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"[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: Akne vulgaris AV adalah penyakit inflamasi kronik yang ditandai adanya lesi polimorfik di area predileksi AV. Tatalaksana AV terdiri dari terapi standar dan terapi adjuvan. Salah satu terapi adjuvan yang selalu diberikan pada pasien AV adalah frekuensi cuci wajah AV. Sampai saat ini, rekomendasi frekuensi cuci wajah pasien dengan AV di negara tropis adalah berdasarkan rekomendasi umun dan pendapat ahli. Tujuan: Mengetahui efektivitas frekuensi cuci wajah sebagai terapi adjuvan pada akne vulgaris derajat ringan dan sedang. Metode: Uji klinis acak buta tunggal dilakukan terhadap mahasiswa AV di Klinik UI Makara pada bulan Mei hingga Juni 2018. Mahasiswa yang memenuhi kriteria penerimaan dan tidak memenuhui kriteria penolakan serta bersedia ikut dalam penelitian mendapat perlakuan berupa frekuensi cuci wajah 2 kali dan 3 kali per hari sesuai hasil randomisasi. Seluruh SP memperoleh terapi standar dan pembersih wajah yang sama. Jumlah lesi AV, kadar sebum, nilai TEWL, serta efek samping pada wajah SP akan dinilai selama 6 minggu dan evaluasi dilakukan pada minggu ke-3 dan minggu ke-6. Analisis hasil penelitian dilakukan dengan metode intention to treat. Hasil: Diperoleh total 36 subjek penelitian. Pada penelitin ini terdapat 1 SP drop out yaitu SP pada kelompok cuci wajah 2 kali per hari. Efektivitas frekuensi cuci wajah 3 kali per hari tidak berbeda bermakna dengan 2 kali per hari dalam penurunan jumlah lesi AV dengan median 23 (0-62) dibandingkan 20 (0-37), p = 0,341. Tidak terdapat perbedaan bermakna antara frekuensi cuci wajah 3 kali dibandingkan 2 kali per hari dalam hal penurunan kadar sebum, peningkatan nilai TEWL dan efek samping yang terjadi. Kesimpulan: Tidak terdapat perbedaan efektivitas frekuensi cuci wajah 3 kali per hari dibandingkan 2 kali per hari sebagai terapi adjuvan dalam hal penurunan jumlah lesi AV pada wajah mahasiswa AVR dan AVS yang mendapat terapi standar.

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Background: Acne vulgaris (AV) is a chronic inflammatory disease characterized by polymorphic lesions in the predilection area. Management of AV consists of standard therapy and adjunctive therapy. One of the adjunctive therapies that must be given to AV patients is the frequency of face washing. Recently, the recommendation of face washing frequency for AV patients in tropical countries is based on the general recommendation and expert opinion. Objective: To evaluate the effectiveness of face washing frequency as an adjuvant therapy on mild and moderate AV. Methods: A single blind randomized clinical trial was conducted on AV students at UI Makara Clinic from May to June 2018. Students who met the criteria of acceptance and did not meet the criteria of rejection and were willing to join the study were treated 2 and 3 times per day according to randomization. All participants were given standard therapy and same cleanser. AV lesions counts, sebum level, TEWL scores, and side effects on participant face would be assessed within six weeks by evaluating at week-3 and week-6. The analysis of study result was done by intention-to-treat method. Result: The total of 36 participants was recruited. In this study, there was 1 participant dropped out from the twice-per-day face washing group. There was no significant difference from the thrice-per-day and twice-per-day groups in terms of decreasing of total AV lesions with median 23 (0-62) versus 20 (0-37), p = 0,341. In addition, there was no significant difference in terms of decreasing sebum level, increasing of TEWL score, and adverse events. Conclusion: There was no difference in effectiveness of face washing frequency 3 times per day compared to 2 times per day with regard to decrease AV lesions in the face of mild and moderate AV students receiving standard therapy. "

