Oki Suwarsa
Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

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ANALYSIS OF CAUSES OF MATERNAL DEATH IN SUKABUMI WEST JAVA Saputri, Nurwinda; Suwarsa, Oki; Susiarno, Hadi
Jurnal Aisyah : Jurnal Ilmu Kesehatan Article in Press
Publisher : STIKes Aisyah Pringsewu Lampung

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Abstract

Maternal mortality in Sukabumi District 2015 is recorded on 54 cases. The government has undergone a variety of efforts to reduce maternal mortality, but the results are not optimal. Identification of the exact cause of maternal mortality, provide valuable input in efforts to prevent future mortality. The purpose of this study was to analyze the factors that contribute to maternal mortality and explore how these factors cause of maternal mortality. Desaign squensial explanatory research using mixed design phased method. The first stage of a study documenting the 54 maternal mortality on Verbal Autopsy Maternal and performed statistical calculations with cross sectional approach. The study documents then conducted qualitative in-depth interviews.The results showed that there is a grouping of maternal mortality in the district which is in District sukabumi Cibadak, District cicantayan, Cisaat, District Talbot and District cirenghas. Factors that play a role in maternal mortality are patient factors, factors of health workers, health facilities factor and resistance factor referral and factors related to the recording and reporting of maternal mortality. Efforts to reduce maternal mortality through the strengthening system of community empowerment and good service. Conclusion factor of maternal mortality is a difficult thing to be resolved with complexity because it requires effort involving many parties.ABSTRAKKasus kematian maternal di Kabupaten Sukabumi tahun 2015 tercatatat 54 kasus kematian maternal. Pemerintah telah melakuan berbagai upaya untuk menurunkan kasus kematian maternal, tetapi hasilnya belum optimal. Identifikasi penyebab kematian maternal yang tepat, memberikan masukan berharga dalam upaya pencegahan kematian dimasa datang. Tujuan penelitian ini adalah menganalisis faktor yang berperan dalam kematian maternal dan menggali bagaimana faktor tersebut menyebabkan kematian maternal. Desaign penelitian menggunakan squensial ekplanatori disagn mixed methode yang dilakukan secara bertahap. Tahap pertama melakukan studi dokumentasi terhadap 54 kasus kematian maternal pada Otopsi Verbal Maternal dan dilakukan perhitungan statistik dengan pendekatan secara cross sectional. Hasil studi dokumen kemudian dilakukan kualitatif dengan metode wawancara mendalam. Hasil penelitian menunjukkan bahwa terdapat pengelompokan kematian maternal di kabupaten sukabumi yaitu di Kecamatan cibadak, Kecamatan cicantayan, Kecamatan cisaat, Kecamatan sukaraja dan Kecamatan cirenghas. Faktor yang berperan dalam kematian maternal ini adalah faktor pasien, faktor tenaga kesehatan, faktor fasilitas kesehatan dan faktor hambatan rujukan serta adany faktor pencatatan dan pelaporan terkait kematian maternal. Upaya penurunan kematian maternal dilakukan melalui penguatan sistem pemberdayaan masyarakat dan pelayanan yang baik.Kesimpulan faktor kematian ibu merupakan hal yang sulit untuk diselesaikan dengan kompleksitas karena memerlukan upaya yang melibatkan berbagai pihak.
AKTIVITAS IL-18, IL-4, DAN IFN- PADA KULTUR LIMFOSIT YANG DISTIMULUS OLEH STAPHYLOCOCCAL ENTEROTOXIN B (SEB) SEBAGAI PETANDA EKSASERBASI TINGKAT SELULER PADA PENDERITA DERMATITIS ATOPIK Suwarsa, Oki
Indonesian Journal of Applied Sciences Vol 1, No 3 (2011)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/ijas.v1i3.1887

