Differentiation capacity of dental pulp stem cell into inner ear hair cell using an in vitro assay: a preliminary step toward treating sensorineural hearing loss.

PURPOSE: Sensorineural hearing loss (SNHL) is commonly caused by the death or dysfunction of cochlear cell types as a result of their lack of regenerative capacity. However, regenerative medicine, such as stem cell therapy, has become a promising tool to cure many diseases, including hearing loss. In this study, we determined whether DPSCs could differentiate into cochlear hair cell in vitro. METHODS: DPSCs derived from human third molar dental pulp were induced into NSCs using a medium containing basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) for 7 days, and then into cochlear hair cell using a medium containing EGF and IGF-1 for the next 14 days. We used the neuroepithelial protein marker nestin and cochlear hair cell marker myosin VIIa as the markers for cells differentiation. Cells expressing the positive markers under the microscope were confirmed to have differentiated into cochlear hair cell. RESULTS: DPSCs were successfully induced to differentiate into NSCs, with mean 24% nestin-positive cells. We found that DPSC-derived NSCs have a great capacity in differentiating into inner ear hair cell-like cells with an average of 81% cells presenting myosin VIIa. Thus, DPSCs have high potential to serve as a good resource for SNHL treatment. CONCLUSION: We found the high potential of DPSCs to differentiate into NSC. The ability of DPSCs in differentiating into neural lineage cell made them a good candidate for regenerative therapy in neural diseases, such as SNHL.

Efficacy of green tea ( Camellia sinensis Linn) 3% extract cream on improvement of striae distensae.

Background: Striae distensae (SD) is a skin condition that frequently causes dermatological consultations and although asymptomatic, it may can cause itch and burning sensation. Green tea extract contains polyphenol, including flavanol, flavandiol, flavonoid, phenolic acid, amino acids and minerals which play a role in the repair of stretch marks through anti-inflammatory mechanism, increase collagen production, fibroblast proliferation, and skin hydration. Objective: To determine the efficacy of green tea extract cream on striae distensae. Methods: This is a pre-experimental clinical trial with a pretest-posttest design on 36 subjects with striae distensae. Diagnosis establishes through history taking and clinical evaluation. Imam Nelva Alviera (INA) score was used as SD severity before and after the application of the 3% green tea extract cream carried out at weeks 0, 2, 4, 6, and 8. Side effects and subjects' satisfaction were also recorded. Cochran test was carried out to see the difference before and after treatment, with a p-value <0.05 considered significant. Results: Majority of study subjects were 18-25 years (77.8%), had history of pregnancy (75%), had a history of menarche at the age of 12 years (27.8%) and all subjects had striae alba. There was significant decrement in INA score for striae distensae (p<0.001) after eight weeks administration of 3% green tea extract cream. Clinical improvement and no side effects were also noted. All subjects were satisfied. Conclusions: The use of 3% green tea extract cream can improve the appearance of SD.

Assessing Acne Severity: Teledermatology Versus Face to Face Consultations During the COVID-19 Pandemic.

