Background:Condyloma acuminata is a type of human papilloma virus (HPV) infection in the anogenital area and often associated with immunosuppressive conditions, such as human immunodeficiency virus (HIV). Low plasma zinc levels could cause alteration of cellular immunity, leading to reduction of interleukin-2 (IL-2) and interferon-γ (IFN-γ), cytokines required for inhibition of HPV replication. Moreover, low plasma zinc levels could cause disruption of apoptotic regulation, results in the unimpeded proliferation of epithelial cells infected with HPV. This study aimed to compare the mean plasma zinc levels in condyloma acuminata patients with HIV and without HIV infection.Methods:This study used a cross-sectional method, involving 27 condyloma acuminata patients without HIV infection and 18 patients with HIV infection, who agreed to enroll and signed the informed consent. This study was conducted in the dermatology and venereology outpatient clinic in Sanglah Hospital and Kerti Praja Foundation, Denpasar. Bivariate analysis of the characteristics, age, sex orientation, location of lesion, clinical form of lesion, type of cases, duration of condyloma acuminata, age of the first sexual contact, comorbidity, treatment history, and mean plasma zinc level of condyloma acuminata patients with HIV and without HIV infection. The CD4+ cell count and history of ARV treatment were also obtained form patients with HIV infection.Results:A total of 45 subjects were diagnosed with condyloma acuminata, consisted of 27 subjects with condyloma acuminata without HIV infection and 18 subjects with HIV infection, showing average age of 32.04 ± 10.414. Mean plasma zinc levels in condyloma acuminata patients with HIV infection was significantly lower than subjects without HIV infection, and the difference in mean plasma zinc levels was 7.31 µg/dL (95% CI 2.25 - 12.37, p <0.05).Conclusions:The mean plasma zinc levels in condyloma acuminata patients with HIV was significantly lower than those of without HIV infection.

Caulerpa sp., a genus of seaweed native to the Indo-Pacific region, has been known for its antioxidant properties and health benefits when consumed as food. Previous studies have reported Caulerpa sp.’s potential as a strong antioxidant, but its effects on the skin in a topical preparation, especially its role in ultraviolet (UV) protection, have not been studied extensively. Our study investigated the protective effects of 0.2% and 0.4% Caulerpa sp. extract gels on photoaging in the UVB-irradiated skin of Wistar mice. The subjects were divided into naive control, vehicle control, and 3 treatment groups (0.2% Caulerpa sp. extract gel, 0.4% Caulerpa sp. extract gel, and 0.02% astaxanthin gel as a standard antioxidant). The groups, except the naive control group, received a total of 840 mJ/cm2 of UVB irradiation in four weeks. Protective effects of the extract were measured through the evaluation of collagen expression, matrix metalloproteinase (MMP)-1 expression and levels, and 8-OhDG expression. Mice who received topical application of Caulerpa sp. extract gel had higher collagen expression, better-preserved collagen structure, lower levels of MMP-1, and less MMP-1 and 8-OHdG expressions compared to the vehicle control group. There was no difference between different concentrations of the extract. Our findings demonstrated that topical application of Caulerpa sp. extract gel significantly protected UVB-irradiated mice skin from photoaging.

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: Condyloma acuminatum is caused by infection from Human Papilloma Virus (HPV), mostly found in the perineum and genital area. Therefore HPV infection is the most common sexually transmitted infection in the world. Infection often occurs in patients with a decreased immune system, such as Human Immunodeficiency Virus (HIV) infection.Case: A 62-year-old man was diagnosed with condyloma acuminatum in the penis and accompanied by stage IV HIV infection. CD4 + count is 23 cells/μL. Patients were given electric surgical therapy and 80% TCA. After receiving 8 treatments in 3 months, there was no significant improvement.Discussion: There are several therapeutic modalities in the management of condyloma acuminatum. Some considerations in the selection of condyloma acuminatum therapy include size, number, anatomic location of the lesion, patient comfort, side effects and the experience of the doctor in charge. The immune system plays an important role in the successful treatment of HPV infections. The risk of persistence, recurrence, and malignant transformation can increase with the decrease in the immune system by HIV infection as measured by CD4 + counts. In this case, more aggressive treatment will be needed and immunomodulators can be given to increase the success of the therapy.Conclusion: Host immune status has a significant impact on the course of HPV disease and response to treatment. HIV patients have an increased risk of HPV infection, with an increase in the duration and persistence of the disease and thus require aggressive therapy.

