Lili Legiawati
Department Of Dermatology & Venereology, Faculty Of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia

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Berbagai Instrumen Penilaian Photoaging dan Karakteristiknya Putu Martha Gerynda Sukma; Shannaz Nadia Yusharyahya; Sri Linuwih SW Menaldi; Lili Legiawati; Rinadewi Astriningrum
Jurnal Kedokteran Meditek Vol 29 No 1 (2023): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i1.2454

Abstract

Seiring dengan bertambahnya usia seseorang, kulit sebagai jaringan terluar dari tubuh manusia akan memberikan gambaran paling terlihat dari proses penuaan. Penuaan kulit dipengaruhi oleh dua faktor yaitu faktor intrinsik dan faktor ekstrinsik. Faktor intrinsik terjadi secara alamiah dan berkaitan dengan proses degenerasi seluler. Faktor ekstrinsik berkaitan dengan pajanan sinar matahari, rokok, dan polusi udara. Penyebab utama penuaan kulit akibat faktor ekstrinsik berupa pajanan kronik sinar ultraviolet dikenal sebagai photoaging. Tanda klinis photoaging dapat bervariasi, namun yang sering ditemukan berupa perubahan pigmentasi dan keriput. Saat ini telah tersedia lebih dari 100 instrumen penilaian penuaan kulit menggunakan fotografi, dermoskopi, dan alat diagnostik multifungsi namun masih belum ada yang dianggap sebagai baku emas. Tinjauan pustaka ini bertujuan untuk membahas berbagai instrumen penilaian photoaging yang sering digunakan dalam praktik klinis sehari-hari dan karakteristik dari masing-masing instrumen tersebut.
Perkembangan Terkini Proses Penuaan Kulit Natalia Rania Sutanto; Shannaz Nadia Yusharyahya; Hanny Nilasari; Lili Legiawati; Rinadewi Astriningrum; Eyleny Meisyah Fitri
Jurnal Kedokteran Meditek Vol 29 No 1 (2023): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i1.2455

Abstract

Penuaan kulit merupakan fenomena biologis yang tidak dapat dihindari oleh manusia. Mekanisme yang mendasari penuaan kulit selalu berkembang sehingga penting untuk mengetahui mekanisme molekular terbaru, serta perubahan yang terjadi akibat penuaan agar klinisi dapat menentukan tata laksana yang tepat untuk mencegah dan mengobati penuaan kulit. Terdapat dua faktor yang berperan dalam terjadinya penuaan kulit, yaitu faktor intrinsik dan ekstrinsik. Faktor intrinsik 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. Pemendekan telomer, stres oksidatif, disfungsi mitokondria, radiasi ultraviolet dan inframerah, peranan polusi udara dan rokok, peranan aryl hydrocarbon receptor (AhR), kerusakan deoxyribo nucleic acid (DNA), cellular senescence, perubahan hormon, pengaruh mikrobiota, vitamin D, akumulasi advanced glycation end products (AGEs), serta inflammaging memegang peranan penting dalam proses penuaan. Proses penuaan tersebut menyebabkan penurunan fungsi dan kapasitas kulit secara progresif yang berpuncak pada gangguan fungsi kulit dan kerentanan terhadap penyakit. 
The importance of multidisciplinary approach in management of pressure injury in elderly with multiple comorbidities Kusumawardhani, Dina; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Astriningrum, Rinadewi; Adistri, Kara
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Pressure injury (PI) can occur as a result of prolonged bed rest in immobilized patients. The healing process is often slow if the wounds are not managed comprehensively, particularly in elderly patients or patients with neurological disorder, diabetes mellitus, and malnutrition. Proper treatment can improve the healing process. Case illustration: A 66-year-old female with multiple comorbidities presented with PI on the left lower back, as well as the sacral and right gluteal regions. She was diagnosed with grade 3 and unstageable PI, and was treated using a multidisciplinary approach. Her wounds were treated with a combination of hydrogels and polyurethane foam dressings. Discussion: Managing comorbidities, optimizing local wound care, regular repositioning in special mattress, and improving nutritional status are necessary to accelerate healing in cases of PI. There was an increase in the wound granulation and epithelialization, as well as a decrease in the ulcer size and exudates after 16 weeks of treatment. A considerable amount of time is needed to treat grade 3 and unstageable PI in an immobile elderly patient with multiple comorbidities. Conclusion: Multidisciplinary collaboration among healthcare workers is essential for the treatment of PI in elderly populations.
The effects of vitamin D on chronic wounds Priyanto, Mufqi Handaru; Miranda, Eliza; Yusharyahya, Shannaz Nadia; Legiawati, Lili; Novianto, Endi; Bramono, Kusmarinah; Krisanti, Roro Inge Ade
Journal of General - Procedural Dermatology and Venereology Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: Wounds that fail to proceed through the normal healing process are referred to as chronic wounds, also known as ulcers. Chronic wounds have immeasurable biological, psychological, social, and economic effects, bringing tremendous challenges for patients, doctors, healthcare providers, and healthcare systems. Discussion: This condition is associated with a variety of comorbidities and complex etiologies. The global incidence of chronic wounds is expected to increase with longer life expectancy. Thus, a holistic approach is necessary, such as proper wound management, proper control of comorbidities, and provision of adequate nutrition, including vitamin D supplementation. Vitamin D is an essential pro-hormone for cell differentiation, proliferation, and growth. It affects the skin’s immune response, and is therefore thought to promote wound healing and tissue repair. Many studies have been published on the association between low vitamin D levels and chronic wounds. However, whether or not vitamin D supplementation directly contributes to wound healing still needs to be elucidated. Conclusion: Despite the many reports on vitamin D as an adjuvant treatment for chronic wounds, further large-scale clinical studies are needed to cement the role of vitamin D as an effective standard therapy for chronic wound healing.
PERAN SUPLEMENTASI VITAMIN D PADA TATA LAKSANA SARKOIDOSIS KUTIS Mutiara Ramadhiani; Yudo Irawan; Shannaz Nadia Yusharyahya; Lili Legiawati
Media Dermato-Venereologica Indonesiana Vol 50 No 1 (2023): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i4.311