Background: Acne vulgaris is a common skin disorder in pilosebaceous units that is self-limited, especially in adolescents. This disease not only causes permanent physical complications but also psychosocial effects that harm the quality of life. Telemedicine has grown its popularity in recent years, especially during the COVID-19 pandemic. Store and Forward (SAF) teledermatology using digital cameras has also increased patient service satisfaction, promising diagnostic reliability, and clinical outcomes similar to face-to-face visits. Objective: We sought to compare the severity of acne vulgaris by teledermatology with face-to-face consultations. We also observe the capability of teledermatology in establishing the severity of acne vulgaris. Methods: This study is an observational analytic study with a cross-sectional design involving 105 patients with a diagnosis of acne vulgaris based on inclusion and exclusion criteria. The characteristics of age and sex were recorded. The severity of acne vulgaris was established directly by the resident and teledermatologically by the dermatologist consultant. Teledermatology was carried out based on photo documentation of five facial lesion areas; namely forehead, chin, right cheek, left cheek, and the entire face, along with photos from the history submitted by the resident. An assessment for acne vulgaris severity was carried out based on the classification from the International Consensus Conference on Acne Classification System. This classification divided acne vulgaris as mild, moderate, and severe with an ordinal measuring scale. A compatibility test was also performed to determine the comparison between teledermatology and face-to-face consultations in establishing the severity of acne vulgaris. Comparison of the severity of acne vulgaris was assessed by the kappa value. Results: Acne vulgaris was found more common in women (n=71, 67.6%) and those aged 18 to 22 years (n=55, 52.4%). Most of the subjects have moderate severity based on face-to-face consultations and teledermatology examination (n=52 (49.5%) and n=50 (47.6%), respectively). The value of the capability test between teledermatology and face-to-face consultations in comparing the severity of acne vulgaris is 0.611, which means the capability is considered good. Conclusion: In this study, the teledermatology examination shows good conformity when compared with face-to-face consultations in assessing severity of acne vulgaris.

Phytochemical Analysis by FTIR of Zanthoxylum Acanthopodium, DC Fruit Ethanol Extract, N-hexan, Ethyl Acetate and Water Fraction.

Background: Andaliman fruit is used as spice in Batak cuisine, North Sumatera, Indonesia. The potency of andaliman fruit extract as herbal medicine is widely studied. Many studies elaborate the benefits of andaliman fruit extract as an antioxidant, antibacterial or anticancer. Objective: The aim of this study was to identify the phytochemical compounds of andaliman fruit extract and its fractions. Methods: The andaliman fruit was originated from Balige city, Tobasa Regency, North Sumatera. The extract was made by maceration within ethanol and followed by fractionation with n-hexan, ethyl acetate and water. The phytochemical screening by chemical reactions, thin layer chromatography, and Fourier Transform Infrared Spectrophotometer were performed. Results: This study found andaliman fruit ethanol extract consists of alkaloids, flavonoids, glycosides, tannins, triterpens, and steroids. The n-hexan fraction consists of triterpens and steroids, ethyl acetate fraction consists of flavonoids and glycosides, and water fraction consists of alkaloid, flavonoid, and glycosides. Andaliman fruit ethanol extract had eight color spots, n-hexan and ethyl acetate fraction had five color spots and water fraction had two color spots. Andaliman fruit ethanol extract had functional group of C-H alkanes, =C-H alkenes (aliphatic), O-H, C=C alkenes, C=C aromatics, C≡C alkynes, C-O, C=O, and NO2. The n-hexan fraction had C-H alkanes, =C-H alkenes (aliphatic), O-H, C=C alkenes, C-O, C=O, and NO2. The ethyl acetate fraction had C-H alkanes, =C-H alkenes (aliphatic), O-H, C=C alkenes, C=C aromatics, C-O, C=O, and NO2. The water fraction had C-H alkanes, =C-H alkenes (aliphatic), O-H, C=C aromatics, C≡C alkynes, and C-O. Conclusion: Phytochemical screening found that andaliman fruit ethanol extract, n-hexan, ethyl acetate and water fraction positive of phytochemical compounds. The FTIR of andaliman fruit ethanol extract, n-hexan fraction, ethyl acetate fraction, and water fraction showed the absorbance of C-H alkanes, O-H, C-O, and C=C alkenes indicating the presence of alkaloids, flavonoids, and triterpenoid saponin.

Bacterial cellulose impregnated with andaliman (Zanthoxylum acanthopodium) microencapsulation as diabetic wound dressing.

Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus which can cause infection, amputation and even death. One of many treatments that can be applied to support the DFU healing processes is by using wound dressings. Bacterial cellulose (BC) is a good material to be used as a wound dressing. However, some of the limitations of BC to be applied as wound dressing are does not possess antibacterial properties and support the healing process. Andaliman (Zanthoxylum acanthopodium) is known to have antioxidant, antibacterial and anti-inflammatory abilities that can support BC as a wound dressing. This research focused on the manufacture of BC/Z. acanthopodium microencapsulated wound dressing composites and evaluate their potential as a DFU wound dressing with a variety of gelatin composition in microencapsulation. The results of FTIR and SEM analysis showed that the Z. acanthopodium impregnation process in BC was successful. The variation of gelatine that used in microencapsulation affected the morphological and effectiveness of the wound dressing. However, overall, the wound dressings showed good antibacterial effect on E. coli and S. aureus bacteria and accelerating the wound closure process 8 times faster (BCAMc12) on the 17th day compared to wounds that did not receive any treatment.

Effect of Moderate Intensity Continuous Training and Slow Type Interval Training to Gene Expression of TGF-ß in Type 2 Diabetes Mellitus Model Wistar Rats.

Background: Physical exercise is a process of increasing contraction of skeletal muscles involving several organ systems to increase energy formation and it is one of the pillars for the management of type 2 diabetes mellitus (TDM2). T2DM affects the expression of the TGF-ß gene. Objective: This study aims to determine the effect of moderate intensity continuous training and slow interval training in expression of TGF-ß gene in wistar rats T2DM model. Methods: A moderate intensity continuous training physical activity given to the diabetic rat group in the form of running on a treadmill with a running speed of 20 m/min for 30 minutes while the slow type interval training physical activity given to the diabetic rat group was in the form of running on a treadmill with a running speed of 20 m/minute for 10 repetition sessions, with a duration of 2 minutes per session with interspersed active breaks for 1 minute. TGF-ß gene expression was measured using real-time methods. Results: The results in the continuous group, TGF-ß significant decreased p < 0.05. In the interval group, TGF- ß insignificant decreased p > 0.05. Moderate intensity continuous training was insignificantly better at decreasing the expression of the TGF-ß genes. Conclusion: This research concluded that there is an effect of moderate intensity continuous training and slow interval training on the expression of TGF-ß genes in wistar rats T2DM.

Skin Changes and Safety Profile of Topical Products During Pregnancy.

Objective: We sought to know the efficacy and safety profile of topical products for use during pregnancy. Methods: We used PubMed, Embase, and Cochrane Library to review literature on topical products and pregnancy. Results: A majority of pregnant women develop skin changes, including physiological or hormonal changes, worsening of preexisting skin conditions, or the appearance of new dermatoses during pregnancy. Most pregnant women are concerned about the availability of treatments options with good safety profiles, especially for skin and hair treatments, to maintain their appearance and health. Although most of the treatments are recommended to be used after delivery, there are some alternatives to prevent and treat skin lesions during pregnancy. Conclusion: The most current and comprehensive information about the efficacy and safety profile of topical products in pregnancy are necessary.

The effect of roselle leaf (Hibiscus sabdariffa L.) extract gel on wound healing.

Roselle (Hibiscus sabdariffa L.) belongs to the genus Hibiscus with proven anti-inflammatory, antioxidant, and antimicrobial properties. Scientific evidence associated roselle content with bioactive compounds, such as phenolic acids, flavonoids, and anthocyanin. Most studies focused on their petals, while research on leaf extract on wound healing has never been done. This study aimed to assess the effect of roselle leaf extract on wound healing in rats. This was an experimental laboratory study with a posttest-only control group design. There were 30 rats divided into 5 groups: negative control, 5%, 10%, and 15% roselle leaf extract, and positive control (bioplacenton). The parameters assessed in this research were wound size and histological assessment. The data were analyzed using ANOVA. P<0.05 was considered statistically significant. Wound healing percentage and epithelial thickness in the 15% group were the largest (84.17%; 64.69 µm). The lowest value was recorded in placebo (64%; 36.33 µm). Meanwhile, wound healing percentage and epithelial thickness of rats in the 5% and 10% groups were 68.53%, 43,57 µm, and 78.11%, 56.49 µm, respectively. Finally, positive control had a 77.44% wound healing percentage and 49.7 µm epithelial thickness. There were no significant differences in wound healing and epithelial thickness among the groups. Roselle leaf extract at 15% concentration showed greater wound healing properties based on clinical and histological assessment. Although there were no statistically significant differences, roselle leaf showed an opportunity to be further investigated as a potential wound healing therapy.