Azithromycin is one of the antibiotics used to treat syphilis, especially in the context of penicillin allergy. Resistance to azithromycin is widely reported associated with one and/or two point mutations on the 23S rRNA gene but has yet to be described in Indonesia.Specimens were collected from 220 patients diagnosed with secondary syphilis. A multiplex nested PCR testing system using the 23S rRNA target gene of Treponema pallidum was designed using three pairs of primers. The first step used PCR pairs of primers to detect T. pallidum. In the second step of PCR using 2 pairs of primers were achieved to identify azithromycin resistant T. pallidum based on A2058G and A2059G point mutations. There was no T.pallidum identified resistant to azithromycin in Jakarta and Bandung. T. pallidum resistance to azithromycin were found in Makassar, Medan, and Bali. The majority of azithromycin resistance was found among heterosexual males and in patients living with HIV. This study has demonstrated T. pallidum resistance to azithromycin in Indonesia appears to be a novel variant of resistance, containing both the A2058G and A2059G mutations that was found in Medan and Makassar.

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Formation of free radicals is an important mechanism causing skin aging. Free radicals are highly reactive molecules with unpaired electrons which can directly disrupt various structures of cell membrane, lipids, proteins, and DNA. Antioxidant is a substance which can give protection from endogenous and exogenous oxidative pressure caused by free radicals. Purple corn contains phenolic acid, vitamin C, and anthocyanin. Anthocyanin is the main contained substance in purple corn and acts as antioxidant and able to inhibit aging process on skin surface of mice exposed with UV-B ray. This research aims to prove the effectivity of administration of purple corn extract cream on inhibiting the elevation of MMP-1 level and the decrease of collagen amount on Wistar mice (Rattus norvegicus) exposed with UV-B. This research is animal experiment with post test only control group design. As many as 36 mice were divided into 2 groups containing 18 mice each, control group with appliance of placebo cream and intervention group applied with 50% purple corn extract cream. All groups were exposed with UV-B with dose of 840 mJ/cm² for 4 weeks, and biopsy was taken to examine the level of MMP-1 and collagen amount on dermis. The results of Shapiro-Wilk and Levene’s test showed that the data distribution between the two groups was normally distributed with homogenous variance and p ≥ 0.05. Comparative analysis with t-independent test showed that there is a significant difference between both groups, either on the mean level of MMP-1 or the collagen amount on both groups with p < 0.05. The mean collagen amount and mean MMP-1 level of intervention 2 are 71.7% and 1.9 mg/ml, respectively. Intervention-1 group shows the mean amount of collagen and MMP-1 level are 65.54 % and 3.22 mg/ml, respectively. The conclusion of this research is the administration of 50% purple corn extract cream inhibits the increase of MMP-1 level and the decrease of the amount of dermal collagen on mice’s skin exposed with UV-B.

Background: Photoaging increases MMP-1 and damage collagen by forming ROS. The antioxidant compounds in Clitoria ternatea L. have been studied to lower ROS, thus inhibiting the emergence of MMP-1 and preserving the collagen. The study initiated to analyze the Clitoria ternatea L. extract cream 5% effect on inhibiting MMP-1 increase and collagen decrease in female Wistar rat's skin exposed to UV-B. Methods: A randomized post-test-only control group design was conducted on 30 female Wistar rats, aged 8-10 weeks old with 130-150 grams bodyweight. They were assigned to three groups: the untreated group, placebo group, and the Clitoria ternatea L. extract cream 5% group. The last two groups were exposed to UV-B. After  four weeks their skin was examined for MMP-1 levels using ELISA and collagen amount using Picro Sirius Red staining. Results: A comparative analysis showed that the lowest mean levels of MMP-1 was seen in the untreated group (4.64 ± 0.14 ng/ml), followed by the Clitoria ternatea L. extract cream group 5% (5.54 ± 0.21 ng/ml) and placebo group (8.68 ± 0.78 ng/ml). The highest mean of collagen amount was seen in the Clitoria ternatea L. extract cream group 5% (76.12 ± 5.09 %pixel), followed by the untreated group (69.38 ± 3.96 %pixel) and placebo group (30.31±8.06 %pixel). The comparative analysis shows a significant difference between groups (p < 0.05). Conclusion: The Clitoria ternatea L. extract cream 5% has proven to inhibited the increase of MMP-1 levels and decrease of collagen amount in Wistar rats skin exposed to UV-B.