Introduction:Renal damage is a consequence of severe malaria, and is generally caused by sequestration of Plasmodium falciparum-infected erythrocytes in the renal microcirculation, which leads to obstruction, hypoxia, and ischemia. This triggers high mobility group box 1 (HMGB1) to send a danger signal through toll-like receptors 2 and 4. This signal up-regulates inducible nitric oxide (iNOS) and nitrotyrosine to re-perfuse the tissue, and also increases heat shock protein 70 (HSP70) expression. As no study has examined the involvement of intracellular secondary molecules in this setting, the present study compared the renal expressions of HSP70, HMGB1, iNOS, and nitrotyrosine between mice suffered from severe malaria and normal mice. Methods: C57BL/6 mice were divided into an infected group (intraperitoneal injection of 10 6 P. berghei ANKA) and a noninfected group. Renal damage was evaluated using hematoxylin eosin staining, and immunohistochemistry was used to evaluate the expressions of HSP70, HMGB1, iNOS, and nitrotyrosine. Results: Significant inter-group differences were observed in the renal expressions of HSP70, HMGB1, and iNOS (p=0.000, Mann-Whitney test), as well as nitrotyrosine (p=0.000, independent t test). The expressions of HSP70 and HMGB1 were strongly correlated (p=0.000, R=1.000). No correlations were observed between iNOS and HMGB, HMGB1 and nitrotyrosine, HSP70 and nitrotyrosine, or iNOS and nitrotyrosine. Conclusions: It appears that HMGB1, HSP70, iNOS, and nitrotyrosine play roles in the renal damage that is observed in mice with severe malaria. Only HSP70 expression is strongly correlated with the expression of HMGB1.

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Aging is a complex process influenced by intrinsic and extrinsic factors. Intrinsic aging is affected by age, genetics, and hormones. A recent study has found that human umbilical vein endothelial cells (HUVEC) exosomes can serve as a new treatment for repairing and rejuvenating skin tissue. Therefore, this research aims to determine the effect of HUVEC exosomes on increasing type I collagen deposition on the skin of intrinsic aging Wistar rats. An experimental laboratory posttest-only control group study was conducted on 30 Wistar rats. The rats were divided into a control group (Group A) and treatment groups receiving 1% HUVEC exosome (Group B) and 1.5% HUVEC exosome (Group C). Collagen deposition was measured using Masson's trichrome staining. Statistical analysis used the Kruskal-Wallis and Mann-Whitney tests (p value < 0.05, significant). After 4 weeks, type I collagen deposition was significantly higher in the treatment groups than in the control group (p = 0.00). The mean values of collagen deposition (%) for Group A, Group B, and Group C were 15.87, 30.71, and 40.72, respectively. The Mann-Whitney test revealed that the HUVEC exosome had a significant effect on collagen deposition. Thereby, HUVEC exosomes can increase type I collagen deposition significantly and can be considered a therapeutic option for skin rejuvenation in future studies.

Penuaan kulit terbagi menjadi penuaan intrinsik dan ekstrinsik. Penuaan ekstrinsik terjadi akibat paparan luar sedangkan penuaan intrinsik merupakan kondisi fisiologis akibat kerusakan DNA. Mekanisme utama penuaan kulit adalah reactive oxygen species (ROS). ROS mengaktivasi faktor transkripsi matriks metaloproteinase (MMP). MMP-1 mampu mendegradasi kolagen I dan III, menyebabkan pengurangan penyebaran/kekuatan mekanis fibroblas pada kulit yang menua, sehingga kulit berkerut dan tidak kenyal. Penggunan D-gal dapat menginduksi ROS dan advanced glycation end products (AGE). Tikus muda galur Sprague-Dawley(16 minggu), tikus model penuaan intrinsik dengan induksi D-galaktosa (usia induksi 8 minggu), dan tikus tua (18 bulan) digunakan pada penelitian ini. Kulit dari punggung diambil dan dilakukan HE. Gambaran klinis menunjukkan tikus muda memiliki bulu halus, berwarna putih kekuningan bersih, tebal dengan mata merah jernih tanpa hiperpigmentasi di telinga sedangkan kulit tikus model tua tampak bulu kering, kasar, rontok dan berwarna kuning kecoklatan dengan kekeruhan pada lensa mata. Pengamatan histologis menunjukkan pada tikus muda tampak epidermis tebal, rete ridge normal, kolagen padat dan lemak subkutan cukup. Tikus model tua tampak epidermis menipis, pendataran rete ridge, kolagen berkurang dan lemak berkurang. Kulit dengan proses penuaan akan mengalami perubahan struktural, biokimia, persepsi neurosensoris, permeabilitas, respon terhadap cedera, dan peningkatan insidensi penyakit kulit. Perubahan struktural yang konsisten pada kulit menua adalah dermo-epidermal junction flattening akibat hilangnya papila dermis serta berkurangnya interdigitasi antar lapisan. Pemberian D-galaktosa menunjukkan peningkatan NO, MDA serta penurunan SOD, GSH, GSH-Px. Disimpulkan bahwa induksi penuaan dengan D-galaktosa berhasil membuat perubahan penuaan pada tikus muda menjadi mendekati tikus tua secara klinis dan histopatologis.