Anti-Aging Activity of Andaliman (Zanthoxylum Acanthopodium DC) Fruit Ethanol Extract on Brain Weight and p16INK4a Expression of Hippocampus in Aging Model Rats.

Background: Physiological aging and due to oxidative stress in long term will have an impact on cellular response disorders, can caused aging of hippocampus and senility. Brain weight is known to decrease with age and p16INK4a as aging biomarkers have been investigated. Andaliman is one of typical herbal plants from North Sumatra has been widely used as an antioxidant, anti-inflammatory and anti-aging. Objective: This study was evaluated effect of andaliman (Zanthoxylum acanthopodium DC) fruit ethanol extract (AEE) on brain weight and p16INK4a expression in aging model rats. Methods: This study was carried out experimentally of 24 male wistar rats. The treatment group consisted of 4 groups; KN= negatif control (normal), KP= positif control (aging model rat), P1 and P2= aging model rat + AEE at dose 150 and 300mg/kgbw, respectively. The aging model rats were D-galactose-induced at dose of 150mg/kgbw for 8 weeks. Brain weigth were recorded by digital scales. p16INK4a expression using immunohistochemical methods. The data analysis with Anova test. Results: This study showed differences brain weight between groups (p=0.523). Brain weight in P1 (1.34±0,06) and P2 (1.30±0.09) tendency increased than KP (1.29±0.62). The p16INK4a expression between groups significant difference (p=0.041), continued with post hoc Least Significant Difference (LSD) showed p16INK4a expression in KN significant decreased than KP (p=0.027). Likewise, p16INK4a expression in P2 was significant decreased than KP (p=0.010). Conclusion: Andaliman ethanol extract at a dose 300mg/kgbw for 8 weeks was improved aging process caused D-galactose induced.

Scabies with Secondary Infection Resembling Kerion-Type Tinea Capitis.

Scabies is an infestation caused by the mite Sarcoptes scabiei var hominis. The clinical picture can vary and in children, scabies occurs in locations that are not usually found in adults. Complications can occur due to secondary impetiginization of scabies lesions. We presented a case of 8-year-old boy with painful red lumps, pus discharge, and alopecia on the back of the head since 2 weeks ago. Dermatological examination revealed multiple erythematous nodules with sinuses in the scalp of the parieto-occipital area and alopecia. Through microscopic examination we found the Sarcoptes scabiei mite; therefore, we conclude that the diagnosis in this patient was impetigenic scabies. Treatment with topical permethrin 5%, oral antihistamine and oral antibiotics resulted in good outcome.

Correlation Between Stress Scale and Serum Substance P Level in Acne Vulgaris.

INTRODUCTION: Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles with polymorphic lesions, consisting of comedones, papules, pustules and nodules with varying degrees of severity. Stress is one of the triggers of acne vulgaris. Peripheral nerves release substance P in response to stress. Substance P causes proliferation and differentiation of sebaceous glands and increases lipid synthesis in sebocytes. PURPOSE: To determine the correlation between stress scale and serum substance P level in acne vulgaris. PATIENTS AND METHODS: This study was an observational analytic study with a cross-sectional design involving 30 patients with acne vulgaris and 30 controls. History taking, dermatological examination and the Holmes-Rahe stress scale questionnaire were performed with each patient to evaluate stress scale, followed by taking blood samples to assess substance P serum levels using the ELISA test. The collected data were analyzed using the Spearman correlation test. RESULTS: In both groups, the majority of subjects were 23-27 years old (36.7%) and most of them were female (76.7%). The majority in the acne vulgaris group had low scores on the stress scale, represented by 17 patients (56.7%). The main cause of stress in the acne vulgaris group was a major change in sleeping habits (66.7%). In the acne vulgaris group, the highest mean value of serum substance P level in high stress scale group was 168.2 pg/mL. There was a positive correlation between stress scale and serum substance P level in acne vulgaris with moderate strength and this was statistically significant (r = 0.446; p = 0.014). Meanwhile, stress scale and serum substance P level in controls were not correlated and this was not statistically significant (r = -0.090; p = 0.636). CONCLUSION: There was a correlation between stress scale and serum substance P level in acne vulgaris.

