Seiring dengan meningkatnya populasi geriatri di Indonesia, masalah penuaan kulit juga turut meningkat. Pada populasi tersebut terjadi berbagai perubahan kulit sehingga kelainan yang ditimbulkan juga berbeda. Stres oksidatif merupakan mekanisme yang diduga kuat sebagai penyebab utama penuaan kulit. Penuaan kulit merupakan proses kompleks yang melibatkan faktor intrinsik dan ekstrinsik. Faktor intrinsik yang berperan adalah genetik, metabolisme sel, dan perubahan hormonal. Selain itu, terdapat faktor ekstrinsik seperti radiasi ultraviolet, inframerah, dan karsinogen lingkungan yang turut berperan pada penuaan kulit. Kedua faktor tersebut menyebabkan perubahan di seluruh lapisan kulit. Untuk mengatasi penuaan kulit, kini telah tersedia berbagai modalitas terapi, namun untuk menentukan terapi yang paling sesuai perlu diketahui fisiologi kulit menua, mekanisme penuaan kulit, dan manifestasi kelainan klinis kulit menua. Secara fisiologi terjadi perubahan permeabilitas, biokimia, vaskularisasi, termoregulasi, respons terhadap iritan, respons imunitas, kapasitas regenerasi, respons terhadap cedera, persepsi neurosensori dan pada tingkat genom. Jumlah sel epidermal dan laju pergantian epidermal menurun sedangkan di adneksa terjadi penurunan jumlah kelenjar sebasea yang mengakibatkan kulit kering dan mudah pecah. Penurunan jumlah melanosit menyebabkan warna rambut menjadi abu-abu keputihan dan muncul pigmentasi atipik di kulit. Folikel rambut kurang aktif sehingga meningkatkan kerontokan dan kebotakan. Di lapisan basal ukuran sel berkurang dan rerata ukuran sel bertambah. Sel keratinosit menjadi lebih pendek dan besar di kulit yang menua. Kata kunci: geriatri, mekanisme penuaan kulit, patofisiologi.   Skin Aging Mechanism as A Basic Prevention and Treatment of Skin Aging Abstract Growing geriatric population generates a rise of aging issues. Process of aging develops multiple skin changes that further emerge other related skin problems. Oxidative stress is believed playing vital role related to aging. The aging process in the skin is complex and influenced by intrinsic and extrinsic factors. Intrinsic factors can be in the form of genetics, cell metabolism, and hormonal changes. Meanwhile, for extrinsic factors, such as exposure to ultraviolet, infrared, and carcinogenic agent also have crucial part in aging process. These factors contribute to all layers of the skin. Nowadays, many treatment modalities available to reverse skin aging, however, better understanding on skin aging mechanism, the pathophysiology, and clinical manifestations of aging skin is important to choose the appropriate treatment for patients. In aging, there are physiological changes in permeability, biochemical structures, vascularisation, thermoregulation, irritative response, immunity response, regenerative capability, inflammatory response, neurosensory perception and in genom level. The number of epidermal cells and epidermal overturn rate decline while there is also reduction of sebaseous glands at adnexa which both are accounted for skin xerosis. Decreasing melanocytes can caused gray hair and atypical pigmentation. Hair follicles also show less activity resulting in hair loss. Basal layer cells are downsizing and rise of average cells size are occured. Keratinocyte becomes shorter and bigger in aging skin. Keywords: geriatric, mechanism, skin aging, pathophysiology.

No abstract

No abstract

Background The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose. Purpose We aimed to compare microneedling (MN) versus fractional CO 2 laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin. Patients and Methods A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35–59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05. Results Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application. Conclusion Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.

No abstract

No abstract

No abstract

Purpose Repeated exposure to ultraviolet light is the most significant factor that contributes to photoaging. Dermoscopy photoaging scale (DPAS) is a noninvasive examination utilized for the diagnosis of photoaging. However, there has been no study analyzing the correlation between DPAS and sun index. Hence, this study aims to find out the dermoscopic features of photoaging and its association with sun index score in the coastal population. Patients and Methods This was a descriptive cross-sectional study on individuals living in Cilincing, a coastal area, at North Jakarta. Healthy male or female subjects aged over 18 years old with sun exposure equal or more than 2 hours daily were recruited consecutively. History taking was performed to document the sociodemographic characteristics (age, gender, skin type, smoking habit) and sun index score. Physical examination and dermoscopic examination were conducted to determine DPAS score. Associations of DPAS and photoaging profiles were analyzed with Chi-squared test while correlation between DPAS score and sun index was analyzed with Pearson correlation test. Results A total of 100 subjects were included in this study. The median DPAS of the subjects was 9 (1–21). Right cheek had the highest median DPAS of 3 (0–6), followed by the left cheek with median DPAS of 3 (0–7). Men had a higher median DPAS score than women (9 vs 8). There was a significant difference between DPAS score and age (p<0.001). There was no significant correlation between DPAS score and sun index (r = −0.005; p = 0.957). Conclusion Factors associated with high DPAS score were cheek predilection, male, actively smoking, Fitzpatrick skin type IV, and increasing age. DPAS score has no correlation with sun index.