Abstract

Staphylococcus aureus (S.aureus) has an important role in the pathogenesis of atopic dermatitis (AD). These role of S. aureus are related to various proteins such as staphylococcal enterotoxin B (SEB), a potent toxin. Interleukin (IL) -18  is an important regulator for interferon (IFN)g ,a cytokine produced by Th-1, and IL-4 produced by Th-2.  Further studies are still needed to discover the mechanism of SEB in AD, particularly IL-18 level, and its activities towards IL-4 and IFN-g  secretions, in regards of therapeutic strategy. The aim of this study is to analyze the activities of IL-18, IL-4, and IFN-g in the lymphocyte culture from AD patients, stimulated  with  SEB and the association between increased IL-18 level with increased  IL-4 and IFNg level. Twenty AD patients (7 male and 13 female) and twenty healthy subjects (9 male, and 11 female) were involved in this study. Study was done in Dr. Hasan Sadikin General Hospital, Bandung, proceeded by experimental invitro test on the lymphocyte culture stimulated with SEB at Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. The study was performed from 4January until 31March 2010.  Lymphocytes from the peripheral blood of the study group and control group were isolated and cultured, then 3 methods were performed towards the cultured lytmphocyte, i.e., no exposure, exposed to PHA, and exposed to SEB. After being incubated for 72 hour, then IL-18, IL-4, and  IFN-g  levels from the supernatant of the lymphocyte culture were evaluated with ELISA method.Mean IL-18 level in the lymphocyte culture of AD group, with no exposure, exposed to PHA, and exposed to SEB were 54,62 pg/ml, 70,09 pg/ml, and 99,38 pg/ml, respectively, whereas,  in the control group were 33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml, respectively. Mean IL-4 level in the study group were 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, and in the control group were  0,32 pg/ml, 0,78 pg/ml, and 3,02 pg/ml, respectively. Mean IFN-g level in the AD group were 12,75 pg/ml, 351,59 pg/ml, and 1293,17 pg/ml, while in the control group were  19,76 pg/ml, 562,81 pg/ml, and 1419,28 pg/ml, respectively.  IL-18, IL-4, and IFN-g  level in the AD group increased after being stimulated with SEB,  (p<0,05), whereas in the control group increase only occured to IL-4, and IFN-g (p<0,05). There were correlation between increased IL-18 level with increased IL-4 level (p<0,05), however the increased of IL-18 level were not related to increased IFN-g level (p>0,05). The increased  IL-18 level contributed more to the increased of IL-4 level than IFN-g  level  (p<0,05).The result of this study, is only IL-18 level increased in any methods performed, compared to control group (p<0,05). This finding leads to the conclusion that IL-18 level is the marker of AD exacerbation in the cellular level of the AD lymphocyte culture stimulated with SEB.