Melasma is a common hypermelanosis disorder that can be frustrating both for patients and physicians because it is very difficult to treat. Azelaic acid, 4-n-butylresorcinol and retinol is some of treatment modalities for melasma, but until now there is no clinical trial studies about combination of these three agents. We reported three mixed type melasma patients whom we treated using liposomal serum containing azelaic acid, 4-n-butylresorcinol and retinol combined with microneedling. We measured the improvement with modified Melasma Severity Index (MASI), Melasma Severity Scale (MSS) and Melas-QoL quesionner. At the start of the trial the average MASI score of all patients was 5.9, MSS was moderate and Melas QoL was 55.3. We re-applied treatment every 14 days for four times. There were improvements in their MASI with the ranged of 41.7%-85%, and Melas-QoL 38.8-83.3%. All of MSS in these three patients was classified into mild in the end of therapy.

<p>Pendahuluan: Ulkus diabetik merupakan bentuk kegagalan proses penyembuhan luka normal. Media terkondisi sel punca mesenkim Wharton’s jelly meningkatkan transkripsi m-RNA dari TGF-β2, hypoxia-inducible factor-1α, dan plasminogen activator inhibitor-1 genes pada fibroblas kulit yang berhubungan dengan penyembuhan luka. Tujuan: Meneliti efektivitas media terkondisi sel punca mesenkim Wharton’s jelly terhadap kecepatan penyembuhan ulkus pada tikus diabetik strain Wistar. Metode: Penelitian eksperimental laboratorik randomized pretest-posttest control group design. Penelitian di laboratorium bagian Farmasi Universitas Setia Budi (USB) Surakarta menggunakan 18 ekor hewan coba tikus strain Wistar yang dibuat luka di area punggung atas, dibagi 2 kelompok. Kelompok 1 diberi gel astaxanthin, kelompok 2 diberi media terkondisi sel punca mesenkim Wharton’s jelly. Perlakuan selama 14 hari. Uji visual menggunakan metode fotografi, luas ulkus diukur menggunakan software image J, persentase penyembuhan ulkus dihitung menggunakan rumus wound closure. Pengamatan dilakukan di hari ke-0, 7, 10, dan 14. Analisis perbedaan rata-rata luas ulkus menggunakan uji Mann-Whitney. Hasil: Berdasarkan luas ulkus dengan perhitungan Image J, didapatkan perbedaan signifikan pada hari ke-7 (p=0,041), hari ke-10 (p= 0,000), dan pada hari ke-14 (p= 0,000) Pada perhitungan menggunakan rumus wound closure dan data Image J, didapatkan perbedaan signifikan, pada kelompok 2 sebagian besar ulkus sudah menutup sempurna di hari ke-7, sedangkan pada kelompok 1 (kontrol) ulkus paling cepat menutup di hari ke-14 dan sebagian besar ulkus belum sembuh di hari ke-14. Simpulan: Media terkondisi sel punca mesenkim Wharton’s jelly efektif mempercepat penyembuhan ulkus pada tikus diabetik strain Wistar.</p><p> </p><p>Introduction: Diabetic ulcer is a sign of wound healing failure. Wharton’s Jelly enhance m-RNA transcription of TGF-β2, hypoxia-inducible factor-1α, and plasminogen activator inhibitor-1 genes in skin fibroblast related to wound healing process. Objective: To prove the effectivity of Wharton’s Jelly mesenchymal stem cell conditioned media on ulcer healing rate in diabetic Wistar rats. Method: A laboratory experimental study with randomized pretest-posttest control group design. This study was conducted at the Pharmacy Laboratory of Setia Budi University Surakarta on 18 Wistar strain rats divided into 2 groups. All rats were injured on upper back area. Group 1 was treated with Astaxanthin gel. Group 2 was treated with Wharton’s jelly mesenchymal stem cell conditioned media, for 14 days. Visual test was performed using the photographic method and ulcer area was measured using image J software; the percentage of ulcer healing was calculated with wound closure formula. Observations were made on days 0,7th,10th, and 14th. Analysis used Mann-Whitney test for data with normal distribution. Results: Wound closure on day 7th (p= 0.000), on day 10th (p= 0.000), on day 14th (p= 0.004) was significantly better in group 2. Based on ulcer area data with Image J software, the difference on day 7th (p= 0.041), on day 10th (p= 0.000), on day 14th (p=0.000) were significant. The ulcer healing rate is a significantly different between groups. In Wharton’s jelly group, most ulcers has closed completely in day 7th, while in astaxanthin group, most ulcer hasn’t closed until day 14th. Conclusion: Wharton’s Jelly mesenchymal stem cell conditioned media, compared to astaxanthin, accelerate the healing rate of diabetic ulcers in Wistar strain rats.</p>

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<p>Latar belakang: Nekrolisis epidermal disebut Sindrom Stevens Johnson (SSJ) apabila yang terlibat kurang dari 10% dari area tubuh, 10% sampai 29% disebut SSJ overlap NET dan lebih dari 30% NET. Tujuan : Untuk mengetahui gambaran umum pasien SSJ-NET serta penggunaan kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2016 – Desember 2017. Metode : Studi deskriptif retrospektif dengan populasi dan sampel penelitian pasien rawat inap di Instalasi Rawat Inap RSUD Dr. Moewardi, Surakarta, periode Januari 2016 – Desember 2017. Sampel menggunakan data sekunder dari status rekam medis di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta. Hasil: Total pasien 26 orang terutama berusia 46 – 55 tahun dan 56 – 65 tahun (23%). Laki-laki lebih banyak (57%). Diagnosis SSJ (61%) terbanyak dibandingkan SSJ overlap NET (19%) ataupun NET (19%). Hipertensi sebagai penyakit penyerta terbanyak (15%). Keterlibatan mukosa terbanyak pada mulut (88 %) dan penyebab terbanyak SSJ-NET melibatkan lebih dari satu macam obat (53%). Obat penyebab yang dicurigai terutama adalah antibiotik golongan sefalosporin dan parasetamol (23%). Rerata lama terapi deksametason adalah 10 hari dengan dosis rata-rata 25 mg per hari. Simpulan: Pengobatan kortikosteroid sistemik pada kasus SSJ – NET di RSUD dr. Moewardi Surakarta pada umumnya menghasilkan perbaikan klinis dengan rata-rata perawatan 10 hari dan dosis rata-rata deksametason 25 mg per hari.</p><p>Background: Epidermal Necrolysis is classified into several degree of severity based on the area of the body involved, below 10% is SJS, 10% - 29% is SJS overlap TEN and 30% is TEN. Objective: To provide general description of SJS-TEN patients and systemic corticosteroids therapy in Dr.Moewardi General Hospital Surakarta January 2016 - December 2017. Methods: A retrospective descriptive study on in-patients in Dr. Moewardi General Hospital Surakarta between January 2016 and December 2017. Results: Total sample was 26 patients, mostly male (57%) in 46 - 55 year-old and 56 - 65 year-old (23%). The most common diagnosis was SJS (61%) followed by SJS overlap TEN (19%) and TEN (19%). Hypertension was the most frequent comorbid disease (15%). Mostly affected was mouth mucosa (88%) and caused by mostly more than one drug (53%). Suspected causative drugs were mostly cephalosporin and paracetamol (23%). The average duration of dexamethason therapy was 10 days with an average dose 25 mg per day. Conclusion: SSJ - NET cases in Dr. Moewardi General Hospital Surakarta were mostly treated with systemic corticosteroids for an average of 10 days and an average dose of dexamethason 25 mg per day.</p>