"Latar belakang: Akne vulgaris (AV) adalah penyakit unit pilosebasea kronis tersering yang dapat menimbulkan dampak psikologis berat dan mengganggu kualitas hidup penderitanya. Penggunaan terapi ajuvan yaitu ekstraksi lesi akne yang dikombinasikan dengan terapi standar dapat memperbaiki kondisi klinis dan kualitas hidup penderita akne. Pengukuran kualitas hidup penting dilakukan untuk menilai keberhasilan terapi. Saat ini telah tersedia kuesioner kualitas hidup spesifik akne berbahasa Indonesia (Acne-QoL- INA) yang tervalidasi, namun belum pernah ada data mengenai perbandingan kualitas hidup antara terapi kombinasi dan terapi standar.Metode: Studi uji klinis acak terkontrol tersamar tunggal ini dilakukan pada subjek akne vulgaris dewasa derajat sedang berdasarkan kriteria Lehmann yang dibagi ke dalam kelompok terapi kombinasi standar dan ekstraksi lesi akne (terapi kombinasi) serta terapi standar tanpa ekstraksi lesi akne (terapi standar). Skor kualitas hidup berdasarkan kuesioner Acne-QoL-INA dinilai pada baseline, minggu ke-4, dan minggu ke-8 setelah terapi. Selain itu, penilaian jumlah lesi dan derajat keparahan akne diukur pada setiap kunjungan oleh seorang evaluator secara tersamar melalui foto klinis.Hasil: Sebanyak 40 subjek dengan median usia 24 tahun (18–48), 17,5% laki-laki dan 82,5% perempuan berpartisipasi dalam penelitian ini. Skor Acne-QoL-INA baseline untuk kelompok kombinasi dan kelompok terapi standar masing-masing adalah 41 (37,5– 57) dan 45,5 (37–63), meningkat menjadi 79 (67,5–94,5) dan 72,5 (59,25–98,5) pada minggu ke-8 namun tidak berbeda bermakna secara statistik antar kedua kelompok (p=0,602). Jumlah lesi baseline pada kedua kelompok masing-masing 35 dan 32, menurun menjadi 18 dan 13 pada minggu ke-8 (p<0,0001) dan perbaikan derajat keparahan menjadi akne ringan pada 100% subjek di minggu ke-8.Kesimpulan: Tidak ada perbedaan dalam skor Acne-QoL-INA dan perbaikan klinis antara kelompok terapi kombinasi dan terapi standar pada pasien AV sedang. Namun, terapi kombinasi cenderung meningkatkan kualitas hidup dan pengurangan lesi lebih baik daripada terapi standar.

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Background: Acne Vulagis (AV) is the most commom chronic disease of the pilosebaceous unit that can have a significant psychological impact and reduce the quality of life. The use of adjuvant therapy such as acne lesion extraction, in combination with standard therapy could better improve clinical outcomes and quality of life. Assessing quality of life is crucial to evaluate the success of therapy. Currently, there has been a validated acne-specific quality of life questionnaire in Indonesian (Acne-QoL-INA), but there is no existing data on the comparison of quality of life between combination therapy and standard therapy.

Method: This single-blinded randomized controlled study was conducted on adult subjects with moderate acne vulgaris based on Lehmann criteria, who were divided into combinations of standard therapy with acne lesion extraction (combination therapy) group, and standard therapy without acne lesion extraction (standard therapy) group. Quality of life score based on the Acne-QoL-INA questionnaire was assessed at the baseline, 4th, and 8th week after therapy. Additionally, the assessment of lesion number and acne grading is also measured at each visit by a blinded evaluator through clinical photos.

Results: A total of 40 subjects with a median age of 24 years old (18–48), comprising 17.5% males and 82.5% females, participated in this study. The baseline Acne-QoL-INA scores for the combination therapy and the standard therapy group were 41 (37.5–57) and 45.5 (37–63), respectively. These scores increased to 79 (67.5–94.5) and 72.5 (59.25– 98.5) at week 8 but did not show statistically significant differences between the two groups (p=0.602). The baseline lesion count in both groups was 35 and 32, respectively, and decreased to 18 and 13 at week 8 (p<0.0001), with an improvement in the severity to mild acne in 100% of subjects by week 8.

Conclusion: There was no difference in Acne-QoL-INA scores and clinical improvement between the combination therapy and standard therapy groups in moderate AV patients. However, combination therapy tended to improve the quality of life and lesion reduction better than standard therapy."