****Staphylococcus aureus (S.aureus) berperan penting pada patogenesis dermatitis atopik (DA). Peran tersebut berhubungan dengan dihasilkannya berbagai protein antara lain toksin poten oleh S. aureus, yaitu staphyloccoccal enterotoxin B (SEB).  Interleukin-18 (IL-18) merupakan regulator penting dari produksi sitokin Th-1 yaitu Interferon-g (IFN-g) dan Th-2 yaitu IL-4. Penelitian untuk mengetahui mekanisme SEB pada DA, khususnya kadar IL-18, dan pengaruh aktivitas IL-18 terhadap sekresi IL-4 dan IFN-g, untuk strategi pengobatan perlu dilakukan. Tujuan penelitian ini adalah untuk menganalisis aktivitas IL-18, IL-4, dan IFN-g pada kultur limfosit yang distimulus oleh SEB pada penderita DA, serta pengaruh kenaikan kadar IL-18 terhadap kenaikan kadar IL-4 dan IFN-g.Penelitian ini dilakukan  pada 20 orang penderita DA (7 laki-laki dan 13 wanita) dan 20 orang sehat (9 laki-laki, dan 11 wanita) di RSUP. Dr. Hasan Sadikin Bandung, merupakan penelitian eksperimental secara invitro pada kultur limfosit yang distimulus oleh SEB di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. Dilakukan isolasi limfosit dari darah perifer kelompok DA dan kontrol, dilanjutkan dengan kultur limfosit, kemudian dilakukan 3 perlakuan yaitu tanpa paparan, dipapar dengan phytohemagglutinin (PHA), dan dipapar dengan SEB. Setelah dieramkan selama 72 jam, kemudian diperiksa kadar IL-18, IL-4, dan IFN-g  dari supernatan kultur limfosit dengan metode ELISA.Kadar IL-18  rata-rata pada kultur limfosit tanpa paparan, paparan PHA, dan paparan SEB kelompok DA  berturut-turut  adalah 54,62 pg/ml, 70,09 pg/ml, dan 99,38 pg/ml.   Sedangkan pada kelompok kontrol berturut-turut adalah   33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml. Kadar IL-4 rata-rata kelompok DA berturut-turut adalah 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, dan pada kelompok kontrol berturut-turut adalah   0,32 pg/ml, 0,78 pg/ml, dan 3,02 pg/ml. Kadar  IFN-g rata-rata kelompok DA  berturut-turut adalah  12,75 pg/ml, 351,59 pg/ml, dan 1293,17 pg/ml, dan pada kelompok kontrol berturut-turut adalah   19,76 pg/ml, 562,81 pg/ml, dan 1419,28 pg/ml.  Pada kelompok DA, kadar IL-18, IL-4, dan IFN-g setelah dipapar SEB, meningkat dibanding dengan sebelum dipapar (p<0,05), sedangkan pada kelompok kontrol hanya kadar IL-4, dan IFN-g yang meningkat (p<0,05). Kenaikan kadar IL-18 berpengaruh terhadap kenaikan kadar IL-4 (p<0,05), tetapi tidak berpengaruh terhadap kenaikan kadar IFN-g  (p>0,05). Kenaikan kadar IL-18 lebih berpengaruh  pada kenaikan kadar IL-4 dibandingkan dengan IFN-g (p<0,05).Pada penelitian ini hanya kadar IL-18 kelompok DA yang meningkat lebih tinggi pada semua perlakuan, dibandingkan dengan kelompok kontrol (p<0,05), sehingga dapat disimpulkan bahwa IL-18 merupakan petanda adanya eksaserbasi tingkat seluler pada kultur limfosit DA yang distimulus oleh SEB.
KEBERHASILAN TERAPI KOMBINASI MENGGUNAKAN METOTREKSAT INJEKSI DAN SIKLOSPORIN PADA PSORIASIS PUSTULOSA GENERALISATA Suwarsa, Oki; Devi Nursjamsi, Nadilla Carissa; Pangastuti, Miranti; Sutedja, Endang; Dharmadji, Hartati Purbo
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n3.1123