Background: Lamellar ichthyosis (LI) is a rare non-syndromic congenital ichthyosis and is autosomal recessive. LI patients are generally born with abnormalities of keratinization, then develop into lamellar scales and persist into adulthood. This study aimed to describe cases of lamellar ichthyosis and provide appropriate management to prevent worsening patient prognosis. Case presentation: A 6-year-old girl and her younger brother, 2-year-old have been complaining of scaly skin all over their bodies since birth. Both patients were born with a history of being covered by a collodion membrane. On physical examination, thick and wide lamellar scales were seen with an erythematous base and palmoplantar hyperkeratosis. Ectropion of the eyelids, eclabium in the mouth area, and microtia in the ears were seen. The results of the dermoscopy examination showed brownish quadrilateral structures with white scales forming a lamellar pattern. Laboratory examination showed vitamin D insufficiency. Both patients were referred to the Pediatric Polyclinic regarding insufficiency and developmental complaints. Patients received therapy in the form of moisturizers, artificial eye drops, topical urea as a keratolytic, and oral vitamin D 2,000 IU per day. There was a clinical improvement after 3 months of treatment. Conclusion: Lamellar ichthyosis is an autosomal recessive congenital ichthyosis with clinical manifestations limited to the skin. In a minority of cases, LI can be inherited in an autosomal dominant manner. Thorough management is necessary to prevent a poor prognosis in patients.

Background: The COVID-19 pandemic causes health workers to use level 2 and level 3 personal protective equipment. Hand washing and the use of latex gloves are important in limiting the spread of COVID-19, but they can potentially induce hand eczema and skin pH disturbance if used too frequently. Purpose: Determine the correlation between the frequency of handwashing and duration of using hand sanitizer and moisturizer as well as skin pH level on the incidence of hand eczema in nurses in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta. Methods: This cross-sectional study was conducted in the COVID-19 treatment room at RSUD Dr. Moewardi Surakarta with 90 nurses as subjects. A validated questionnaire carried out the frequency of handwashing, hand sanitizer, moisturizer, duration of using latex gloves, and hand eczema complaints. The subject’s pH assessment was conducted after 4-5 hours in the COVID-19 treatment room. Data were analyzed bivariately with a Spearman rank correlation test. Result: There was a significant correlation with the incidence of hand eczema with the frequency of handwashing with soap (r=0.305 and p=0.003) and the duration of using latex gloves (r=0.328 and p=0.002) with a weak category correlation (r=0.200-0.399). The frequency of using hand sanitizer, moisturizer, and skin pH did not correlate with the incidence of hand eczema. Conclusion: Frequency of handwashing and the duration of using latex gloves correlated with the incidence of hand eczema, meanwhile frequency of using hand sanitizer, using moisturizer, and skin pH didn’t correlate with the incidence of hand eczema.

Background: Psoriasis Vulgaris is an autoimmune disease characterized by chronic skin inflammation and epidermal hyperplasia. Psoriasis Area Severity Index (PASI) score is one of the assessments to measure the psoriasis severity. Oral methotrexate is one of the effective therapies for psoriasis patients. Narrow Band-Ultraviolet B (NB-UVB) phototherapy is an adjunctive psoriasis therapy given concurrently with oral methotrexate. Purpose: Determine the difference in Psoriasis Area Severity Index (PASI) scores between Psoriasis Vulgaris patients treated with oral methotrexate and a combination of oral methotrexate and NB-UVB phototherapy. Methods: This observational analytic study was conducted at the Dermatology and Venereology Clinic, Dr. Moewardi General Hospital Surakarta. The patients received oral methotrexate and a combination of oral methotrexate and and Narrow Band-Ultraviolet B (NB-UVB) phototherapy. A retrospective study of medical records was conducted to determine the patient's PASI score before the therapies and 3 months after. All data were analyzed with the Shapiro Wilk normality test and the independent T-test. A p-value was <0.05, and it was considered significant. Result: The mean of decreased PASI scores in the oral methotrexate group was (6.00 +2.47) and (6.08 +2.17) in the combination therapy group. Based on the statistical test results from the 24 subjects, it was found that the PASI score decreased (p=0.931). Conclusion: There was no significant difference in the decrease in PASI between the oral methotrexate group and the combination therapy group. The mean reduction of PASI scores was more significant in the combination therapy than in the methotrexate group

Nail psoriasis can affect the patient's quality of life, so to evaluate the quality of life in patients with skin diseases in general, the Dermatology Quality of Life Index (DLQI) can be used. The questionnaire was unable to distinguish the impact on quality of life caused by nail abnormalities or skin lesions, so a special scoring system was needed to evaluate the quality of life for nail psoriasis patients with the Nail Psoriasis Quality of Life Scale 10 (NPQ10). To find the relationship between the severity of nail posirais based on Nail Psoriasis Severity Index (NAPSI) score with DLQI and NPQ10. The total respondents were 20 people with a diagnosis of nail psoriasis who came to the Dermatovenereology Outpatient Clinic of Dr. Moewardi General Hospital, Surakarta from April-June 2020. We took photography and dermoscopy of fingernails and toes and then calculated the NAPSI score. All respondents filled out the DLQI and NPQ10 questionnaires. Pearson's (r) correlation test was used to find the relationship between the mean and standard deviations of NAPSI and DLQI and NPQ10. We also tested the correlation between DLQI and NPQ10. The data significance value was declared significant if p <0.05. The results of the correlation test between NAPSI scores with DLQI and NPQ10 showed a statistical relationship, where the correlation value between NAPSI and DLQI was slightly more significant than NPQ10 (r = 0.948: r = 0.877; p <0.05). The mean value of DLQI and NPQ10 in women was higher than men (14.12 ± 8.21: 11.5 ± 8.29 and 11.5 ± 3.58: 8.16 ± 4.52) with a correlation test value of DLQI and NPQ10 is r = 0.888, p <0.05. We found that the association between NAPSI correlates more significantly with DLQI than NPQ10. This may be due to some questions that do not reflect the daily activities of our study subjects, but NPQ10 score in women is higher than men where the quality of life for nail psoriasis is also influenced by gender.