"Latar Belakang: Akne vulgaris (AV) adalah peradangan kronik pilosebasea yang umum terjadi pada semua usia, terutama remaja dan dewasa muda serta dapat memengaruhi psikologis pasien. Tata laksana AV merupakan sebuah tantangan karena keberagaman dalam menentukan diagnosis dan pilihan terapi antar negara. Indonesia mempunyai beberapa pedoman tatalaksana AV yang mempunyai similaritas antara lain konsensus IAEM 2015, PPK Perdoski dan PPK RSCM di tahun 2017.Tujuan: Penelitian ini bertujuan untuk menganalisis efektivitas terapi standar AV berdasarkan panduan praktik klinis di Indonesia.Metode: Penelitian merupakan studi observasional analitik secara retrospektif di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo menggunakan rekam medis tahun 2017-2019. Sampel penelitian merupakan rekam medis pasien AV baru yang diikuti selama 3 bulan dan dengan metode total sampling. Data subjek yang diambil termasuk karakteristik sosiodemografi, karakteristik klinis, diagnosis, terapi berdasarkan PPK RSCM 2017, dan hasil terapi. Studi dan analisis dilakukan pada bulan April 2023 hingga Juli 2023.Hasil: Terdapat 131 SP yang memenuhi kriteria, 63,4% AV sedang, 20,6% AV ringan, dan 16% AV berat. Sebagian besar SP (92,4%) mempunyai AV dengan awitan sebelum usia 25 tahun. Median lama sakit AV yaitu 48 bulan. Riwayat terapi AV sebelumnya ditemukan pada 58% SP dan riwayat konsumsi obat akne pada 16% SP. Faktor risiko terbanyak berupa riwayat AV pada orang tua. Terapi utama paling banyak digunakan yaitu kombinasi retinoic acid, benzoyl peroxide, antibiotik topikal dan antibiotik oral pada 22,2% SP. Terapi standar AV secara bermakna menurunkan median jumlah lesi noninflamasi (25 vs. 8; p<0,001), median jumlah lesi inflamasi (10 vs. 2; p<001), median jumlah lesi total (41 vs. 10; p<0,001) setelah 3 bulan terapi, dengan median penurunan ketiga jumlah lesi lebih dari 50%. Proporsi derajat keparahan AV berbeda secara bermakna pada 3 bulan (p<0,001), dimana AV ringan meningkat (20,6% vs 93,1%) dan AV sedang atau berat menurun (sedang = 63,6% vs. 6,1%; berat = 16% vs. 0,8%).Kesimpulan: Terapi standar AV berdasarkan PPK di Indonesia efektif dalam mengurangi jumlah lesi noninflamasi, lesi inflamasi, dan lesi total, dan menurunkan derajat keparahan AV.

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Background: Acne vulgaris is a prevalent chronic inflammation of the pilosebaceous unit affecting all ages, especially teenagers and young adults, and often leads to psychological impairment. Management of acne vulgaris has been challenging due to various diagnostic parameters and treatment options across nations. Several treatment guidelines are available in Indonesia, of which have similarities among one another, such as consensus by Indonesian Acne Expert Meeting in 2015 and clinical practice guidelines by the Indonesian Society of Dermatology and Venereology and by Dr. Cipto Mangunkusumo National Central General Hospital in 2017.

Objective: This study aims to investigate the effectiveness of standard therapy for acne based on the clinical practice guidelines in Indonesia

Methods: This is an analytical retrospective observational study using medical records from Dr. Cipto Mangunkusumo National Central General Hospital between 2017 – 2019. Research samples were medical records of new acne patients followed for 3 months by a total sampling technique. Extracted data included sociodemographic and clinical characteristics, diagnosis, and therapy based on the clinical practice guideline by Dr.Cipto Mangunkusumo National Central General Hospital in 2017 and the results. This study was conducted from April 2023 to July 2023.