Abstract

Psoriasis pustulosa generalisata (PPG) adalah bentuk khusus dari psoriasis yang bersifat akut dan berat. Etiologi yang belum diketahui secara pasti menyebabkan pengobatan PPG masih menjadi suatu tantangan. Terapi kombinasi dapat diberikan pada PPG yang berat maupun yang tidak memberikan respons terhadap terapi sistemik tunggal, selain itu terapi kombinasi juga dapat meningkatkan efektivitas dari obat tunggal. Dilaporkan satu kasus PPG pada seorang wanita yang diterapi dengan menggunakan kombinasi metotreksat (MTX)  injeksi dan siklosporin. Dari anamnesis dan pemeriksaan fisis didapatkan pustula berkelompok pada dasar makula eritem yang bergabung membentuk lake of pus, disertai gejala sistemik demam dan leukositosis. Keluhan tersebut sudah berulang sejak 13 tahun yang lalu. Pasien diberikan terapi kombinasi injeksi MTX dan siklosporin. Pustula pada pasien menghilang setelah tujuh hari pemberian obat. Terapi kombinasi dengan MTX injeksi dan siklosporin ini baru pertama kali dilakukan 19 Mei?26 Mei 2017 di Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dan memberikan hasil yang baik. [MKB. 2017;49(3):208?12]Kata kunci: Metotreksat, metotreksat injeksi, psoriasis pustulosa generalisata, siklosporin Succesful Treatment of Generalized Pustular Psoriasis with a Combination of Methotrexate Injection and CyclosporineGeneralized pustular psoriasis (GPP) is a special form of acute and severe psoriasis. The definite etiology of GPP remains a challenge. Combination therapy may be given to severe GPP or GPP that does not respond to a single systemic therapy sincecombination therapy may also improve the effectiveness of a monotherapy drug. A GPP case was reported in a woman treated with a combination of methotrexate (MTX) and cyclosporine. From anamnesis and physical examination it was revealed that there were clustered  pustules on the base of erythematous macules that form a lake of pus accompanied by systemic symptoms of fever and leukocytosis. This was a recurrent complaint since 13 years ago. Patients were given combination therapy of MTX injection and cyclosporine. Pustules disappeared after seven days of drug administration. This case was the first combination therapy with MTX injection and cyclosporine used during the period of 19 May to 26 May 2017 at the Department of Dermatology and Venereology Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, resulting in good results. [MKB. 2017;49(3):208?12]Key words: Cyclosporine, generalized pustular psoriasis, methotrexate, methotrexate injection
PENGARUH MEDIA FILM TERHADAP SIKAP IBU PADA DETEKSI DINI KANKER SERVIKS Mulyati, Sri; Suwarsa, Oki; Desy Arya, Insi Farisa
Jurnal Kesehatan Masyarakat Vol 11, No 1 (2015): JURNAL KESEHATAN MASYARAKAT (KEMAS) JULI 2015
Publisher : Jurusan Ilmu Kesehatan Masyarakat Fakultas Ilmu Keolahragaan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v11i1.3401

Abstract

Salah satu cara yang praktis dan murah untuk mencegah terjadinya kanker serviks adalah melalui tes Inspeksi Visual Asam Asetat (IVA). Upaya untuk mempengaruhi sikap ibu pada tes IVA adalah pendidikan kesehatan melalui film. Tujuan penelitian ini adalah untuk mengetahui pengaruh pendidikan kesehatan melalui film terhadap sikap ibu pada tes IVA. Penelitian ini dilakukan pada tahun 2014. Rancangan penelitian ini adalah non randomized within group design. Pengambilan sampel dilakukan dengan teknik consecutive sampling pada 60 responden.  Analisis bivariat yang digunakan pada penelitian ini adalah  uji wilcoxon. Hasil penelitian menunjukkan terdapat pengaruh positif pendidikan kesehatan melalui film terhadap sikap ibu (P&lt;0,05) dengan peningkatan median (rentang) skor sikap dari 44,23 (19,23-75) menjadi 78,85 (25-94,23). Kesimpulan penelitian ini adalah terdapat pengaruh positif pendidikan kesehatan melalui film terhadap sikap ibu. The Visual Inspection with Acetic Acid (VIA) test is a practical and cheaper way to prevent cervical cancer. One way to influence attitude in VIA test is health education based on the movie. The purpose of this study was to determine the effect of health education based on the movie on the attitude,of women in VIA test. The study conducted at 2014. The study design was nonrandomized within group design. The sampling technique was consecutive sampling technique on 60 respondents. The data analysis employed  bivariable analysis with wilcoxon test. This study shows there was a significant positive effect of the health education based on the movie on the mother’s attitude (P&lt;0.05) with median and range attitude score increasing from 44.23 (19.23-75) to 78.85(25-94.23). This study concludes that there is significant positive effect of the health education based on the movie on attitude.
Quality of Life in Children with Atopic Dermatitis Wicaksana, Muhammad Akbar; Suwarsa, Oki; Dwiyatnaningrum, Fenny
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (841.296 KB) | DOI: 10.15850/amj.v4n3.652

