi URJ Kulit dan Kelamin RSUD Dr. Soetomo. Uji tempel menggunakan 12 bahan standar alergen kosmetik. Hasil: Enam belas pasien dari 30 sampel (53,33%) didapatkan hasil positif dengan satu atau lebih alergen dan 14 pasien (46,67%) negatif terhadap alergen yang ditempelkan. Hasil uji tempel positif terbanyak dari 16 pasien tersebut adalah alergen pewarna rambut yaitu 13 pasien (43,3%), diikuti pewangi 6 pasien (20%) dan pengawet 5 pasien (16,7%). Simpulan: Uji tempel alergen standar kosmetik dapat digunakan sebagai pemeriksaan penunjang terhadap penderita dermatitis kontak alergi kosmetik di Divisi Alergi Imunologi URJ Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya. Kata kunci: dermatitis kontak alergi, alergen kosmetik, uji tempel, relevansi klinis.