The effect of Aloe vera ethanol extract on the growth inhibition of Candida albicans.

Aim Candida albicans can cause two major types of infections: superficial infections (such as oral or vaginal candidiasis) as well as life-threatening systemic infections, and Aloe vera extract is one of the potentially useful therapeutic options. The aim of this study was to determine antifungal properties of Aloe vera ethanol extract on vulvovaginal candidiasis caused by Candida albicans. Methods Aloe vera ethanol extract was prepared by the maceration method with 70% ethanol and dissolved in DMSO into multiple concentrations (6.25%, 12.5%, 25%, and 50%). Candida albicans was cultured in Sabouraud dextrose agar for 72 hours and disc diffusion method was used to evaluate the inhibitory effect of each concentration in comparison with fluconazole. Zones of inhibition at 72 hours were measured and documented, then analysed to get the mean inhibition zone (MIZ). Results After 72 hours, all concentrations of Aloe vera ethanol extract showed inhibition effect against C. albicans with mean inhibition zones of each concentration, 12.450±0.208 mm (6.25%), 13.975±0.457 mm (12.5%), 15.650±0.420 mm (25%), and 17.225±0.512 mm (50%), respectively. Fluconazole revealed comparable antifungal effect with MIZ of 11.025±0.478 mm. Oneway ANOVA test showed a significant effect of Aloe vera ethanol extract on inhibition zone of Candida albicans growth (p<0.005). Conclusion Aloe vera ethanol extract possesses concentration dependent activity against Candida albicans that is comparable with standard antifungal agents.

Differences of Microbiomes Found in Non-Inflammatory and Inflammatory Lesions of Acne Vulgaris.

PURPOSE: Bacterial activity and inflammation both influence acne vulgaris (AV) formation. Cutibacterium acnes is considered as an actor involved in inflammation of AV. Besides Cutibacterium acnes, other microbiomes found in AV may also play a role in the pathogenesis. This research was conducted to overview microbiomes found in non-inflammatory and inflammatory lesions of AV. PATIENTS AND METHODS: An observational descriptive study with cross-sectional approach was designed. Sample collection was performed with 40 subjects with AV. In every patient, both non-inflammatory (closed comedone) and inflammatory (pustule) lesion samples were collected by swab. Afterward, bacterial culture was performed, continued by bacterial identification. RESULTS: In non-inflammatory lesions, the growth of nine bacterial species was observed from 40 samples. In an anaerobic culture, Cutibacterium acnes (17,5%) was identified. In aerobic cultures, different bacterial species were found including Staphylococcus epidermis (52.5%), Staphylococcus hominis (12.5%), Staphylococcus haemolyticus (7.5%), Micrococcus luteus (7.5%), Leuconostoc mesentroides (7.5%), Staphylococcus aureus (5%), Kocuria varians (5%), and Staphylococcus vitulinus (2.5%). In inflammatory lesions, nine bacterial species were found, in which was the anaerobic culture we identified Cutibacterium acnes (25.0%). Aerobic cultures have revealed the growth colonies of Staphylococcus epidermidis (42.5%), Staphylococcus hominis (22.5%), Staphylococcus aureus (12.5%), Staphylococcus haemolyticus (10.0%), Leuconostoc mesentroides (5.0%), Staphylococcus cohnii (2.5%), Staphylococcus arlettae (2.5%), and Dermacoccus nishinomyaensis (2.5%). Two mixed bacterial growths were observed in non-inflammatory lesions, while four mixed bacterial growths were found in inflammatory lesions. CONCLUSION: Differences in bacterial isolates were observed both in non-inflammatory and inflammatory lesions of AV.