Results: There were 131 subjects included, of which 63,4% were with moderate acne, 20,6% with mild acne, and 16% with severe acne. Most participants (92,4%) experienced acne for the first time before 25 years old. The median duration from the first occurrence of acne to the visit was 48 months. History of topical and oral acne therapy was found in 58% and 16% of participants, respectively. History of acne in parents was the most reported risk factor. Most subjects (22,2%) received a combination of retinoic acid, benzoyl peroxide, topical antibiotic, and oral antibiotic. Standard therapies significantly reduced the median of non-inflammatory lesions (25 vs. 8; p<0,001), inflammatory lesions (10 vs. 2; p<001), and total lesions (41 vs. 10; p<0,001) after a 3 month-therapy, with the median of reduction for all type of lesions over 50%. The proportion of acne severity differed significantly after three months (p<0,001), with an increasing proportion of mild acne (20,6% vs 93,1%) and decreasing percentage of moderate and severe acne (moderate = 63,6% vs. 6,1%; severe = 16% vs. 0,8%).

Conclusion: Standard therapy for acne vulgaris in clinical practice guidelines in Indonesia is effective for noninflammatory lesions, inflammatory lesions, and total lesions, as well as acne severity after 12 weeks."

"ABSTRAK Latar belakang dan tujuan. Penggunaan antibiotik pada akne vulgaris (AV) saat ini dihadapi permasalahan resistensi Propionibacterium acnes (PA) dan bakteri lainyang berperan pada AV. Data pola resistensi AVS dan AVB di RS CiptoMangunkusumo (RSCM) tahun 2006 menunjukkan adanya resistensi PA terhadaperitromisin (63,2%), klindamisin (57,9%), dan tetrasiklin (47,4%). Tidak ditemukanPA yang resisten terhadap doksisiklin maupun minosiklin. Penggunaan antibiotikpada AV dapat menyebabkan perubahan pola resistensi sehingga penelitian inibertujuan memberikan data terbaru mengenai pola bakteri dan resistensinya terhadapantibiotik lini pertama pada AVS dan AVB di Departemen Ilmu Kesehatan Kulit danKelamin RSCM, yaitu tetrasiklin, doksisiklin, minosiklin, klindamisin daneritromisin. Metode. Penelitian ini merupakan penelitian deskriptif dengan desain potong lintang.Spesimen untuk kultur dan uji resistensi didapatkan dari ekstraksi komedo tertutupyang selanjutnya dibiakkan secara aerob dan anaerob. Pemeriksaan uji resistensidilakukan secara kuantitatif dengan menggunakan MIC strip test. Hasil. Dari 91 subjek, bakteri yang ditemukan terdiri atas PA 11,0%, Staphylococcusepidermidis (SE) 50,5%, Staphylococcus aureus (SA) 7,7% dan bakteri lain sebesar40,7% (aerob) dan 19,8% (anaerob). Sebagian kecil PA (10%) resisten terhadaptetrasiklin, klindamisin, dan eritromisin. Tidak ditemukan PA yang resisten terhadapdoksisiklin dan minosiklin. Bakteri SE resisten terhadap eritromisin (65,2%),klindamisin (52,2%), tetrasiklin (32,6%), dan doksisiklin (4,3%). Tidak ditemukanSE yang resisten terhadap minosiklin. Sebagian kecil SA resisten terhadaperitromisin (28,6%), doksisiklin (14,3%) dan klindamisin (14,3%). Tidak ditemukanSA yang resisten terhadap tetrasiklin dan minosiklin. Kesimpulan. Bakteri yang ditemukan pada pasien AVS dan AVB antara lain,Staphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, danStaphylococcus aureus 7.7%. Bakteri paling banyak ditemukan resisten terhadaperitromisin dan ketiga bakteri tersebut seluruhnya masih sensitif terhadap minosiklin. ABSTRACT Background and objective: The resistance of Propionibacterium acnes (PA) andother bacteria that implicated in acne vulgaris (AV), has been a problem in AVtherapy. The latest data in the Department of Dermatology and Venereology, CiptoMangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin(63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance todoxycycline and minocycline. The use of antibiotics may cause changes insusceptibility. This study aimed to provide the latest bacterial profile and resistancepattern to first-line antibiotics used in moderate and severe AV: tetracycline,doxycycline, minocycline, clindamycin and erythromycin.Methods: This is a descriptive, cross-sectional study. Specimens were extractedfrom closed comedones and cultured in media for aerobic and anaerobic bacteria.Antibiotic resistance was measured quantitatively using MIC strip test.Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcusepidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and otherbacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) wasresistant to tetracycline, clindamycin, and erythromycin but not to doxycycline andminocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%),tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A smallnumber of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) andclindamycin (14.3%) but not to tetracycline and minocycline.Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted ofStaphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, andStaphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, butstill completely sensitive to minocycline.;Background and objective: The resistance of Propionibacterium acnes (PA) andother bacteria that implicated in acne vulgaris (AV), has been a problem in AVtherapy. The latest data in the Department of Dermatology and Venereology, CiptoMangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin(63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance todoxycycline and minocycline. The use of antibiotics may cause changes insusceptibility. This study aimed to provide the latest bacterial profile and resistancepattern to first-line antibiotics used in moderate and severe AV: tetracycline,doxycycline, minocycline, clindamycin and erythromycin.Methods: This is a descriptive, cross-sectional study. Specimens were extractedfrom closed comedones and cultured in media for aerobic and anaerobic bacteria.Antibiotic resistance was measured quantitatively using MIC strip test.Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcusepidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and otherbacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) wasresistant to tetracycline, clindamycin, and erythromycin but not to doxycycline andminocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%),tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A smallnumber of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) andclindamycin (14.3%) but not to tetracycline and minocycline.Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted ofStaphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, andStaphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, butstill completely sensitive to minocycline.;Background and objective: The resistance of Propionibacterium acnes (PA) andother bacteria that implicated in acne vulgaris (AV), has been a problem in AVtherapy. The latest data in the Department of Dermatology and Venereology, CiptoMangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin(63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance todoxycycline and minocycline. The use of antibiotics may cause changes insusceptibility. This study aimed to provide the latest bacterial profile and resistancepattern to first-line antibiotics used in moderate and severe AV: tetracycline,doxycycline, minocycline, clindamycin and erythromycin.Methods: This is a descriptive, cross-sectional study. Specimens were extractedfrom closed comedones and cultured in media for aerobic and anaerobic bacteria.Antibiotic resistance was measured quantitatively using MIC strip test.Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcusepidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and otherbacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) wasresistant to tetracycline, clindamycin, and erythromycin but not to doxycycline andminocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%),tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A smallnumber of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) andclindamycin (14.3%) but not to tetracycline and minocycline.Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted ofStaphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, andStaphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, butstill completely sensitive to minocycline.;Background and objective: The resistance of Propionibacterium acnes (PA) andother bacteria that implicated in acne vulgaris (AV), has been a problem in AVtherapy. The latest data in the Department of Dermatology and Venereology, CiptoMangunkusumo Hospital, Jakarta (2006) showed resistance to erythromycin(63.2%), clindamycin (57.9%) and tetracycline (47.4%), and no resistance todoxycycline and minocycline. The use of antibiotics may cause changes insusceptibility. This study aimed to provide the latest bacterial profile and resistancepattern to first-line antibiotics used in moderate and severe AV: tetracycline,doxycycline, minocycline, clindamycin and erythromycin.Methods: This is a descriptive, cross-sectional study. Specimens were extractedfrom closed comedones and cultured in media for aerobic and anaerobic bacteria.Antibiotic resistance was measured quantitatively using MIC strip test.Results: Bacteria were isolated from 91 subjects and consisted of Staphylococcusepidermidis (SE)(50.5%), PA (11.0%), Staphylococcus aureus (SA)(7.7%) and otherbacteria [aerobic (40.7%) and anaerobic (19.8%)]. A small number of PA (10%) wasresistant to tetracycline, clindamycin, and erythromycin but not to doxycycline andminocycline. SE was resistant to erythromycin (65.2%), clindamycin (52.2%),tetracycline (32.6%), and doxycycline (4.3%) but not to minocycline. A smallnumber of SA was resistant to erythromycin (28.6%), doxycycline (14.3%) andclindamycin (14.3%) but not to tetracycline and minocycline.Conclusion: Bacterial profile in moderate and severe acne vulgaris consisted ofStaphylococcus epidermidis 50.5%, Propionibacterium acnes 11.0%, andStaphylococcus aureus 7.7%. Bacteria were commonly resistant to erythromycin, butstill completely sensitive to minocycline."