Abstract

Sarkoidosis merupakan kelainan inflamasi multisistem yang ditandai dengan terbentuknya granuloma dan terjadi pada berbagai organ, terutama paru dan kulit. Granuloma berisi sel imun berupa makrofag yang juga berperan dalam metabolisme vitamin D. Makrofag pada granuloma sarkoidosis terbukti mampu memproduksi 1,25-dihidroksi vitamin D (kalsitriol) di luar ginjal yang berasal dari prekusor 25-hidroksi vitamin D (calcifediol). Selain itu, metabolisme 1,25-dihidroksi vitamin D di makrofag tidak memiliki mekanisme umpan balik yang efektif dalam menjaga keseimbangan kadar vitamin D di tubuh. Penurunan ini dapat mengganggu keseimbangan kadar kalsium pada pasien sarkoidosis. Pemberian suplementasi vitamin D dianggap sebagai terapi adjuvan dalam tata laksana sarkoidosis, namun diketahui dapat menyebabkan hiperkalsemia. Perubahan kadar vitamin D pada sarkoidosis tidak selalu menjadi indikasi pemberian suplementasi vitamin D, diperlukan pemeriksaan laboratorium yang tepat sebelum memberikan suplementasi vitamin D guna mengurangi risiko terjadinya hiperkalsemia pada sarkoidosis. Pemberian suplementasi vitamin D dalam dosis rendah diperbolekan bagi pasien sarkoidosis yang tidak disertai kondisi hiperkalsemia, namun perlu dilakukan pemeriksaan kadar vitamin D dan kalsium secara rutin.
KOMORBIDITAS PADA AKNE Andira Hardjodipuro Hardjodipuro; Rinadewi Astriningrum; Irma Bernadette; Lili Legiawati; Sandra Widaty
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.334