Antibacterial Activity of Passion Fruit Purple Variant (Passiflora edulis Sims var. edulis) Seeds Extract Against Propionibacterium acnes.

BACKGROUND: Passion fruit is used commercially for consumption and in beverages. This plant exhibits various pharmacological properties and possesses a complex phytochemistry. In recent years, this plant has been shown to have potential antimicrobial activity. The seeds contain a high amount of piceatannol, which exhibits an inhibitory effect on Propionibacterium acnes. Therefore, the seed extract of purple variant, Passiflora edulis Sims var. edulis, may have potential antibacterial activity against P. acnes. AIM: To evaluate the antibacterial activity of P. edulis Sims var. edulis seeds extract on P. acnes. METHODS: Seed extract was prepared by maceration and dissolved in DMSO in multiple concentrations. Propionibacterium acnes was cultured in Brucella blood sheep 5% agar for 24 hours and the agar disc diffusion method was used to evaluate the inhibitory effect of each concentration (1.25%, 2.5%, 5%, 10%, 20%, and 40%), in comparison with clindamycin and erythromycin. Zones of inhibition at 24 hours were measured and documented, then analyzed to obtain the mean inhibition zone (MIZ). The Mann-Whitney test was conducted to compare the antibacterial activity of the extract, clindamycin and erythromycin. A serial dilution assay of five different concentrations (5%, 10%, 15%, 20%, and 25%) in brain-heart infusion broth was performed to determine the minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC). RESULTS: After 24 hours, all concentrations of P.edulis Sims var. edulis showed an inhibitory effect against P. acnes, with MIZs for of each concentration of 1.25% 6 mm, 2.5% 6.83 mm, 5% 8.5 mm, 10% 10.08 mm, 20% 14 mm, and 40% 16 mm. Clindamycin revealed comparable antibacterial effect to 5% seed extract, with an MIZ of 8 mm. However, erythromycin was found to be superior to the seed extract, with a 22.67 mm MIZ (p<0.05). The serial dilution assay revealed an MIC of 20% and MBC of 25%. CONCLUSION: Seed extract of P. edulis Sims var. edulis had good antibacterial activity against P. acnes, and the effect increased with the concentration.

Utilisation of Cryolipolysis among Asians: A Review on Efficacy and Safety.

Cryolipolysis is a non-invasive fat reduction method that is capable of reducing subcutaneous fat significantly without damaging surrounding tissues, by applying cold temperature to induce adipocyte apoptosis. Most of the clinical studies in cryolipolysis were conducted in the Caucasian population, and only a few numbers in Asian, who has darker skin with Fitzpatrick skin type III to V. Higher rate of pigmentary changes were reported with the use of cryotherapy in darker skin. Therefore, this report is aimed to provide a comprehensive review regarding utilisation, efficacy and safety profiles of cryolipolysis among Asians. Currently, there are only four clinical trials conducted exclusively in an Asian population. Two studies were conducted in Korea, whereas others in China and Thailand. Cryolipolysis was performed in the abdomen, arm, inner thighs, and submental regions. The reported side effects were mild and transient, including erythema, hematoma, numbness, and pain. There were no pigmentary changes reported. Although only limited data available, those studies have proved that cryolipolysis utilisation among Asians or darker skin types provides the same efficacy and safety profiles as in Caucasians. Therefore, cryolipolysis might be proposed as the first treatment choice for Asian patients who opted to do body contouring.

Correlation between Serum 25-Hydroxyvitamin D Levels with Keloid Severity.

