No abstract

Syphilis is a chronic and systemic sexually transmitted infection caused by Treponema pallidum. The prevalence of syphilis according to the World Health Organization (WHO) is around 12 million cases worldwide and in pregnant women around 1.8 million cases. Syphilis screening in pregnancy is important to break the chain of transmission of congenital syphilis. We reported Mrs. S, 33 years old, 18 weeks pregnant, came with history of itchy patches appeared 8 months ago along with her husband and abortion 1 year ago. The plantar pedis dextra et sinistra showed multiple hyperpigmented macules and no clinical founding in the vagina. Serological tests, reactive Venereal Disease Research Laboratory (VDRL) 1:32, Treponema pallidum hemagglutination (TPHA) >1:5120 and non-reactive human immunodeficiency virus (HIV), support the diagnosis of latent syphilis. Patients were injected with benzathine penicillin 2.4 million units 3 times (1 week apart). Serological test evaluated at months 1, 3 and 6. At month 6, there was a decrease in VDRL value 4 times the initial value, indicating successful therapy in laten syphilis and had received therapy according to the guidelines for late latent syphilis. Syphilis in pregnancy can cause congenital syphilis in the fetus, although latent syphilis has no symptoms. The patient's VDRL titer was reactive in early latent syphilis (>1:8), but based on history and duration of infection more than 1 year including late latent syphilis. Based on this case report, we found that the VDRL titer value did not always correspond to the duration of infection.

Aging is a complex process influenced by intrinsic and extrinsic factors. Intrinsic aging is affected by age, genetics, and hormones. A recent study has found that human umbilical vein endothelial cells (HUVEC) exosomes can serve as a new treatment for repairing and rejuvenating skin tissue. Therefore, this research aims to determine the effect of HUVEC exosomes on increasing type I collagen deposition on the skin of intrinsic aging Wistar rats. An experimental laboratory posttest-only control group study was conducted on 30 Wistar rats. The rats were divided into a control group (Group A) and treatment groups receiving 1% HUVEC exosome (Group B) and 1.5% HUVEC exosome (Group C). Collagen deposition was measured using Masson's trichrome staining. Statistical analysis used the Kruskal-Wallis and Mann-Whitney tests (p value < 0.05, significant). After 4 weeks, type I collagen deposition was significantly higher in the treatment groups than in the control group (p = 0.00). The mean values of collagen deposition (%) for Group A, Group B, and Group C were 15.87, 30.71, and 40.72, respectively. The Mann-Whitney test revealed that the HUVEC exosome had a significant effect on collagen deposition. Thereby, HUVEC exosomes can increase type I collagen deposition significantly and can be considered a therapeutic option for skin rejuvenation in future studies.