Background: Pemphigus Vulgaris (PV) is a chronic autoimmune bullous disease characterized by flaccid blisters on the skin and mucous membrane. This study aimed to report a serial case of PV followed by hypertension as comorbidity. Case presentation: Four patients, 2 males, and 2 females were hospitalized due to PV. All of these patients also suffer from hypertension, but only 2 patients take antihypertension. Drugs relatively, histopathology features of all patients revealed a cleft above the basal epidermal layer with a tombstone appearance. Pemphigus vulgaris can be accompanied by hypertension as comorbidity, but its pathogenesis is unclear. A low level of programmed cell death 1 (PD1) in PV patients promotes downregulating protective factors, including T regulator (Treg) cells. In addition, decreasing the PD1 level may cause apoptosis and inflammation process in the vascular endothelial, which may lead to hypertension. Conclusion: Pemphigus vulgaris is significantly associated with hypertension.

Psoriasis adalah gangguan kronis yang dimediasi sistem imun dengan kecenderungan poligenik. Nitric oxide (NO) telah dianggap sebagai faktor penting dalam patogenesis psoriasis. Penelitian ini bertujuan untuk mengetahui korelasi kadar serum NO dengan tipe dan derajat keparahan psoriasis. Penelitian ini menggunakan metode potong lintang dengan subjek penelitian pasien psoriasis pada periode Mei-September 2018. Pengukuran perbedaan rata-rata kadar serum NO kelompok pasien dan kontrol dianalisis menggunakan t-test. Uji korelasi Spearman digunakan untuk melihat korelasi kadar serum NO dengan berbagai tipe dan derajat keparahan proriasis yang dinilai dengan skor Psoriasis Area and Severity Index (PASI). Terdapat perbedaan yang signifikan antara kadar serum NO pada kelompok kontrol dibandingkan kelompok pasien psoriasis (p=0,037). Pasien dengan psoriasis pustular generalisata memiliki rerata kadar NO tertinggi (59,07 mol/l. Tidak terdapat korelasi antara kadar serum NO dengan derajat keparahan (r=0.008, p=0.971) dan jenis psoriasis (r=-0.157, p=0.486). Tingkat NO yang meningkat pada psoriasis merupakan indikator bahwa stres oksidatif memainkan peran penting dalam etiopatogenesis psoriasis.

Background: Psoriasis Vulgaris is an autoimmune disease characterized by chronic skin inflammation and epidermal hyperplasia. Psoriasis Area Severity Index (PASI) score is one of the assessments to measure the psoriasis severity. Oral methotrexate is one of the effective therapies for psoriasis patients. Narrow Band-Ultraviolet B (NB-UVB) phototherapy is an adjunctive psoriasis therapy given concurrently with oral methotrexate. Purpose: Determine the difference in Psoriasis Area Severity Index (PASI) scores between Psoriasis Vulgaris patients treated with oral methotrexate and a combination of oral methotrexate and NB-UVB phototherapy. Methods: This observational analytic study was conducted at the Dermatology and Venereology Clinic, Dr. Moewardi General Hospital Surakarta. The patients received oral methotrexate and a combination of oral methotrexate and and Narrow Band-Ultraviolet B (NB-UVB) phototherapy. A retrospective study of medical records was conducted to determine the patient's PASI score before the therapies and 3 months after. All data were analyzed with the Shapiro Wilk normality test and the independent T-test. A p-value was <0.05, and it was considered significant. Result: The mean of decreased PASI scores in the oral methotrexate group was (6.00 +2.47) and (6.08 +2.17) in the combination therapy group. Based on the statistical test results from the 24 subjects, it was found that the PASI score decreased (p=0.931). Conclusion: There was no significant difference in the decrease in PASI between the oral methotrexate group and the combination therapy group. The mean reduction of PASI scores was more significant in the combination therapy than in the methotrexate group

No abstract

Psoriasis adalah bagian dari dermatosis eritroskuamosa dengan etiologi yang belum diketahui secara pasti. Nitric oxide (NO) yang merupakan regulator pertumbuhan dan diferensiasi keratinosit diduga memainkan peran kuat dalam patogenesis penyakit ini. Tujuan dari penelitian ini adalah untuk mengetahui tingkat perbedaan kadar serum NO terhadap derajat keparahan dan durasi penyakit psoriasis. Metode: penelitian cross-sectional pada 22 subjek penderita psoriasis vulgaris di Poliklinik Kulit dan Kelamin RS Dr. Moewardi Surakarta periode Mei-September 2018 dengan 22 individu sehat sebagai kontrol. Tingkat keparahan psoriasis pada subjek dinilai berdasarkan psoriasis area severity index (PASI), pemeriksaan laboratorium serum NO darah menggunakan metode Greiss. Analisis data dilakukan menggunakan uji T dan uji Kruskal-Wallis (p<0,05). Terdapat perbedaan yang signifikan antara kelompok serum NO penderita dan kelompok kontrol (p=0,020); tidak ada tingkat perbedaan yang signifikan antara serum NO penderita dan skor PASI serta durasi penyakit. Hal tersebut menunjukan bahwa NO merupakan unsur penting dalam proses inflamasi pada psoriasis, terutama saat kondisi lesi aktif.