"ABSTRAKPrevalensi kasus jerawat (acne vulgaris) 75-85% pada orang dewasa, terutama pada usia remaja, dan sering menjadi kronis. Etiopatologis jerawat multi-faktorial, antara lain disebabkan oleh stres oksidatif dan pengaruh hormon serta pola makan. Tujuan dari penelitian adalah untuk membuktikan bahwa ekstrak etanol kulit buah manggis (Garcinia mangostana L) yang mengandung senyawa aktif xanthones dengan aktivitas anti-oksidan, anti-bakteria dan anti-inflamasi, dapat menunjang terapi medis untuk jerawat. Uji klinis dilakukan secara acak, berpembanding dan tersamar ganda selama 3 minggu pada 94 subyek berjerawat ringan dan sedang, berumur 18-30 tahun yang tinggal di asrama agar relatif homogen. Parameter penelitian adalah derajat keparahan jerawat menurut kriteria Lehman dan kadar malondialdehid (MDA) di dalam darah subyek. Perlakuan dengan pemberian 400 mg ekstrak 3 kali sehari, bersamaan terapi standar dengan krim topikal asam retinoat 0,025% pada lesi jerawat di wajah pada malam hari. Keparahan jerawat berkurang tidak bermakna (p > 0.2) dan penurunan kadar MDA dalam plasma darah tidak bermakna (p = 0.49).

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ABSTRACTThe prevalence of acne (acne vulgaris) is 75-85% in adults, especially in adolescence, and often becomes chronic. Etiopatology of acne is multi-factorial, partly due to the oxidative stress and the influence of hormones and diet. The purpose of this study is to prove that the ethanol extract of mangosteen rind (Garcinia mangostana L) containing xanthones with properties of anti-oxidant, anti-bacterial and anti-inflammatory, can support medical therapy for acne. A randomized, double-blind and controlled clinical trial done for 3 weeks in 94 subjects with mild and moderate acne, aged 18-30 years living in a dorm which is relatively homogeneous. Parameters of the study are the degree of severity of acne according to Lehman criteria and the levels of malondialdehyde (MDA) in the blood of the subjects. Intervention by administering 400 mg extract 3 times a day, along with standard therapy with topical cream of 0.025% retinoic acid applied in acne lesions on the face at night. Improvement of acne severity was not significant (p > 0.2) and decreased levels of MDA in blood plasma was not significant (p = 0.49)."

"ABSTRAKPrevalensi kasus jerawat (acne vulgaris) 75-85% pada orang dewasa, terutama pada usia remaja, dan sering menjadi kronis. Etiopatologis jerawat multi-faktorial, antara lain disebabkan oleh stres oksidatif dan pengaruh hormon serta pola makan. Tujuan dari penelitian adalah untuk membuktikan bahwa ekstrak etanol kulit buah manggis (Garcinia mangostana L) yang mengandung senyawa aktif xanthones dengan aktivitas anti-oksidan, anti-bakteria dan anti-inflamasi, dapat menunjang terapi medis untuk jerawat. Uji klinis dilakukan secara acak, berpembanding dan tersamar ganda selama 3 minggu pada 94 subyek berjerawat ringan dan sedang, berumur 18-30 tahun yang tinggal di asrama agar relatif homogen. Parameter penelitian adalah derajat keparahan jerawat menurut kriteria Lehman dan kadar malondialdehid (MDA) di dalam darah subyek. Perlakuan dengan pemberian 400 mg ekstrak 3 kali sehari, bersamaan terapi standar dengan krim topikal asam retinoat 0,025% pada lesi jerawat di wajah pada malam hari. Keparahan jerawat berkurang tidak bermakna (p > 0.2) dan penurunan kadar MDA dalam plasma darah tidak bermakna (p = 0.49).

