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UVB-Induced Oxidative Collapse and Melanogenic Activation in a Rat Model of Cutaneous Hyperpigmentation: A Multi-Parametric Analysis Sesia Pradestine; Endra Yustin Ellistasari; Nurrachmat Mulianto; Indah Julianto; Muhammad Eko Irawanto; Nugrohoaji Dharmawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1442

Abstract

Background: Ultraviolet B (UVB) radiation is a primary driver of cutaneous hyperpigmentation disorders, with oxidative stress recognized as a key pathogenic mechanism. However, a comprehensive, multi-level characterization of the causal link between chronic UVB exposure and the resulting oxidative, histological, and melanogenic responses is needed. This study aimed to quantitatively validate a preclinical model of UVB-induced hyperpigmentation by characterizing the reciprocal regulation of key oxidative stress biomarkers and correlating these changes with objective histological evidence of hyperpigmentation. Methods: This controlled in vivo experimental study used 14 male Sprague Dawley rats, divided into a control group (KN; n=7) and a UVB-exposed group (KP; n=7). The KP group received chronic UVB radiation (300 mJ/cm² daily, 5 days/week for 4 weeks). Dorsal skin tissue was harvested for analysis. Oxidative stress was assessed by quantifying malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) levels via ELISA. Hyperpigmentation was objectively validated and quantified using Fontana-Masson staining for melanin deposition and immunohistochemistry for microphthalmia-associated transcription factor (MITF). Results: Chronic UVB exposure induced significant hyperpigmentation, confirmed by a 5.8-fold increase in epidermal melanin content (p < 0.001) and a 4.1-fold increase in the number of MITF-positive melanocytes (p < 0.001) in the KP group. This was accompanied by a profound oxidative imbalance: MDA levels increased by 7.5-fold (p < 0.001), while the activities of SOD, CAT, and GPx decreased by 80.5%, 65.2%, and 71.4%, respectively (all p < 0.001). A strong negative correlation was observed between MDA and all antioxidant enzymes, particularly SOD (r = -0.985, p < 0.001). Conclusion: Chronic UVB exposure directly triggers a collapse of the cutaneous antioxidant network, leading to severe lipid peroxidation. This state of profound oxidative stress is causally linked to melanocyte activation and excessive melanin synthesis, driving the hyperpigmentation phenotype. This robustly validated preclinical model provides a powerful platform for investigating the molecular pathophysiology of UVB-induced pigmentary disorders and for evaluating novel therapeutic interventions.
Topical Polypeptide Gel in Diabetic Ulcers: Clinical Insights Into a New Adjunctive Treatment Modality Octarica, Stella Gracia; Widhiati, Suci; Ellistasari, Endra Yustin; Dharmawan, Nugrohoaji; Julianto, Indah
Journal of Social Research Vol. 4 No. 10 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i9.2794

Abstract

Diabetic ulcers are a common and challenging complication of diabetes, contributing to morbidity, infection, and a high risk of amputation. Innovative adjuncts, such as topical polypeptide gel, which contains amino acids to support tissue regeneration, are proposed to accelerate wound healing; however, supporting clinical data are limited. A quasi-experimental analysis was conducted in 11 patients. Each received a daily topical 7% polypeptide gel in addition to standard care. Ulcer area was measured at baseline (day 0) and after 14 days using digital documentation analysis using ImageJ. The primary outcome was the percentage reduction in ulcer size. Patients were analysed for associations between percentage of improvement with age, gender, diabetes type, and ulcer site. Eleven patients with diabetic ulcers completed the 14-day treatment protocol. The cohort comprised 54.5% females with a mean age of 54.1 ± 7.3 years and predominantly insulin-dependent diabetes (72.7%). Baseline ulcer area averaged 982.1 ± 1315.1 mm², reducing to 184.0 ± 297.7 mm² by day 14, representing an 86.2 ± 6.7% mean area reduction. All patients achieved ?76% healing, with 45.5% achieving ?90% area reduction and 9.1% achieving complete healing. The Wilcoxon signed-rank test demonstrated statistically significant ulcer area reduction (Z = -2.934, p = 0.003). No significant associations were found between healing percentage and patient demographics, diabetes type, ulcer location, or comorbidity burden (all p > 0.05). No treatment-related adverse events were reported during the study period. Topical polypeptide gel demonstrated rapid wound surface area reduction in the majority of the subjects over 14 days, independent of patient age, gender, diabetes type, or ulcer location. These findings suggest its promise as an adjunctive early-phase therapy for diabetic ulcers.
Cluster Differentiation 133 Expression in Patients With Basal Cell Carcinoma: an Immunohistochemical Review Utama, Rahmat Firdaus Dwi; Dharmawan, Nugrohoaji; Murastami, Ammarilis; Mulianto, Nurrachmat; Setyawan, Novan Adi
Journal of Social Research Vol. 4 No. 10 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i9.2802