Abstract

Akne vulgaris (AV) merupakan salah satu penyakit kulit yang paling sering ditemui, terutama pada remaja dan dewasa muda. Patogenesis terjadinya AV setidaknya diperankan oleh empat faktor penting, yaitu hiperproliferasi lapisan epidermis pada folikel, peningkatan produksi sebum, proses peradangan, dan kolonisasi Cutibacterium acnes. Proses tersebut juga dipengaruhi oleh berbagai faktor, antara lain faktor genetik, hormonal, psikologis, gaya hidup, dan lingkungan. Lesi AV bersifat polimorfik dan memiliki derajat keparahan yang beragam. Lesi tersebut diketahui memberikan dampak terhadap kualitas hidup penderitanya. Berbagai studi terkini melaporkan bahwa terdapat berbagai komorbiditas yang dapat memberikan beban tambahan atau memperburuk kondisi AV. Komorbiditas didefinisikan sebagai penyakit yang terjadi secara simultan. Berbeda dengan sindrom yang memiliki arti sekumpulan gejala yang terjadi serentak atau sekumpulan tanda yang menandakan suatu penyakit tertentu. Komorbiditas akne yang telah banyak diinvestigasi antara lain resistensi insulin, hipovitaminosis D, 1 hipervitaminosis B12, gangguan gastrointestinal, gangguan psikologis, disfungsi kelenjar tiroid, dislipidemia, defisiensi seng, dan hipovitaminosis A dan E.
KASUS RECESSIVE DYSTROPHIC EPIDERMOLYSIS BULLOSA-MITIS YANG TERDIAGNOSIS PADA SAAT LANJUT USIA Inadia Putri Chairista; Shannaz Nadia Yusharyahya; Lili Legiawati; Rahadi Rihatmadja; Rinadewi Astriningrum
Media Dermato-Venereologica Indonesiana Vol 50 No 1 (2023): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v50i1.402

Abstract

Introduction: Recessive dystrophic epidermolysis bullosa (RDEB) is a rare bullous disease caused by mutations in the COL7A1 gene encoding anchoring fibril collagen that maintains skin integrity. Case: Male, 67-year-old, presented with blisters and wound on various parts of the body, worsening in the recent year. They had been known to easily appear after trauma since. Vesicles-bullae, erosions-excoriations, milia, and atrophic scars were found on the axillae, groins, and limbs, as well as hyperkeratosis and anonychia of the hands and. Histopathological examination showed subepidermal cleft, milia and fibrosis, without immunoglobulin deposits on immunofluorescence. Discussion: Contrary to classical RDEB, blisters in mitis variant do not always cause impairment. The pronounced symptoms in advanced age might be mistaken for epidermolysis bullosa acquisita. Negative immunoglobulin deposition is the diagnostic key, confirming that blister does not result from an autoimmune process, but rather, from trauma to the abnormal skin, more so by flattening of the rete ridges in the elderly. In the absence of definitive therapy, treatment is symptomatic. Conclusion: The diagnosis RDEB-mitis might be missed in geriatric. Correct diagnosis has implication on management because not only does RDEB-mitis require no immunosuppressant, measures to minimize blister formation is more important to save patient from complication.
Microbioma in Aging Skin Nugraheni Pasaribu, Uly Aanda Maria; Rihatmadja, Rahadi; Yusharyahya, Shannaz Nadia; Widaty, Sandra; Legiawati, Lili; Pandjaitan-Sirait, Sondang MHA
Journal La Medihealtico Vol. 5 No. 3 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i3.1315

Abstract

Microbiota is inseparable to the skin. Just as in the gastrointestinal tract, the skin microbiome reflects the health of the organ where it resides. It contributes to skin barrier function and ensures its homeostasis. However relatively stable over time, microbiome composition and number may be influenced by various aging -related changes − dryness, blemish, wrinkles and alteration of sebaceous gland activity impacting the skin ecological conditions − and vice versa. Several generations have been reported to promote the process while others may play a more protective role in this regard.
Markedly clinical improvement of papulopustular rosacea with multimodality therapeutic approach: a case report Priyanto, Mufqi Handaru; Wardani, Amanda Nandi; Legiawati, Lili; Sitohang, Irma Bernadette Simbolon; Suseno, Lis Surachmiati
Bali Dermatology Venereology and Aesthetic Journal BDVAJ - Volume 6, Issue 1 (June 2023)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/85p5m842