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Background: Atopic dermatitis (AD) is the most common chronic skin disease in children which caused significant morbidity and impaired quality of life (QoL). The main goal of AD therapy is to prevent flare -ups, prolong remission and increase QoL. Therefore, the study aimed to discover QoL in children with AD.Methods: The study was conducted at Pasundan Public Health Centre, Al Islam General Hospital and Kimia Farma Private Dermatology Clinic, from September to November 2015. This descriptive study used consecutive sampling with 24 outpatients who were admitted to the health facility and diagnosed as AD. A questionnaire on Infant Dermatitis Quality of Life for infants aged 0–4 years, and Children Dermatology Life Quality Index for children aged 5–16 years was used in this study to measure QoL.Results: Out of 24 patients, 9 patients aged 0–4 years had mean score of 4.44±4.36, and 15 patients aged 5–16 years had mean score of 5.80±3.95. Mean SCORAD Objective in patients aged 0–4 and 5–16 was 15.61±7.75 and 17.44±11.Conclusions: The QoL in children with AD vary among patients. Most of the patients have mild-moderate impairment in QoL. 
Relationship between Knowledge, Attitude and Practice of Student’s Personal Hygiene with Scabies Incidence in Pesantren Darul Fatwa, Jatinangor, West Java, Indonesia Purnama, Karinna Dwi; Sjambas, Dedi Rachmadi; Suwarsa, Oki
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (621.223 KB) | DOI: 10.15850/amj.v4n3.1198

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Background: Scabies is a parasitic infection caused by Sarcoptesscabiei Hominis varian and Acarina order. Sarcoptes scabiei infects both male and female in any age groups, ethnics, and socio-economic levels. Transmission of scabies can pass through by a direct contact from skin-to-skin or indirect contact through sharing bed, clothes, and towels. Pesantren as an educational institution supplies facilities that are shared thus making students susceptible to scabies infection. This study was conducted to discoverrelationshipbetween knowledge, attitude, and practice of student’s personal hygiene with scabies incidence.Methods: An analytic observational study was conducted from October to November 2015 in Pesantren Darul Fatwa, Jatinangor. Study was conducted with cross-sectional design and total sampling for the sample size. Total of 37 students whoparticipated in this study were 22 malesand 15 females. This study was begun with a stand alone-questionnaire, fill out on knowledge, attitude, and practice of personal hygiene that was supervised by researcher, and physical examination for scabies diagnosis that was performed by doctors.Results: Based on history taking and physical examination, 15 out of 37 students were diagnosed with scabies positive. All of them were males, dominated by 13 year old students, 1st and 2nd Junior High School students. Statistical analysis with chi-square test showed that there were no relationship between knowledge, attitude and practice of student’s personal hygiene with  scabies incidence.Conclusions: There is no relationship between knowledge, attitude and practice of student’s personal hygiene with  scabies incidence in Pesantren
A NOSOCOMIAL INFECTION MANIFESTED AS ERYSIPELAS IN PEMPHIGUS FOLIACEUS PATIENT UNDER INTRAVENOUS DEXAMETHASONE TREATMENT Pranata, Achmad Yudha; Gunawan, Hendra; Sutedja, Endang; Suwarsa, Oki; Dharmaji, Hartati Purbo
Indonesian Journal of Tropical and Infectious Disease Vol 6, No 2 (2016)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (290.292 KB) | DOI: 10.20473/ijtid.v6i2.1992

