Melasma is a hyperpigmentation disorder that is often found, is chronic. Hydroquinone is considered the standard therapeutic standard of melasma, has limitations and side effects vary. L-ascorbic acid acts as a reactive oxygen species (ROS) scavenger and has the ability to bind copper ions in the tyrosinase workplace. Glutation has the function of depigmentation of the skin that inhibits melanogenesis by suppressing the activity of tyrosinease enzymes. The purpose of this study was to prove and analyze the effectiveness of serum combination therapy L-ascorbic acid 10% and glutation 2% in lowering MASI score compared to serum hydroquinone 4% in melasma patients. Clinical experimental research method, pre and posttest double blind randomized controlled trial with the study subjects as many as 36 melasma patients. In group I was given a combination of serum L-ascorbic acid 10% and glutation 2%, while group II got serum hydroquinone 4%. The effectiveness of serum is assessed with an MASI score. The analyses used are t-paired tests, Wilcoxon tests and Difference-in-Differences (DID) analyses. Statistical tests are considered meaningful if p<0.05. The results of the study in both groups had a significant decrease in MASI score (p<0,001), but the decrease did not differ significantly between the two groups. The decrease in MASI scores between the two groups made no significant difference in week 4 (p=0.535) and 8th (p=0.303). The conclusion of this study was a combination of serum L-ascorbic acid 10% and glutation 2% lowered MASI score, but not proven more effective in lowering MASI score than serum hydroquinone 4% in melasma patients.
<p>Manifestasi kulit dapat menjadi gejala dan tanda awal defisiensi nutrisi pada anak. Defisiensi nutrisi tersebut antara lain malnutrisi protein energi, defisiensi asam lemak esensial, defisiensi vitamin A, pelagra, defisiensi kobalamin, scurvy dan defisiensi zink. Beberapa malnutrisi dapat memberikan gejala kulit cukup khas dan terkadang tumpang tindih. Gejala kulit awal pada defisiensi nutrisi anak dapat didiagnosis dini sehingga dapat segera diberi tatalaksana suplementasi yang tepat untuk mencegah komplikasi yang lebih berat.</p><p>Skin manifestations can be an early symptom and sign of nutritional deficiency in children. Such nutritional deficiencies include energy protein malnutrition, essential fatty acid deficiency, vitamin A deficiency, pellagra, cobalamin deficiency, scurvy, and zinc deficiency. Some malnutritions can provide quite typical and sometimes overlapping skin symptoms. Early skin symptoms in a child's nutritional deficiency can be diagnosed early and immediately given appropriate supplementation procedures to prevent more severe complications.</p>
Discoid lupus erythematosus is the most common forms of chronic cutaneous lupus erythematosus. It is characterized by clinical manifestations of erythematous macules, papules, or plaques with a coin-like shape and the face is the most common predilection site. Clinical features often resemble granuloma faciale. This case report aimed to distinguish discoid lesions on the face based on the histopathological examination. A 71-year-old male with a few reddish lumps appeared on his face since three months ago. Physical examination showed multiple discrete erythematous plaques with overlying squamous. Hematoxylin and eosin staining on the epidermis demonstrated basket weave type orthokeratosis, basal vacuolar cell degeneration, epidermal atrophy with flat rete ridges, and follicular plugging while in the dermis obtained inflammatory cell infiltrates, especially in periadnexal areas. Histopathological features of DLE are hyperkeratosis, pilosebasea gland atrophy, follicular plugging, basal membrane thickening, and cellular infiltrate in periadnexa or perivascular areas more visible than in other types of CLE. In DLE, no subepidermal gren zone and eosinophil infiltrate were found, like histological features of granuloma faciale. Histopathological examination can be used to establish a diagnosis for discoid lesions on the face, although serology examination remains as the gold standart. Keywords: Discoid lupus erythematosus; Granuloma faciale; Histopathology
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