Aging is an inevitable and dynamic biological process that is characterized by the progressive deterioration of body systems and declines in physiological reserve capacity. Aging skin has distinct two types: intrinsic and extrinsic. Intrinsic changes reduce collagen production, blood flow, amount of skin lipid, and loss of rete ridges. Intrinsic aging or chronological aging is cannot be restored to the skin with characterized by sagging skin and some expression of excess wrinkling lines. Intrinsic aging changes in thickness and characteristics of the epidermis, dermis, and hypodermis. Histologically, epidermis thinner by leveling off the dermo-epidermal junction. In the dermis, collagen fibers become thicker and irregular than younger skin, reducing the elasticity of the skin, while hypodermis reduces lipid volume.

Introduction: In geriatrics, there are changes in structure and function results in histopathological, physiological and clinical skin changes. The conditions can cause morbidity and decreases the quality of life of patients. This study was the first study that provide the characteristics of geriatric skin disorders in Dr. Mohammad Hoesin Hospital Palembang. Methods: This study was descriptive observational with cross-sectional design using total sampling method performed among patients in Geriatric Outpatient Clinic, Dermatology and Venereology Outpatient Clinic and geriatric inpatient room in Dr. Mohammad Hoesin Hospital on July-September 2019. Results: Physiological skin changes in geriatrics include xerosis cutis (13,95%), seborrheic keratosis (13,17%), guttate hypomelanosis (8,5%), senile lentigen (6,97%), freckle (2,32%), periorbital hyperpigmentation (1,55%), senile purpura (0,77%) and poikiloderma civatte (0,77%). The most skin disorder found were lichen simplex chronicus (11,1%), pressure ulcers (9,25%), senile pruritus (8,32%), asteatotic dermatitis (6.47%) and candidiasis (3,7%). The most common comorbid condition were diabetes mellitus in 16 patients (22,5%), CVD in 7 patients (9,9%), hypertension in 6 patients (8,5%), AKI in 6 patients (8,5 %), and HHD in 4 patients (5,6%). Diabetes mellitus was significantly associated with xerosis cutis (p = 0,0007), senile pruritus (p = 0,015), and guttate hypomelanosis (p = 0,016). Conclusion: The most physiological skin changes found in geriatric patients in Dr. Mohammad Hoesin Hospital were xerosis cutis, seborrheic keratosis, and guttate hypomelanosis, while skin disorder were lichen simplex chronicus, pressure ulcer, and senile pruritus. Diabetes mellitus was significantly associated with skin disorders.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum (T. Palladium). Human Immunodeficiency Virus (HIV) is a virus that attacks the body's immune system, decreased the number of CD4 cells that makes the immune system decrease, and facilitates syphilis infection. Syphilis increased the risk of spreading HIV infection with skin barrier destruction. The diagnosis of syphilis is made based on a complete history, including sexual history, clinical manifestations, and examination. The treatment of syphilis with HIV and without HIV similar, penicillin is still the gold standard for syphilis treatment with HIV. Prevention of syphilis with HIV are educated, screening for syphilis and other sexually transmitted infections, as well as early detection and therapy of partners. The prognosis for syphilis in HIV is worse than for syphilis without HIV.

The pilosebaceous unit is a sebaceous gland with hair follicles. One of the hormones that affects the pilosebaceous unit is androgen, a steroid hormone that plays an important role in the expression of the phenotype of men and women. Androgen consist of testosterone and dihydrotestosterone which are activated by androgen receptors. Androgen in the pilosebaceous unit affect sebum production and hair growth. Androgen receptors in the sebaceous glands are found on sebocytes and in hair follicles in the dermal papillae of hair follicles

Diabetes mellitus (DM) is a chronic and complex disease that affects various parts of the body. It can lead to multiple systemic complications and also cutaneous manifestation. Diabetic foot ulcer (DFU) is one of the most devastating complications of DM in dermatology. The main etiology is an increase in plasma glucose, risk factors, or comorbidities due to DM itself. Neglected DFU can lead to further complications, including high amputation and mortality rates; thus, the healing of ulcers is the main objective of the treatment. Management is divided into the standard of care and adjuvant therapies. This study aims to optimize DFU management, so it can provide proper treatment and prevent complications.

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Phototherapy is a therapeutic procedure in dermatology. Phototherapy uses certain ultraviolet wavelengths classified into 3 types,broadband UVB (BBUVB), narrowband UVB (NBUVB), and psoralen UVA (PUVA). The most widely used is NBUVB for treating psoriasis, atopic dermatitis and vitiligo. The mechanism of action of phototherapy is to reduce epidermal proliferation, suppress the immune system, reduce the inflammatory process, and induce repigmentation. Before starting phototherapy, the dose adjustment depends on skin type and minimal erythema dose (MED). Frequency of use is recommended based on the severity of the disease, continuously administered needed. Besides of this therapeutic effect, some contraindications and side effects that need to be considered in the use of phototherapy such as drug interactions, photoallergic and risk of skin malignancy.

A non-invasive method of examination, dermoscopy (DS) can be used to detect Sarcoptes scabiei, but needs special training and expensive. Videomicroscope (VM) is able to visualize burrow, mites and eggs, so prompt treatment can be given. The aim of the study is to compare VM and DS, confirmed by skin scraping microscopic examination as standard diagnostic. The method was analytic observational study comparing VM and DS in 210 presumptive scabies patients in Palembang municipal orphanage. By consecutive sampling, 139 patients were included, 73 (52.5%) were men, 66 (47.5%) were women. Majority age were 11-20 years: 85 (61.2%) and 5-11 years: 44 (31.7%). The most common locations were interdigital manus/pedis 125 (89.9%), dorsum manus/pedis 106 (76.6%), wrist joint 102 (73.4%). VM’s sensitivity 92%, specificity 88%, accuracy 91%, positive predictive value (PPV) 96%, negative predictive value (NPV) 79%, area under curve (AUC) 90.3%. DS’ sensitivity 85%, specificity 71%, accuracy 81%, PPV 90%, NPV 60%, AUC 77.7%. There is a significant difference in specificity, accuracy and AUC, specificity of VM 88% and DS 71%, p 0.0007 < 0.05, accuracy value of VM 91%, DS 81%, with p 0.0257 < p 0.05; AUC of VM examination 90.3%, DS 77.7%, p 0.0069 < p 0.05. There was a significant difference between VM and DS examination with Z=2.23 p 0.0257 (Z>1.96). VM is better than DS, VM can be used as a diagnostic method especially at primary health service, a rapid mass screening and for evaluation of post-therapeutic follow up of scabies in epidemic area.