BACKGROUND: Keloids are dermal fibroproliferative tumours characterised by excessive deposition of extra cellular matrix components. The active form of vitamin D is known to inhibit the proliferation of keloid fibroblasts by inhibiting extracellular matrix production induced by transforming growth factor ß (TGF-ß) and increasing matrix metalloproteinase (MMP) activity. Vitamin D derivatives are thought to be an early preventive treatment strategy for keloid. AIM: To determine the correlation between serum 25-hydroxyvitamin D level with keloid severity. METHODS: This is a cross-sectional analytic study involving 32 keloid patients. Keloid patients were diagnosed by history and clinical examinations. Then an assessment of the severity was conducted using the Vancouver Scar Scale (VSS). We conducted blood sampling and measurement of serum 25-hydroxyvitamin D level to the patients. This study has been approved by the Health Research Ethics Commission of the Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital Medan. RESULTS: There is negative correlation between serum 25-hydroxyvitamin D level with severity in keloid patients (p = 0.0001; r = -0.737). There is no significant correlation between serum 25-hydroxyvitamin D level with gender (p = 0.271), age (p = 0.201; r = -0.232), duration of keloid (p = 0.505; r = -0.122) and family history (p = 0.262). CONCLUSION: Lower level of plasma 25-hydroxyvitamin D, the severity of keloid became an increasingly heavy. There is no significant difference between serum 25-hydroxyvitamin D level with gender, age, duration of keloid and family history in keloid patients.

The Role of Digital Fluorescence in Acne Vulgaris: Correlation of Ultraviolet Red Fluorescence with the Severity of Acne Vulgaris.

BACKGROUND: Colonization of Propionibacterium acnes (P. acnes) and increased sebum production play important roles in the pathogenesis of acne vulgaris. Severity of acne vulgaris correlates with the lesion counts both noninflammatory and inflammatory. Digital fluorescence has been found useful in pathogenesis investigation and treatment evaluation. Ultraviolet-induced red fluorescence (UVRF) was found to be correlated with sebum and porphyrin production that can be synthesized by P. acnes. Therefore, UVRF assessment could be useful for the evaluation of the degree and extent of acne vulgaris. OBJECTIVE: To evaluate the correlation of UVRF with the severity of acne vulgaris using the digital fluorescence tool. METHODS: Forty-five patients were diagnosed with mild-to-severe acne vulgaris according to Lehmann classification. Lesion counts both noninflammatory and inflammatory and UVRF assessment using Visiopor PP34 camera were done to all participants in 5 divided facial areas (forehead, nose, right and left cheeks, and chin). Clinical assessment for each patient was done by 3 dermatologists. Determination of correlation between UVRF with acne lesion counts was done using Pearson test and with acne severity using Spearman test. RESULTS: From 45 participants, majority had moderate acne (64.4%), followed by severe (24.5%) and mild acne (11.1%). Mean number of UVRF spots was 39.98 ± 11.45 and percentage area covered with UVRF was 4.39 ± 1.72. There was no correlation found between acne lesion counts, including noninflammatory and inflammatory with the number and percentage area covered with UVRF spots. Severity grade of acne vulgaris was found to be uncorrelated with the number of UVRF spots (r = 0.27, p=0.073) and percentage area covered with UVRF spots (r = 0.173, p=0.256). CONCLUSION: The severity of acne vulgaris has no correlation with spot counts and percentage area covered with UVRF. Digital fluorescence might be helpful in investigating further of the interrelated pathogenesis factors of acne.

Is There a Correlation between Severity of Melasma and Quality of Life?