Abstract

Introduction: Rosacea is a chronic inflammatory skin disease that mainly affects the central area of the face. There are four subtypes, and they may progress between subtypes or span multiple subtypes. Due to its long course of the disease, optimum treatments are needed to control the disease progression. Case: We reported rapid improvement of combining topical metronidazole, doxycycline, and light emitting diode for treating a patient with papulopustular rosacea in a 44-years-old woman, a week from the initial therapy. Discussion: Therapeutic approaches to rosacea mainly focus on controlling the symptoms with anti-inflammatory agents. More recently, photodynamic therapy, especially light-emitting diodes, has been introduced as a valid alternative or an adjuvant therapy to conventional treatment through their synergic mechanism between therapeutic modalities. Conclusions: This combination treatment may be effective for treating papulopustular rosacea without any side effects.
Inhibitor Transient Receptor Potential Vanilloid Type 1: Penggunaan Topikal pada Berbagai Dermatosis Muhammad, Parikesit; Paramitha Wibawa, Larisa; Keumala Budianti, Windy; Legiawati, Lili; Menaldi, Sri Linuwih; Rosdiana, Dewi Selvina
Jurnal MedScientiae Vol 3 No 2 (2024): August
Publisher : Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/JMedScientiae.v3i2.3179

Abstract

Transient receptor potential vanilloid type 1 (TRPV1) plays an important role in the pathophysiology of pruritus and pain. TRPV1 inhibitors can reduce the sensation of itching and pain by blocking nociceptive signals from peripheral nerve fibers to the central nervous system. Topical TRPV1 inhibitors is also thought to improve skin barrier function. Therefore, TRPV1 inhibitors are considered as potential therapy in various dermatoses. Topical TRPV1 inhibitors that are currently being studied are asivatrep for atopic dermatitis and trans-4-tert-butylcyclohexanol for various dermatoses associated with sensitive skin. Further studies with better quality and longer duration are needed to assess the efficacy and safety profile of TRPV1 inhibitors.
Co-Authors Adistri, Kara Andhira, Vega Andira Hardjodipuro Hardjodipuro Barros, Terlinda Batubara, Irwan Bianti, Marsha Chairista, Inadia Putri Chandrakesuma, Vivianne Christine Lieana Devi Arofah Dewi Lestarini Eliza Miranda Endi Novianto Evita H. Effendi Eyleny Meisyah Fitri Fauziah, Siti Nurani Fifi Mifta Huda Gunardi, Keiko Yolanda Halim, Dionisius Ivan Yonathan Hanny Nilasari Hartanto, David Dwiadiputra Hoemardani, Aida SD Huda, Fifi Mifta Ika Anggraini Ilyas, Nabila Chalisya Imelda Wihadi Inadia Putri Chairista Indah Widyasari Irawan, Yudo Irma Bernadette Irma Bernadette Joanne Natasha Jonlean, Reganedgary Joses Saputra Krisanti, RR Inge Ade Kusmarinah Bramono Kusumawardhani, Dina Larisa Paramitha Lis Surachmiati Marizki Ramadhani, Reinanda Marsha Bianti Melody Febriana Andardewi Menaldi, Sri Linuwih Susetyo Wardhani Mochamad H Azis Muhammad, Parikesit Mutiara Ramadhiani Nadia Yusharyahya, Shannaz Natalia Rania Sutanto Novita Suprapto Nugraheni Pasaribu, Uly Aanda Maria Oktarina, Caroline Pandelaki, Paulus Anung Anindita Priyanto, Mufqi Handaru Puteri, Fathirah Rahmatiah Putu Martha Gerynda Sukma Rahadi Rihatmadja Rahadi Rihatmadja Randy Satria Nugraha Rusdy Reshinta, Reisa Rheza, Agung Mohamad Rinadewi Astriningrum Roro Inge Ade Krisanti Rosdiana, Dewi Selvina Sampurna, Adhimukti T Sandra Widaty Sarah Qanita Edwar Shannaz Nadia Yusharyahya Sirait, Sondang Panjaitan Siskawati, Yulia Siti Nurani Fauziah Sitohang, Irma Bernadette S. Situmeang, Irhen Sondang P Sirait Sondang P. Sirait Sri Adi Sularsito Sri Adi Sularsito Sri Adi Sularsito Sri L. Menaldi Sujudi, Yufanti Surachmiati Suseno, Lis Suseno, Lis Surachmiati Terlinda Barros Valdi Ven Japranata Vivianne Chandrakesuma Wahyudi, Danang T Wardani, Amanda Nandi Widyasari, Indah Wihadi, Imelda Windy Keumala Budianti Wresti Indriatmi B. Makes Yudo Irawan Yudo Irawan Yudo Irawan