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Introduction: Puncture wound in diagnostic interventions permits the entry of bacteria into the skin or soft tissue, thus precipitating nosocomial infection, such as erysipelas. There are other risk factors of nosocomial infections including old age, immunosuppressive drugs, and underlying diseases. Pemphigus foliaceus (PF) is an autoimmune disease with corticosteroid treatment as the mainstay therapy, which could cause immunosuppression and predispose patients to infection. The objective of this paper was to report erysipelas as one of the manifestations of nosocomial infection in patients under immunosuppressive therapy. Case: A case of erysipelas acquired on the 9th day of hospitalization in a PF patient underwent intravenous dexamethasone injection, with history of puncture wounds on the previous day on the site of erysipelas was reported. The clinical findings of erysipelas were well defined, painful erythema and edema that felt firm and warm on palpation, with blisters and pustules on top. Gram staining from the pustules and blisters fluid revealed Gram (+) cocci. Patient was given 2 grams intravenous ceftriaxone for 7 days and saline wet compress. Improvement on the erysipelas was seen the day after ceftriaxone injection. The patient was discharged after 12 days of hospitalization with improvement both on the PF and the erysipelas. On the next visit 7 days later, the erysipelas lesion disappeared. Conclusion: Puncture wound and immunosuppresive treatment are the factors that could cause erysipelas as a nosocomial infection, and an appropriate treatment of the infection would decrease the functional disability of the patient.
The Positive Skin Prick Test not Correlate with Disease Severity and Quality of Life in Atopic Dermatitis Patients Suwarsa, Oki; Sormin, Erfina Rohana; Sutedja, Endang; Dharmaji, Hartati Purbo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 29, No 3 (2017): DESEMBER
Publisher : Faculty Of Medicine Airlangga University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (385.549 KB) | DOI: 10.20473/bikkk.V29.3.2017.229-233

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Background: Atopic dermatitis (AD) is a skin disease which cause stress to the patients. The chronic process of AD can cause physical, social, and psychological impairments. The severity of AD can also be affected by allergen exposures, which in turn will affect the quality of life of the patient. Skin prick test (SPT) can be used to evaluate allergen sensitization. Purpose: To evaluate correlation between SPT positivity to severity and quality of life of AD patients. Methods: The study was an observational cross-sectional study. Twenty five AD patients were recruited based on inclusion and exclusion criteria. Questionnaire was used to measure the quality of life of patients, and Scoring of Atopic Dermatitis (SCORAD) to measure the disease severity. Most of participants were women (80%), with median of age 26.84±13.71. Results: Positive SPT was obtained in 68% of patients, most of them were caused by house dust mites (55.2%). Seventy six percent of patients experienced mild AD, 12% moderate AD, and also 12% patients experienced severe AD. Significant correlation was observed between the severity and quality of life (p=0.001;r=0.617), while the SPT positivity has no correlation with the severity (p=0.912;r=-0.023) and quality of life (p=0.959;r=0.011). Conclusion: This study revealed that the severity of the disease has a correlation with quality of life, but SPT positivity has no significant correlation with severity and quality of life.
Quality of Life in Children with Atopic Dermatitis Wicaksana, Muhammad Akbar; Suwarsa, Oki; Dwiyatnaningrum, Fenny
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2911.887 KB) | DOI: 10.15850/amj.v4n3.652

Abstract

Background: Atopic dermatitis (AD) is the most common chronic skin disease in children which caused significant morbidity and impaired quality of life (QoL). The main goal of AD therapy is to prevent flare -ups, prolong remission and increase QoL. Therefore, the study aimed to discover QoL in children with AD.Methods: The study was conducted at Pasundan Public Health Centre, Al Islam General Hospital and Kimia Farma Private Dermatology Clinic, from September to November 2015. This descriptive study used consecutive sampling with 24 outpatients who were admitted to the health facility and diagnosed as AD. A questionnaire on Infant Dermatitis Quality of Life for infants aged 0–4 years, and Children Dermatology Life Quality Index for children aged 5–16 years was used in this study to measure QoL.Results: Out of 24 patients, 9 patients aged 0–4 years had mean score of 4.44±4.36, and 15 patients aged 5–16 years had mean score of 5.80±3.95. Mean SCORAD Objective in patients aged 0–4 and 5–16 was 15.61±7.75 and 17.44±11.Conclusions: The QoL in children with AD vary among patients. Most of the patients have mild-moderate impairment in QoL. 
PERBANDINGAN KADAR INTERLEUKIN-17 SERUM PASIEN AKNE VULGARIS TIPE PAPULOPUSTULAR DENGAN KOMEDONAL Maulinda, Shinta; Hindritiani, Reti; Ruchiatan, Kartika; Suwarsa, Oki
Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v48n3.846