Abstract

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in humans, developing on skin exposed to ultraviolet light and rarely metastasizing. Cancer stem cell markers such as CD133 have been extensively studied in various malignancies, but their expression in BCC remains controversial and has not been widely studied in Indonesia. Determine the difference in CD133 expression between BCC patients and normal skin. Analytical observational study with a case control design was conducted at Dr. Moewardi General Hospital in Surakarta from April to July 2025. The sample included 13 BCC tissues and 13 normal skin controls taken by consecutive sampling from paraffin blocks from 2021-2024. CD133 immunohistochemical staining was performed with Allred scoring by a single pathologist on at least four random fields of view. Descriptive analysis presented demographic characteristics and Allred scores, while the Chi square test was used to compare CD133 expression between groups with significance at p < 0.05. The mean CD133 Allred score was 7.15 ± 0.56 in KSB tissue and 7.31 ± 0.48 in normal skin. Strongly positive CD133 expression was found in 12/13 BCC patients and 13/13 normal skin. Chi square analysis showed no significant difference in CD133 expression between the BCC and normal skin groups (p=0.308). CD133 expression based on the Allred score did not differ significantly between BCC tissue and normal skin, indicating that CD133 is not useful as a single marker for the diagnosis or prognosis of KSB
Platelet-Rich Plasma-Derived Exosomes Modulate Follicular Regeneration: A Comparative Mechanistic Analysis with Minoxidil in a Preclinical Model of Androgenetic Alopecia Trya Oktaviani; Arie Kusumawardani; Suci Widhiati; Nugrohoaji Dharmawan; Endra Yustin Ellistasari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1437

Abstract

Background: The therapeutic armamentarium for androgenetic alopecia (AGA) is limited, with variable efficacy and potential side effects associated with standard treatments like minoxidil. Platelet-rich plasma-derived exosomes (PRP-Exo) represent a novel acellular strategy, offering a concentrated payload of regenerative biomolecules. This study aimed to rigorously evaluate the therapeutic efficacy and underlying mechanisms of PRP-Exo, as a monotherapy and in combination with minoxidil, in a validated murine model of AGA. Methods: A parallel-group, randomized, double-blind, controlled experimental study was conducted. Thirty-two male C57BL/6 mice with testosterone-induced AGA were randomized (n=8/group) to one of four groups: Negative Control (NC), Positive Control (PC; 5% topical minoxidil), Treatment 1 (T1; intradermal PRP-Exo), or Treatment 2 (T2; combination of PRP-Exo and minoxidil). PRP-Exo were characterized by Transmission Electron Microscopy, Nanoparticle Tracking Analysis, and ELISA for marker proteins. After a 14-day treatment period, efficacy was assessed via hair follicle density (HFD), anagen-to-telogen (A/T) ratio, and hair shaft thickness. Mechanistic insight was obtained by quantifying tissue protein levels of Ki-67 and β-catenin by ELISA. Results: All active treatments significantly improved hair regeneration compared to the NC group. The combination therapy (T2) demonstrated the most profound effects across all metrics, showing statistically superior outcomes compared to both minoxidil (PC) and PRP-Exo (T1) monotherapies in HFD (65.8 ± 12.1 vs. 36.2 ± 8.5 and 47.3 ± 10.4 follicles/mm², respectively; p<0.01). Furthermore, T2 treatment led to the highest A/T ratio and hair shaft thickness. ELISA revealed that T2 treatment also resulted in the highest tissue concentrations of the proliferation marker Ki-67 and the Wnt pathway protein β-catenin, suggesting enhanced mitogenic activity and modulation of key developmental pathways. Conclusion: PRP-Exo is a potent hair regenerative agent, significantly outperforming minoxidil in this preclinical model. The combination of PRP-Exo and minoxidil exhibits a synergistic effect, promoting superior follicular regeneration by concurrently stimulating tissue proliferation and upregulating key components of the anagen-promoting Wnt signaling pathway. These findings underscore the significant clinical potential of PRP-Exo as a next-generation therapy for AGA.
UVB-Induced Oxidative Collapse and Melanogenic Activation in a Rat Model of Cutaneous Hyperpigmentation: A Multi-Parametric Analysis Sesia Pradestine; Endra Yustin Ellistasari; Nurrachmat Mulianto; Indah Julianto; Muhammad Eko Irawanto; Nugrohoaji Dharmawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1442

