Psoriasis merupakan peradangan kulit kronik dengan dasar genetik. Untuk mencapai remisi dan kualitas hidup yang baik, pilihan terapi disesuaikan dengan kebutuhan perorangan pasien. Tipe dan derajat keparahan psoriasis perlu ditentukan guna memilih tata laksana yang sesuai karena memengaruhi keberhasilan terapi, masa remisi, serta tingkat morbiditas. Penelitian ini bertujuan menilai kesesuaian tata laksana psoriasis berdasarkan derajat keparahan dengan menggunakan Panduan Praktik Klinis (PPK) RSUPN dr. Cipto Mangunkusumo (RSCM) dan Persatuan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI). Studi retrospektif ini mengambil subjek seluruh pasien baru psoriasis di Divisi Alergi Imunologi, Departemen Ilmu Kesehatan Kulit dan Kelamin RSCM periode Oktober 2017 – Oktober 2018. Keparahan psoriasis dinilai dengan skor body surface area (BSA) dan psoriasis area severity index (PASI). Sebanyak 32 di antara 35 pasien (91,4%), skor BSA dan/atau PASI terdokumentasi pada rekam medis, dan 30 di antara 32 pasien (93,8%), mendapatkan pilihan terapi sesuai dengan tipe psoriasis atau skor BSA dan/atau PASI. Kepatuhan pasien sangat penting sehingga pemilihan tata laksana psoriasis perlu mempertimbangkan kenyamanan pasien terkait efek samping pengobatan, kemudahan pasien untuk mengakses fasilitas, dan aspek ekonomi. Kesesuaian terapi tidak mencapai 100% karena kontraindikasi pemberian terapi standar, penolakan pasien, dan ketidaktersediaan obat misalnya metotreksat. Sebanyak 93,8% pasien psoriasis di RSCM telah ditata laksana sesuai dengan PPK RSCM dan PERDOSKI.Kata Kunci: BSA, PASI, psoriasis, tata laksana
Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.
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