BACKGROUND: Melasma is a common chronic acquired hyper melanosis. It has significant impacts on appearance, psychosocial and emotional distress, hence reducing the quality of life of the affected patients. Melasma quality of life scale (MelasQoL) is a new quality of life (QoL) questionnaire consists of 10 questions, scored from 1 to 7, with higher index scores indicating poor QoL. The severity of melasma can be assessed by the Melasma Area and Severity Index (MASI) score. AIM: We aimed to determine the correlation between the severity of melasma (MASI score) and quality of life. MATERIAL AND METHODS: This was a cross-sectional analytic study involving 30 subjects with melasma. The diagnosis was made based on history, clinical features and by Wood's lamp examination. MASI score was determined to assess the severity of melasma. Subjects answered 10 items of MelasQol questionnaire. All collected data were processed and statistically analysed by Spearman correlation test to determine the association of MASI score with MelasQoL. Association of quality of life with clinical pattern and depth of lesion were analysed by Mann Whitney test. RESULTS: There was no significant correlation between MASI score and MelasQoL (p = 0.797; r = 0.049). Likewise, there was no association of quality of life with clinical pattern type (p = 0.12) and depth of lesion (p = 0.92). CONCLUSION: There was no significant correlation between the MASI score and quality of life.

The Effect of Oral Probiotic on the Interleukin-10 Serum Levels of Acne Vulgaris.

BACKGROUND: Acne vulgaris is a chronic inflammatory skin disorder that commonly found in pilosebaceous units which can have an impact on the patient's psychological burden. The relationship between dermatology and mental health is increasingly understood by the evidence shows that functional integrity and microbes in the gastrointestinal tract may play a role in mediating skin inflammation and emotional behaviour. The gut-brain-skin theory was first described in 1930 by Stokes and Pillsbury, became the basis of many current studies that look for clinical implications of the relationship between the gastrointestinal tract, brain and skin in acne vulgaris. Probiotics are live microorganisms which can provide a healthy effect to the hosts when consumed in adequate amounts. AIM: To determine the effect of oral probiotic on the interleukin-10 serum levels in acne vulgaris and also to determine the side effect of oral probiotic on acne vulgaris. METHODS: This is a pre-experimental clinical study with a pretest-posttest design involving 33 subjects with acne vulgaris. The subjects in this study were measured for IL-10 serum levels before and after oral probiotic was given for 30 days. This research has been approved by the Health Research Ethics Commission of the Faculty of Medicine, Universitas Sumatera Utara. RESULTS: This study found an increase in serum IL-10 levels after oral probiotic in acne vulgaris. The value of serum IL-10 levels before oral probiotic administration was 5.27 ± 1.49 pg/ml, while the value of serum IL-10 levels after oral probiotic administration was 6.19 ± 1.68 pg/ml) with p values obtained through Wilcoxon test was 0,0001 (p < 0.05). The side effect of oral probiotic found in this study is bloating that was found in 2 subjects within the first week using oral probiotic. CONCLUSION: Oral probiotic trigger elevated IL-10 serum levels of acne vulgaris. This study supports previous studies that suggested oral probiotic can be considered as adjuvant acne vulgaris therapy and its side effect is quite safe and tolerable.

Correlation between Serum Leptin Level with Type and Number of Lesion Skin Tag.

BACKGROUND: Skin tag is a benign tumour of connective tissue in the skin, sessile or pedunculated, skin-like to brownish coloured and often arises in the flexure area. Etiopathogenesis of skin tag is still unclear, but one of the aetiology is associated with leptin hormone. AIM: To determine the correlation between leptin serum level with type and number of the lesion skin tag. METHODS: This study is an observational analytic study with a cross-sectional design involving 33 skin tag patients. Diagnosis of skin tag was based on history and clinical examination; we conducted blood sampling and measurement of serum leptin level to the patients. RESULTS: We found the mean serum leptin level of skin tag patients were highest on the type of lesion mixed (31.54 ± 12.85 ng/ml). The mean number of skin tag lesions was 13.6 ± 5.8 lesions. There is a very high positive correlation between serum leptin level with a number of skin tag (r = 0.86) with p < 0.05 and significant correlation between serum leptin level with the type of lesions (p = 0.037). CONCLUSION: Serum leptin level has a very high positive correlation to a number of skin tag and significant correlation between serum leptin level with the type of lesion.