Combination of adipose-derived stem cell conditioned media and minoxidil for hair regrowth in male androgenetic alopecia: a randomized, double-blind clinical trial.

INTRODUCTION: Treatments for AGA have yet to produce satisfactory outcomes and may cause intolerable side effects. Recent studies have reported that adipose tissue-derived stem cell conditioned media (ADSC-CM) could induce hair growth and regeneration. OBJECTIVE: To investigate the efficacy of ADSC-CM combined with minoxidil for hair regeneration therapy in male AGA. METHODS: This study lasted for 6 weeks. Subjects were divided into two groups: concentrated and non-concentrated ADSC-CM. Scalp was divided vertically in half before intradermal injection was administered from the frontal region of the scalp toward the vertex with a 30G needle, spaced about 1 cm apart. Treatment side received 2 ml of ADSC-CM; the other side was given 2 ml of NaCl 0.9% as placebo. Patients applied 5% minoxidil twice daily post-injection. Improvements were assessed using photographs and trichoscan every 2 weeks. RESULTS: Hair count, hair density, and mean thickness increased significantly on both sides after 6 weeks, while vellus rate decreased proportionally with the increase of terminal rate. No statistically significant differences between treatment groups were found. Minimum side effects were reported, and subjects were satisfied with the results. CONCLUSION: Combination of ADSC-CM and minoxidil could be a potential agent for hair regrowth. Follow-up research with extensive populations, longer duration, and different study design may be required to confirm the exact mechanisms of ADSC-CM on hair growth. TRIAL REGISTRATION: Clinicaltrials.gov, NCT05296863. Registered 25 March 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05296863 .

A Comparative Study on Adipose-Derived Mesenchymal Stem Cells Secretome Delivery Using Microneedling and Fractional CO2 Laser for Facial Skin Rejuvenation.

Background: The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose. Purpose: We aimed to compare microneedling (MN) versus fractional CO2 laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin. Patients and Methods: A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35-59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05. Results: Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application. Conclusion: Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.

Stem Cells as a Therapeutic Choice in Dermatological Disorders.

Stem cells are known for their extraordinary properties, mainly their potency, self-renewal, and clonality. In recent years, we have witnessed notable advancements in the field of cell therapy. Due to its remarkable properties and versatility, this cutting-edge therapy has now become a potentially promising cure for many diseases. Stem cell-based therapies have been utilized to treat various dermatological conditions, for instance, autoimmune skin disorders, atopic dermatitis, skin aging, wound healing, scar treatment, and many others. This article aims to serve as an overview of cell-based therapy's current application in dermatology field.

Hair disorder in dr. Cipto Mangunkusumo cosmetic dermatology and venereology outpatient clinic of Jakarta, Indonesia: A socio-demographic and clinical evaluation.

Hair disorder has a significant impact on sociopsychology. In Indonesia, there are currently few and out-of-date studies on hair disorders. Our study aimed to provide an update on the epidemiology of hair loss, which is common in Indonesia. This is a retrospective study of hair disorder cases seen at Dr. Cipto Mangunkusumo's Cosmetic Dermatology Outpatient Clinic at the National Central General Hospital from January 2017 to December 2019. Each patient's age, gender, family history, education, occupation, body mass index (BMI), comorbidities, and diagnosis were recorded. Hair disorders were found to be more prevalent in males (54.6 percent) with a mean age of 26.41 ± 12.8 years old and the highest age group of 18-39 years old (59.4 percent) among the 64 patients who were eligible for the study. There were 32 cases (50.0%) of alopecia areata (AA), 20 cases (31.2%) of alopecia androgenetic (AGA), 9 cases (14.0%) of telogen effluvium (TE), 2 cases of cicatricial alopecia (CA) due to lupus erythematosus (DLE), and 1 case of trichotillomania (TTM). Female patients had significantly more TE cases. Cases of AGA in the study, mainly early-onset AGA (mean age 29.45 ± 10.29 years old, 39.5% in 18-39 years old) showed a significant positive familial history. At dr Cipto Mangunkusumo National General Hospital Jakarta, the most common types of hair disorders were AA, AGA, and TE, with each disease having a unique socio-demographic and clinical profile.

Trichloroacetic Acid Peeling for Treating Photoaging: A Systematic Review.

