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GAMBARAN DEPOSISI KOLAGEN TIPE I TERHADAP USIA TIKUS GALUR WISTAR: PENELITIAN IN VIVO Frieda Yanuar; Indah Julianto; Nugrohoaji Dharmawan; Arie Kusumawardani; Novan Adi; Endra Yustin Ellistasari
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 5 No 2 (2022): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (379.183 KB)

Penuaan kulit merupakan akumulasi berbagai perubahan progresif yang terjadi pada sel dan jaringan kulit. Kulit manusia terdiri matriks ekstraseluler (MES) dermal dengan protein penyusunnya adalah kolagen. Selama penuaan, kolagen tipe I mengalami perubahan organisasi dan struktural, penurunan sintesis protein MES, dan terjadi peningkatan degradasi metaloproteinase mengakibatkan hilangnya kekuatan mekanik. Studi menunjukkan peran penurunan fungsi penghalang kulit terkait usia dalam penuaan pada tikus. Tujuan penelitian ini untuk mengetahui deposisi kolagen tipe I berdasarkan usia pada jaringan kulit tikus Wistar. Desain penelitian merupakan observasional analitik cross-sectional. Penelitian menggunakan tikus Wistar yang telah memenuhi kriteria inklusi dan eksklusi. Tikus dikelompokkan menjadi kelompok usia 3 bulan, 6 bulan, 12 bulan, dan 18 bulan. Pengambilan jaringan kulit dengan biopsi plong dilanjutkan pembuatan preparat dengan pewarnaan Trichome masson. Perhitungan deposisi kolagen dilakukan pada area berwarna biru dan diinterpretasikan (%) menggunakan software ImageJ. Rerata persentase deposisi kolagen terbesar pada kelompok usia 3 bulan dengan nilai 57,6±0,17% dan 57,5±0,43% pada pembesaran 40x dan 100x. Persentase deposisi kolagen terendah terdapat pada kelompok usia 18 bulan dengan nilai 12,1±1,6% dan 6,9±0,52% pada pembesaran 40x dan 100x. Pada penelitian ini dapat disimpulkan bahwa terdapat penurunan deposisi kolagen jaringan kulit tikus Wistar seiring dengan pertambahan usia akibat proses penuaan, dengan deposisi kolagen jaringan kulit tikus Wistar kelompok usia muda lebih besar dibandingkan kelompok usia yang lebih tua. DOI : 10.35990/mk.v5n2.p183-194

TERAPI PSORIASIS DI MASA PANDEMI COVID-19 Siti Efrida Fiqnasyani; Arie Kusumawardani
Media Dermato-Venereologica Indonesiana Vol 50 No 2 (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.v50i2.315

Psoriasis is a chronic residive inflammatory skin disease caused by an autoimmune process. The worldwide prevalence of psoriasis ranges from 2-3% with the prevalence in Asia tends to be low, which is less than 0.5%. Psoriasis consists of erythematous scaly plaques and occurs most commonly on the elbows, knees, scalp, and lower back. Because of the reported frequent recurrences, psoriasis requires maintenance therapy in the form of systemic therapy such as retinoids, methotrexate, alefacept, and efalizumab. Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is highly contagious. The COVID-19 pandemic has a negative impact on psoriasis management and healthcare delivery. Infection of COVID-19 and its related medications can also affect the clinical severity and exacerbation in patient with psoriasis. Inadequate management of COVID-19 can trigger a cytokine storm and cause acute respiratory distress syndrome (ARDS), sepsis, and other complications. COVID-19 patients who experience a cytokine storm with elevated IL-6 and IL-17 may potentially experience psoriasis exacerbations. Biological therapy for psoriasis during pandemic should be carefully considered according to the individual patientâ€™s condition.

Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris Lidjaja, Lifesia Natali; Muhammad Eko Irawanto; Nur Rachmat Mulianto; Arie Kusumawardani; Ivani; Vrenda Alia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 10 (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.v8i10.1104

Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV. Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity. Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05). Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.

Terapi Probiotik pada Akne Vulgaris Reti Anggraeni; Arie Kusumawardani
MEDICINUS Vol. 34 No. 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Acne vulgaris (AV) is a skin chronic inflammatory disease that affects pilosebaceous unit and results in non-inflammatory abnormalities in the form of open comedones (blackhead) and closed comedones (whitehead) and also inflammatory lesions such as papules, pustules and nodules. Many factors contribute to the pathogenesis of AV including skin microbiomes like Propionibacterium acnes (P. acnes) and Malassezia spp. which is associated through its effect on sebum secretion, comedones formation and inflammatory response. Antibiotic therapy with the target of P. acnes has long been the mainstay of AV therapy where it can actually affect the composition of skin microbiomes. As antibiotic resistance increases, knowledge of skin microbiomes associated with AV becomes very relevant and important to be an alternative basis for AV alternative therapy.