Abstract

Background: Ultraviolet B (UVB) radiation is a primary driver of cutaneous hyperpigmentation disorders, with oxidative stress recognized as a key pathogenic mechanism. However, a comprehensive, multi-level characterization of the causal link between chronic UVB exposure and the resulting oxidative, histological, and melanogenic responses is needed. This study aimed to quantitatively validate a preclinical model of UVB-induced hyperpigmentation by characterizing the reciprocal regulation of key oxidative stress biomarkers and correlating these changes with objective histological evidence of hyperpigmentation. Methods: This controlled in vivo experimental study used 14 male Sprague Dawley rats, divided into a control group (KN; n=7) and a UVB-exposed group (KP; n=7). The KP group received chronic UVB radiation (300 mJ/cm² daily, 5 days/week for 4 weeks). Dorsal skin tissue was harvested for analysis. Oxidative stress was assessed by quantifying malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) levels via ELISA. Hyperpigmentation was objectively validated and quantified using Fontana-Masson staining for melanin deposition and immunohistochemistry for microphthalmia-associated transcription factor (MITF). Results: Chronic UVB exposure induced significant hyperpigmentation, confirmed by a 5.8-fold increase in epidermal melanin content (p < 0.001) and a 4.1-fold increase in the number of MITF-positive melanocytes (p < 0.001) in the KP group. This was accompanied by a profound oxidative imbalance: MDA levels increased by 7.5-fold (p < 0.001), while the activities of SOD, CAT, and GPx decreased by 80.5%, 65.2%, and 71.4%, respectively (all p < 0.001). A strong negative correlation was observed between MDA and all antioxidant enzymes, particularly SOD (r = -0.985, p < 0.001). Conclusion: Chronic UVB exposure directly triggers a collapse of the cutaneous antioxidant network, leading to severe lipid peroxidation. This state of profound oxidative stress is causally linked to melanocyte activation and excessive melanin synthesis, driving the hyperpigmentation phenotype. This robustly validated preclinical model provides a powerful platform for investigating the molecular pathophysiology of UVB-induced pigmentary disorders and for evaluating novel therapeutic interventions.
Hubungan Karakteristik Klinis dengan Gambaran Histopatologi Pasien Karsinoma Sel Basal di RSUD Dr. Moewardi Surakarta Adjie, Sugih Primas; Mawardi, Prasetyadi; Dharmawan, Nugrohoaji; Julianto, Indah
Jurnal Impresi Indonesia Vol. 4 No. 10 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i10.7060

Abstract

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, with varying clinical and histopathological manifestations. The infiltrative nature of BCC affects tumor aggressiveness and its prognosis. In Indonesia, data regarding the relationship between clinical characteristics and histopathological features of BCC are still limited. This study aims to analyze the relationship between clinical characteristics and the infiltrative nature in BCC patients at Dr. Moewardi General Hospital, Surakarta. A retrospective cross-sectional study used medical records and paraffin blocks of BCC patients diagnosed from January 2021 to February 2025. The evaluated characteristics included age, sex, anatomical location, lesion size, and histopathological subtypes. Histopathological features were analyzed based on infiltrative and non-infiltrative tumor characteristics. Of the 29 patients analyzed, the majority were female (55.2%) with a median age of 57 years. Most lesions were ?2 cm² (82.8%) and located on the middle face (75.9%). The dominant histopathological subtypes were nodulo-ulcerative (41.4%) and nodular (34.4%). Only 48.3% of cases were infiltrative. No significant relationship was found between clinical characteristics and the infiltrative nature of the tumor, emphasizing the importance of histopathological evaluation in determining tumor aggressiveness. These findings are essential for the development of diagnostic and therapeutic strategies for BCC in Indonesia.
The Clinical Relevance of Serum Interleukin-21 in Grading Acne Vulgaris Dewi, Ayu Kusuma; Irawanto, Muhammad Eko; Kusumawardani, Arie; Dharmawan, Nugrohoaji; Mulianto, Nurrachmat
Journal of Social Research Vol. 4 No. 11 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i10.2795

