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"Describes a three-tiered approach to acne management including diet, nutritional supplements, and topical applications, offering additional advice on how to address age-related acne and treat acne scars"

"Latar belakang: Akne vulgaris (AV) merupakan kelainan kulit akibat peradangan kronik folikel pilosebasea yang sering dijumpai pada remaja dan dewasa muda. Pada pasien perempuan didapatkan prevalensi AV yang lebih tinggi dan dampak psikososial yang lebih berat. Beberapa studi meneliti terdapat hubungan antara peningkatan kadar homosistein dengan derajat keparahan AV, namun peran homosistein dalam patogenesis AV masih belum jelas. Kadar homosistein ditentukan oleh multifaktor sehingga temuan di Indonesia dapat berbeda dibandingkan penelitian terdahulu. Secara fisiologis, kadar homosistein pada perempuan lebih rendah dari laki-laki.Tujuan: Mendapatkan data kadar homosistein plasma pada pasien perempuan dengan AV ringan (AVR), AV sedang (AVS), dan AV berat (AVB) serta mengetahui korelasi kadar homosistein plasma dengan berbagai derajat keparahan AV.Metode: Studi potong lintang dilakukan terhadap 46 subjek penelitian (SP), direkrut secara consecutive sampling, yang terdiagnosis AV berdasarkan kriteria Lehmann pada bulan April-Juni 2019. Setiap SP akan diambil darahnya untuk dilakukan pemeriksaan kadar homosistein plasma dengan metode chemiluminescent microparticle immuno assay (CMIA).Hasil: Pada pasien perempuan dengan AV didapatkan rerata kadar homosistein plasma kelompok AVR, AVS, dan AVB yaitu 7,39 (1,84) μmol/L, 7,14 (1,73) μmol/L, dan 6,95 (1,14) μmol/L. Terdapat korelasi negatif lemah yang tidak bermakna antara kadar homosistein plasma dengan derajat keparahan AV (r=-0,0964, p=0,524).Kesimpulan: Kadar homosistein plasma ditemukan lebih rendah pada kelompok AVS dan AVB. Dari hasil penelitian didapatkan bahwa semakin rendah kadar homosistein plasma, maka semakin berat derajat keparahan AV.

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Background: Acne vulgaris (AV) is a skin disorder caused by chronic inflammation of pilosebaceus that is primarily found in adolescents and young adults. In female patient, there is a higher prevalence of AV and more severe psychosocial impact. Several studies have investigated association between the levels of serum homocysteine and severity of AV, but the role of homocysteine in AV is not clearly understood. Homocysteine levels are thought to be affected by varying factors, so it is assumed that homocysteine levels in Indonesian people will yield a different results. Physiologically, female has a lower homocysteine levels.

Objective: This study aims to know the levels of homocysteine plasma in female patients suffering from mild, moderate, and severe AV, also its correlation with the degree of AV severity.

Methods: This cross-sectional study included 46 subjects, recruited by consecutive sampling, who have been diagnosed with AV based on Lehmann criteria on April-June

2019. Blood sample will be taken from each subject to measure homocycsteine plasma levels by using chemiluminescent microparticle immuno assay method (CMIA).

Results: In female patients, the mean plasma homocycteine levels of mild, moderate, and severe groups were respectively 7,39 (1,84) μmol/L, 7,14 (1,73) μmol/L, and 6,95 (1,14) μmol/L. There was no significant corelation between plasma homocysteine levels and the degree of acne severity (r=-0,0964, p=0,524).

Conclusion: Levels of plasma homocysteine was found lower on moderate and severe AV groups. The lower the levels of plasma homocysteine, the more severe the the degree of acne severity.

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"Latar 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.

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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."

"[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.]"

"Akne vulgaris (AV) merupakan kelainan kulit menahun folikel pilosebasea yang banyak dijumpai remaja dan dewasa muda. Beberapa penelitian melaporkan adanya hubungan antara seng dan AV. Penelitian dengan desain kasus kontrol ini bertujuan mencari hubungan kadar seng serum dengan derajat keparahan AV berdasarkan klasifikasi Lehmann dan dengan jumlah lesi inflamasi. Tujuh puluh subyek dengan AV, terdiri atas 35 AV ringan (AVR) [kelompok A] dan 35 AV sedang (AVS) dan AV berat (AVB) [kelompok B] berdasarkan klasifikasi Lehmann diperiksakan kadar seng serum yang diukur menggunakan Atomic absorption spectrophotometry. Hasil kadar seng serum kelompok A median (min-maks) 11,15 (10,23-14,21) μmol/L dan kelompok B median (min-maks) 9,93 (6,72-10,69) μmol/L. Kadar seng serum kelompok A lebih tinggi dibandingkan kelompok B (p<0,001). Terdapat korelasi negatif yang bermakna antara kadar seng serum dengan jumlah lesi inflamasi pada AV(r -0,488). Sebagai tambahan didapatkan korelasi negatif kadar seng serum dengan jumlah lesi non inflamasi (r-0,582) ataupun total lesi AV (r-0,662). Hasil penelitian ini membuktikan bahwa kadar seng serum berhubungan dengan derajat keparahan AV menurut klasifikasi Lehmann, yakni kadar seng serum lebih rendah pada AV derajat berat dan sedang dibandingkan derajat ringan, dan sejalan dengan hubungannya terhadap jumlah lesi, baik inflamasi, non inflamasi, dan total lesi.

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Acne vulgaris (AV) is a chronic cutaneous disorder in pilosebaceous follicles affecting many of the adolescents and young adults. Several studies have reported an association between serum zinc level and acne vulgaris. This case-control study aimed to find the relationship between serum zinc level with severity of AV according on Lehmann?s classification and the number of inflamatory lesions. Seventy AV subjects, consisting of 35 subjects with mild AV (Group A) and 35 subjects with moderate and severe AV (Group B) based on Lehmann's classification are measured their serum zinc levels with Atomic absorption spectrophotometry. In group A serum zinc level median (min-max) was 11,15 (10,23-14,21) μmol/L and in group B, median (min-max) was 9,93 (6,72-10,69) μmol/L. Serum zinc levels in group A were statistically significant higher than group B (𝑃𝑃<0,001). There was a negative correlation between serum zinc levels with the number of inflammatory lesions (r-0,488). Additional result obtained were negative correlation between serum zinc levels with number of non-inflammatory lesions (r-0,582) and total lesion of AV (r-0,662). The results of this study proved that serum zinc levels was associated with the severity of AV according to Lehmann's classification,i.e. serum zinc levels were lower in severe and moderate acne compared with mild acne, and in line with its correlation to number of lesions, either inflammatory, non-inflammatory, and total lesions."

"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)."

"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."