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ABSTRACT

The prevalence of acne (acne vulgaris) is 75-85% in adults, especially in adolescence, and often becomes chronic. Etiopatology of acne is multi-factorial, partly due to the oxidative stress and the influence of hormones and diet. The purpose of this study is to prove that the ethanol extract of mangosteen rind (Garcinia mangostana L) containing xanthones with properties of anti-oxidant, anti-bacterial and anti-inflammatory, can support medical therapy for acne. A randomized, double-blind and controlled clinical trial done for 3 weeks in 94 subjects with mild and moderate acne, aged 18-30 years living in a dorm which is relatively homogeneous. Parameters of the study are the degree of severity of acne according to Lehman criteria and the levels of malondialdehyde (MDA) in the blood of the subjects. Intervention by administering 400 mg extract 3 times a day, along with standard therapy with topical cream of 0.025% retinoic acid applied in acne lesions on the face at night. Improvement of acne severity was not significant (p > 0.2) and decreased levels of MDA in blood plasma was not significant (p = 0.49)."

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

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

"ABSTRAKLatar Belakang: Fototerapi NB-UVB merupakan salah satu modalitas terapi penyakit kulit pada lansia, terlebih populasi ini sering kali memiliki komorbiditas untuk mengonsumsi obat sistemik. Penentuan dosis awal yang akurat penting, karena dosis yang terlalu rendah akan memperpanjang waktu respons terapi sedangkan dosis yang terlalu tinggi dapat meningkatkan risiko efek fototoksik. Penentuan dosis awal fototerapi NB-UVB menggunakan pengukuran DEM merupakan metode yang lebih akurat dibandingkan dengan menggunakan tipe kulit Fitzpatrick karena respons tiap individu terhadap pajanan sinar dapat berbeda. Kulit lansia berbeda dibandingkan kulit dewasa akibat proses penuaan. Sejumlah perubahan yang terjadi dapat memengaruhi respons kulit terhadap pajanan sinar ultraviolet, termasuk respons eritema. Perbedaan respons eritema pada lansia dapat mengakibatkan perubahan DEM. Penentuan dosis fototerapi berdasarkan DEM yang tepat akan memberikan hasil terapi yang lebih optimal. Metode: Penelitian ini adalah uji klinis dengan analisis statistik yang membandingkan DEM pada lansia dan dewasa. Pada penelitian ini dilakukan perhitungan DEM berdasarkan respons eritema kulit relatif terhadap enam dosis pajanan sinar NB-UVB yang berbeda pada lansia berumur di atas 60 tahun dan dewasa berumur 18-45 tahun. Total 69 sampel dibagi menjadi kelompok dewasa dan lansia. Penyinaran dilakukan dengan alat fototerapi Waldmann UV109 TL-01 pada jendela yang dibuka. Jendela diradiasi sesuai dosis dimulai dari 300, 500, 700, 900, 1100, dan 1300 mJ/cm2. Hasil penyinaran dibaca pada 24 jam dan 48 jam pasca penyinaran oleh tiga orang penilai berbeda dengan pemahaman yang sama terhadap pembacaan DEM nilai ICC mendekati 1 Hasil: Pada kelompok dewasa, rerata DEM 24 jam didapatkan sebesar 554 182 mJ/cm2 dan rerata DEM 48 jam sebesar 606 167 mJ/cm2. Rerata DEM 24 jam lansia adalah 702 340 mJ/cm2 dan DEM 48 jam 836 341 mJ/cm2. DEM 24 jam dan 48 jam lansia lebih tinggi dibandingkan dewasa, namun hanya DEM pada 48 jam yang bermakna secara statistik p=0,026 . Pada kelompok lansia, terdapat perbedaan yang bermakna secara statistik antara DEM 24 dan 48 jam p

