Introduction: Melasma is a condition of hyperpigmentation of the facial skin that increases in prevalence with ageing. The alleged involvement of reactive oxygen species and antioxidants is the basis of the pathology of melasma. Glutathione is one of the non-enzymatic antioxidants produced by the body and plays a role in melanogenesis. The purpose of this study was to examine serum glutathione levels on the severity of melasma. Methods: This study used a cross-sectional design conducted at the Cosmetic Dermatology Clinic at Sanglah Hospital, Denpasar, from September to October 2016. Serum glutathione was examined through venous blood with ELISA method, and the severity of melasma was assessed using melasma area severity index (MASI). Independent t-test and ANOVA were used to evaluate differences in plasma glutathione levels based on the characteristics of the sample. Pearson correlation test and linear regression were used to assess the relationship between MASI and plasma glutathione. Results: This study involved 47 people with a clinical diagnosis of melasma. There was a significant strong negative correlation between plasma glutathione and MASI (p<0.001; r = −0.624). Mild melasma (1.89 ± 0.28 µmol/L) had higher plasma glutathione levels compared to moderate melasma (1.53 ± 0.13 µmol/L) and severe (1.18 ± 0.20 µmol/L) (p=0.043). Linear regression showed a significant negative linear relationship between MASI scores against plasma glutathione (β = −58.2; p <0.01). Conclusion: Glutathione plasma has a strong negative correlation with the MASI score in person with melasma.

Introduction: Bullous pemphigoid is an autoimmune disorder. The incidence of bullous pemphigoid has increased over time, current understanding regarding treatment and complication is an important issue considering the disease often occur in elderly resulting in high rates of morbidity to the patients. Aim of current case report is to describe the clinical relevance regarding symptom and treatment of bullous pemphigoid.Case presentation: A 65 years old female patient, came with chief complaints of bullae in abdominal region with itching and burning sensation in the ruptured bullae. Over time bullae spread in lower and upper extremity. Patient was admitted for four days with therapy intravenous steroids, oral antihistamine, and potent topical steroids. Patient was discharged from hospital in well condition.Conclusion: Bullous pemphigoid is an inflammatory autoimmune skin disease and usually result in good prognosis with adequate management.Keywords: autoimmune, bullous, pemphigoid, skin, disease.