Abstract

Patogenesis akne vulgaris (AV) bersifat multifaktorial dan faktor yang berperan penting adalah inflamasi yang terutama diinduksi oleh reaksi imunologis terhadap Propionibacterium acnes (P. acnes). Bakteri ini dapat ditemukan baik pada lesi inflamasi berupa papula dan pustula, maupun noninflamasi seperti komedo, dengan jumlah P. acnes lebih tinggi pada lesi inflamasi. Secara klinis komedo merupakan lesi noninflamasi, namun secara mikroskopis sudah terjadi inflamasi. P. acnes dapat menginduksi pelepasan sitokin proinflamasi antara lain IL-17. Tujuan penelitian ini adalah membandingkan kadar IL-17 serum antara pasien AV tipe papulopustular dan komedonal. Penelitian ini merupakan penelitian analitik observasional secara potong lintang dengan peserta penelitian masing-masing 12 pasien AV tipe papulopustular dan komedonal derajat dua atau lebih di Poliklinik Dermatologi Kosmetik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Dr. Hasan Sadikin Bandung selama periode Oktober?November 2014. Pada kedua kelompok dilakukan pengambilan darah tepi untuk pengukuran kadar IL-17 serum dengan metode ELISA. Hasil penelitian menunjukkan kadar IL-17 serum rata-rata (SD) pada pasien AV tipe papulopustular adalah 0,65 (1,12) pg/mL, sedangkan pada tipe komedonal adalah 0,46 (0,42) pg/mL, perbedaan tersebut secara statistik tidak bermakna (p=1,000). Simpulan, kadar IL-17 serum pasien AV tipe papulopustular tidak berbeda dibanding dengan AV tipe komedonal menunjukkan bahwa kemungkinan pada lesi komedo sudah terjadi inflamasi. [MKB. 2016;48(3):160?3]Kata kunci: Akne vulgaris, IL-17 serum, tipe komedonal, tipe papulopustular Comparison of Interleukin-17 Serum Level between Papulopustular and Comedonal Types of Acne VulgarisThe pathogenesis of acne vulgaris (AV) is multifactorial and inflammation, which is primarily cause by induction of immunological response to Propionibacterium acnes (P. acnes), is suggested as the main important factor in AV development. These bacteria can be found in the form of papules and pustules in inflammatory lesions and as comedones in noninflammatory lesions, with a higher presentation seen in the inflammatory lesions. Clinically, comedo is a noninflammatory lesion; however, inflammation can be observed microscopically. P. acnes can release proinflammatory cytokines, including IL-17. The aim of this study was to compare the IL-17 serum level between papulopustular type and comedonal type of AV. This study was a cross sectional-analytic observational, conducted at the Cosmetic Dermatology Clinic, Dermatology and Venereology, Dr. Hasan Sadikin General Hospital Bandung during October?November 2014. The participants were AV patients with at least second degree papulopustular (n12) and comedonal types (n12). Blood samples from all subjects were collected and the IL-17 serum levels were measured using ELISA methods. This study showed that the mean (single deviation) IL-17 serum levels in papulopustular and comedonal type of AV were 0.65 (1.12) pg/mL and 0.46 (0.42) pg/mL, respectively, and the difference was not statistically significant (p:1.000). The IL-17 serum level in the papulopustular type is not different from that of the comedonal type of AV in this study, which indicates that the inflammatory events probably had occurred  in comedonal lesions. [MKB. 2016;48(3):160?3]Key words: Acne vulgaris, comedonal type, IL-17 serum level, papulopustular type