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ABSTRACTBackground UVB phototherapy is one of therapy modalities of skin diseases in elderly, in which comorbidities are often present thus taking systemic agent. To determine initial dosage is important. A dosage that is too low would lengthen the therapy response period, whereas a dosage that is too high could increase phototoxic side effect. The determination of UVB phototherapy initial dosage using MED measurement is a more accurate method compared with Fitzpatrick skin type due to different response of each individual to light exposure. Elderly rsquo s skin is different compared with adult rsquo s skin because of aging. Such changes could influence skin response to ultraviolet light exposure, for instance, erythema response. The difference of erythema response in elderly could lead to MED change. The determination of phototherapy dosage based on accurate MED would yield better therapy outcome. Methods This study was a clinical trial with statistical analysis to compare MED in elderly and adults. In this study, MED calculations were based on skin erythema responses relative to six different exposure doses of NB UVB in elderly people aged over 60 years and adults aged 18 45 years. The irradiation is done with a Waldmann UV109 lamp on the opened window. Window irradiated according to dosage starting from 300, 500, 700, 900, 1100, and 1300 mJ cm2. Responses were examined at 24 hours and 48 hours post irradiation by three different assessors with the same understanding of the DEM reading ICC values approaching 1 Results In adult group, the mean of 24 hours MED was 554 182 mJ cm2 and 48 hours MED was 606 167 mJ cm2. In elderly group, the mean of 24 hours MED was 702 340 mJ cm2 and 48 hours MED was 836 341 mJ cm2. 24 hours MED and 48 hours MED in elderly were higher compared with adults rsquo , although only 48 hours DEM that was statistically significant p 0.026 . In elderly group, a statistically significant difference between 24 hours MED and 48 hours MED was found p"

"ABSTRAKJerawat merupakan gangguan estetika pada kulit yang umumnya terjadi pada usia remajadengan gambaran klinis berupa adanya komedo, papul, pustul, dan nodul. Salah satu tanamanrimpang yang dapat digunakan sebagai obat jerawat adalah rimpang kencur (Kaempferiagalanga L) karena mempunyai khasiat sebagai anti bakteri dan anti inflamasi. Tujuanpenelitian ini adalah untuk mengetahui aktivitas antibakteri ektrak rimpang kencur terhadapbakteri P.acne, mengetahui kestabilan fisik sediaan gel ektrak rimpang kencur, keamanannya,dan manfaatnya sebagai gel anti jerawat derajat ringan dan sedang. Ekstraksi yang digunakandengan cara maserasi menggunakan etanol 96%. Uji aktifitas anti bakteri diamati padakonsentrasi 0,75; 1,25; 1,75; 2,25%. Konsentrasi 0,75% mempunyai diameter zona hambat11,5 mm pada media Brucella. Berdasarkan uji kestabilan fisik gel ekstrak rimpang kencurmempunyai stabilitas fisik yang baik pada akhir penelitian, pH mengalami sedikitpenurunan,uji viskositas dan konsistensi tidak banyak mengalami perubahan, dan ujikeamanan pada 12 orang tidak mengalami alergi dan iritasi. Uji manfaat dilakukan pada 60orang berjerawat ringan dan sedang dengan jenis lesi; komedo, papul, pustul, nodul.Perlakuan terhadap 30 orang yang diberi gel ekstrak etanol rimpang kencur dan gelklindamisin 1,2% diberikan pada 30 orang sebagai kontrol positip. Setelah dievaluasi selama3 minggu, gel ekstrak etanol rimpang kencur memberikan perbaikan signifikan (p<0,01)pada jerawat derajat ringan dan sedang.

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ABSTRACTAcne is a skin disorder that generally aesthetic occurs in adolescence with clinicalfeatures such as the presence of comedones, papules, pustules, and nodules. Oneof the rhizomes of plants that can be used as an acne medication is kencurrhizome (Kaempferia galanga.L) because it has peculiar properties as an antibacterial and anti inflammatory. The purpose of this study was to know about theanti bacterial activity of kencur rhizome extract the P acne bacteria,knowing thephysical stability from the preparation of kencur rhizome extract gel,safety,andbenefits as an anti acne gel in mild and moderate level. Extraction was macerationusing 96% ethanol.Antibacterial activity test performed at concentrations 0,75;1,25; 1,75; 2,25%. Concentration of 0,75% has 11,5 mm in the inhibition zone ofBrucella media. Based on the physical stability test, kencur rhizome extract gelhas good physical stability at the end of the study. The level of pH as a slightdecrease,viscosity and consistency test has not the changed much of the gel safetytesting in 12 peoples do not showed allergies and irritation. The benefit testconducted on 60 people with mild and moderate acne lesion types of comedones,papules, pustules, nodules. The gel contain 0,75% extract of rhizome kencur and1,2% clindamycin gel was applied in each 30 peoples who severe acne at faceshowed, after 3 week evaluation the result showed that extract of rhizome kencurprovide a significan improvement (p<0,01) in mild and moderate acne."