Abstract

Acne vulgaris (AV) is an inflammatory skin disorder with multifactorial pathogenesis involving genetics, hormones, and immune dysregulation. Interleukin-21 (IL-21), a pleiotropic cytokine mainly secreted by T follicular helper and Th17 cells, has been implicated in various inflammatory skin diseases. However, its role in AV remains unclear. This cross-sectional study included 46 patients with AV, classified into mild (n=19), moderate (n=16), and severe (n=11) groups. Serum IL-21 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared across groups, and interobserver reliability of AV severity grading was evaluated using Cohen’s kappa test. One-way ANOVA was applied to assess differences in IL-21 levels among severity groups, with a significance level set at p<0.05. The mean serum IL-21 level was highest in the severe AV group (303.53 pg/mL), followed by the moderate (223.7 pg/mL) and mild (213.2 pg/mL) groups. Although there was a trend toward increasing IL-21 levels with higher AV severity, statistical analysis revealed no significant difference among the three groups (p=0.130). Serum IL-21 levels were elevated in AV patients compared with previously reported healthy controls but did not differ significantly across severity levels. These findings suggest that IL-21 may play a role in the pathophysiology of AV, though it is not a reliable marker of clinical severity. Further case-control and tissue-based studies are needed to clarify its role.
Nevus Unius Lateris with Hemophilia: A rare case report Murastami, Ammarilis; Fiqnasyani, Siti Efrida; Widyastuti, Zilpa; Dharmawan, Nugrohoaji
Health and Medical Journal Vol 5, No 3 (2023): HEME September 2023
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v5i3.1314

Abstract

Latar Belakang: Nevus Unius Lateris (NUL) adalah kelainan bawaan jaringan kulit langka, ditandai distribusi lesi unilateral mengikuti garis Blaschko. Lesi ditemukan pada tahun pertama kehidupan dengan bercak coklat kekuningan, batas yang jelas, dan permukaan verukosa. Pemeriksaan multidisiplin dianjurkan untuk menegakkan diagnosis dan memberikan penatalaksanaan yang tepat. Terapi bertujuan untuk mengangkat dan menghancurkan lesi hiperkeratosis dengan pembedahan/non-pembedahan. Elektrokauter dapat menjadi pilihan untuk membantu mencegah perdarahan setelah operasi dermatologis, terutama hemofilia. Kasus: Tn. A, 24 tahun, pekerjaan wiraswasta, datang dengan keluhan utama beberapa plak yang meninggi di belakang lehernya. Keluhan pertama muncul sebagai bintik pada usia 6 tahun dan naik perlahan, dan menyebar luas. Pasien memiliki riwayat hemofilia A. Pemeriksaan dermatologis, beberapa nodul verukosa hiperpigmentasi bertangkai dengan batas teratur, garis yang jelas tersusun secara linier mengikuti garis Blaschko di daerah coli posterior. Hasil pemeriksaan dermoskopi menunjukkan pola sirkular hiperpigmentasi dengan struktur epidermis eksofitik dan pola serebriform. Pemeriksaan histopatologi menunjukkan hiperkeratosis, akantosis, papilomatosis minimal, dan deposit melanin dengan kepadatan ringan-sedang. Pasien didiagnosis dengan nevus unius lateris dan diterapi bedah listrik. Pasien diberikan antibiotik sistemik oral dan analgesik selama lima hari setelah prosedur dan disarankan untuk kontrol pada hari ketiga, dan pengangkatan jahitan dilakukan pada hari ketujuh. Kesimpulan: Beberapa perawatan medis dan bedah telah dicoba, tetapi tidak ada pengobatan yang ideal atau dapat diterima secara universal. Namun, kekambuhan dapat terjadi berbulan-bulan atau bertahun-tahun setelah pengangkatan lesi dengan metode apa pun. Terapi dengan bedah listrik dapat dipilih untuk membantu mencegah perdarahan yang mungkin terjadi setelah prosedur melalui target hemostasis dan untuk kerusakan jaringan superfisial.
Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1046

Abstract

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.
Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report Kamilah, Lian; Bobby Febrianto; Nurrachmat Mulianto; Nugrohoaji Dharmawan; Harijono Kariosentono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1046

Abstract

Background: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing. Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks. Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case.