<p>Isotretinoin merupakan pilihan terapi oral yang paling efektif untuk kasus akne vulgaris derajat berat, tidak responsif terhadap terapi konvensional, akne dengan jaringan parut berat, dan akne kronis. Efek samping mukokutaneus paling sering dan tergantung dosis (dose-dependent), diduga berkaitan dengan berkurangnya produksi sebum, berkurangnya ketebalan stratum korneum, dan berubahnya fungsi barier epidermis. ATRA (all-transretinoic acid) dapat meningkatkan ekspresi TRAIL, yang merupakan protein ligan TNF-related menginduksi apoptosis. Vitamin E (-tokoferol) dapat menekan jumlah reseptor ligan apoptosis serta mengatur profil lipid epidermal. Beberapa penelitian menunjukkan vitamin E dapat mengurangi efek samping isotretinoin.</p><p>Isotretinoin is the most effective choice of oral therapy for severe acne, acne unresponsive to conventional therapy, severe acne scars, and chronic acne. Mucocutaneous side effects are the most frequently occurring and dose-dependent, thought to be related to reduced sebum production, reduced stratum corneum thickness, and epidermal barrier function. ATRA (all-trans retinoic acid) increases the expression of TRAIL, a TNF-related ligand protein that induces apoptosis. Vitamin E (-tocopherol) can suppress apoptotic ligand receptors and regulate lipid profiles. Several studies show the advantages of vitamin E in reducing side effects of isotretinoin.</p>
Background:Vitiligo is an autoimmune disease that causes progressive skin melanocyte destruction, clinically seen as asymptomatic depigmentation macule and poliosis. CD8+ T cell is the primary effector of melanocyte destruction, and the activities of CD8+ T cell are driven by interferon-γ (IFN-γ). The current vitiligo treatment options are often not satisfied with many limitations and a high recurrence rate. Janus Kinase (JAK) inhibitor is one of the emerging vitiligo therapies which has a more specific target with a direct effect on CD8+ T cell cytotoxicity and IFN-γ. Methods: In writing this article, the literature review method was used, and sources consist of relevant Latar belakang: Vitiligo merupakan penyakit autoimun yang menyebabkan destruksi melanosit secara progresif pada kulit, menimbulkan makula depigmentasi asimtomatik dan poliosis. Sel T CD8+ merupakan efektor primer yang menyebabkan kematian melanosit dan aktivitasnya ditingkatkan oleh interferon-γ (IFN-γ). Pilihan terapi vitiligo saat ini seringkali tidak memuaskan, memiliki keterbatasan, dan memiliki tingkat kekambuhan yang tinggi. Inhibitor Janus Kinase (JAK) merupakan salah satu terapi baru vitiligo yang memiliki target lebih spesifik dengan efek langsung terhadap sitotoksisitas sel T CD8+ dan IFN-γ. Metode: Dalam penulisan artikel ini digunakan metode tinjauan pustaka dengan bersumber pada journals obtained through online search engines. Result: Several studies show that repigmentation in the facial area increases between 51-92%. Repigmentation occurs better in areas exposed to sunlight or a combination of phototherapy because repigmentation in vitiligo lesions requires suppression of the autoimmune process and melanocyte regeneration. Conclusion:Many studies showed the results of vitiligo therapy using JAK inhibitors were very promising and safe. The vitiligo therapy using JAK inhibitor showed higher efficacy on the facial area and combined with ultraviolet exposure. artikel relevan yang didapatkan melalui pencarian secara daring. Hasil: Beberapa studi menunjukkan adanya repigmentasi pada area wajah meningkat antara 51-92%. Repigmentasi terjadi lebih baik pada area terpapar sinar matahari atau kombinasi fototerapi disebabkan karena repigmentasi pada lesi vitiligo membutuhkan supresi dari proses autoimun dan regenerasi melanosit. Simpulan: Berbagai studi menunjukkan hasil terapi inhibitor JAK terhadap vitiligo sangat menjanjikan dan cukup aman. Terapi inhibitor JAK menunjukkan efektivitas lebih tinggi pada area wajah dan dengan kombinasi paparan ultraviolet.
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