Photoaging can significantly contribute to lower quality of life. Medium-deep peeling using trichloroacetic acid allows controlled keratocoagulation through the dermis and into the dermal papillary layer that is effective for skin rejuvenation. The purpose of this article is to give updates regarding the efficacy, possible adverse events, and patient satisfaction of trichloroacetic acid (TCA) peeling for skin rejuvenation by assessing various photoaging parameters. A systematic review of prospective trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane, and Scopus databases was conducted on November 2, 2020. Treatment efficacy was assessed based on the photoaging parameters used by each study. Adverse events and patient satisfaction as the secondary outcome were assessed based on patients-perceived improvements. Five studies included three randomized comparison studies and two prospective cohort studies. These studies show that TCA peeling significantly improve the cosmesis of photoaged facial skin. Low concentration is effective for superficial sun damage. Medium-depth peels using a higher concentration of TCA or as combination therapy are effective as skin resurfacing agents to reduce wrinkles. Some adverse effects may occur but usually resolve within weeks. Overall patients were satisfied with the treatment result. An equivalent basic skin preparation such as topical retinoic acid skin priming prior to intervention is necessary for more objective comparison. Further research studies with a larger sample size and longer follow-up period are required. This evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities.

Acne Vulgaris Mimicking Cutaneous Lupus Erythematosus in an Adolescent: Report of a Rare Case.

Acne vulgaris is a chronic and self-limiting disorder of the pilosebaceous unit which is primarily seen in adolescents. Acne vulgaris presents as polymorphic lesions, consisting of comedones, papules, pustules, cysts, nodules, scarring, and dyspigmentation. Acneiform presentation of cutaneous lupus erythematosus (CLE) is extremely rare. The presentation of CLE is notoriously diverse and often mimics a broad range of unrelated skin disorders. We present a case by referring to American College of Rheumatology (ACR) criteria for systemic lupus erythematosus (SLE); our patient's conditions did not meet any of the clinical criteria of the Systemic Lupus International Collaborating Clinics (SLICC) for SLE. Subsequent to thorough history-taking, physical examination, and laboratory evaluations, the diagnosis of acne vulgaris was established, and a diagnosis of CLE was excluded. As acneiform presentation of CLE is rare, we here present a case which resembled both acne vulgaris and CLE. We describe our experience in establishing the diagnosis of severe acne vulgaris accompanied by scars in a 12-year-old boy with a malar rash and scars on his frontal and malar area who had initially been misdiagnosed as having CLE. This unusual case highlights the broad spectrum of adolescent acne and the importance of clinical identification of the disease so that unnecessary workups might be avoided.

Antimicrobial resistance of Neisseria gonorrhoeae in Jakarta, Indonesia: a cross-sectional study.

Background Neisseria gonorrhoeae has developed resistance to various antimicrobials. At least 10 countries have reported treatment failures with extended-spectrum cephalosporins. Periodic surveillance is essential to determine local treatment guidelines. This study was conducted to determine the resistance of N. gonorrhoeae to penicillin, tetracycline, levofloxacin, cefixime and ceftriaxone among the high-risk population for acquiring STIs in Jakarta and to identify factors associated with resistance. METHODS: A cross-sectional study was conducted in Jakarta, Indonesia, from September to November 2018. In all, 98 high-risk males and females who fulfilled the study criteria were included. Specimens were collected from urethral or endocervical swabs, put into Amies transport medium and then transported to the Laboratory of Clinical Microbiology, Universitas Indonesia for culture and identification. Proven gonococcal isolates were examined for susceptibility to various antimicrobials using the disk diffusion method according to Clinical and Laboratory Standard Institute guidelines. RESULTS: Of the 98 specimens, 35 were confirmed to be N. gonorrhoeae. The proportion of N. gonorrhoeae specimens resistant to penicillin, tetracycline, levofloxacin, cefixime and ceftriaxone among the high-risk population was 97.1%, 97.1%, 34.3%, 0% and 0% respectively. The possible factors associated with resistance could only be analysed for levofloxacin. Age, sexual orientation and a history of orogenital sexual activity during the past month were not associated with N. gonorrhoeae resistance to levofloxacin. CONCLUSION: This study detected no resistance of N. gonorrhoeae to cefixime and ceftriaxone. Further studies with larger samples are needed to obtain more representative results of N. gonorrhoeae resistance and the possible factors associated with resistance.