Peran Balneoterapi pada Psoriasis Putri Oktriana Rachman; Budi Eko Prasetyorini; Nathania Amelinda; Fatimah Fitriani; Arie Kusumawardani
MEDICINUS Vol. 35 No. 2 (2022): MEDICINUS
Publisher : PT Dexa Medica

Psoriasis is a chronic recurrent inflammatory disease influenced by several risk factors, including genetics, immune system, environment, and hormones. Skin lesions associated with psoriasis are well-defined erythematous plaques covered in thick, layered, white scales. Psoriasis treatment varies according to the severity of the condition and may include topical or systemic medications, light therapy, or natural elements such as minerals and balneotherapy. Balneotherapy may be used in conjunction with other treatments for psoriasis due to its efficacy in healing psoriasis lesions, particularly plaque forms. Balneotherapy is a traditional medicinal treatment that involves bathing, drinking, or inhaling mineral-containing water. Mineral sources include mineral water, mineral mud (peloids), and natural gas from natural springs. Balneotherapy can thin the stratum corneum and lucidum, decrease the number of lymphocytes, histiocytes, granulocytes, and eosinophils, increase skin permeability, decrease inflammation, improve microcirculation and the skin immune system, and decrease pro-inflammatory cytokines in psoriasis. This article aims to explore the efficacy of balneotherapy as adjuvant therapy for psoriasis to accelerate clinical improvement and reduce disease recurrence.

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

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.

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

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.

The Differential Biopsychosocial Burden of Psoriasis and Vitiligo: A Comparative Analysis of Participation Restriction and its Clinical and Psychiatric Correlates Nurrachmat Mulianto; Shelly Lavenia Sambodo; Muhammad Eko Irawanto; Arie Kusumawardani
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.805

Visible skin diseases like psoriasis vulgaris and vitiligo impose a significant psychosocial burden. However, the comparative impact on real-world functioning and the interplay of clinical, social, and psychiatric factors remain poorly understood, particularly in non-Western populations. This study aimed to quantitatively compare participation restriction between these two conditions and to identify its key biopsychosocial predictors. This comparative cross-sectional study, conducted in a tertiary Indonesian hospital, enrolled 50 patients (25 with psoriasis vulgaris, 25 with non-segmental vitiligo). The primary outcome was participation restriction, measured by the 18-item Participation Scale (P-Scale). Clinical severity was assessed using the Psoriasis Area and Severity Index (PASI) and Vitiligo Area Scoring Index (VASI). Crucially, depressive and anxiety symptoms were screened using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale, respectively. A hierarchical multiple linear regression analysis was performed to identify predictors of participation restriction. Patients with psoriasis reported profoundly higher mean P-Scale scores (43.16 ± 5.01) compared to those with vitiligo (25.72 ± 4.21; p < 0.001), indicating more severe restrictions. Psoriasis patients also exhibited significantly higher scores for depressive symptoms (PHQ-9: 11.52 ± 3.18 vs. 5.68 ± 2.29; p < 0.001) and anxiety symptoms (GAD-7: 10.24 ± 2.95 vs. 5.12 ± 2.15; p < 0.001). The hierarchical regression model was highly significant (F(7, 42) = 28.14, p < 0.001), explaining 82.4% of the variance in P-Scale scores. After controlling for demographic and clinical factors, a diagnosis of psoriasis (β = 0.45, p < 0.001), higher clinical severity (β = 0.28, p = 0.002), and higher depressive symptom severity (PHQ-9 score; β = 0.39, p < 0.001) were significant independent predictors of greater participation restriction. In conclusion, psoriasis vulgaris is associated with a dramatically greater burden of participation restriction than vitiligo. This burden is driven by a complex interplay of the disease's clinical severity, its inherent diagnosis-specific factors, and, critically, comorbid depressive symptoms. These findings underscore the necessity of a biopsychosocial approach in dermatology, advocating for routine mental health screening and integrated care models to address the multifaceted drivers of disability in patients with chronic inflammatory skin disease.

The correlation between patient satisfaction treatment of narrowband ultraviolet B phototherapy and the improvement of psoriasis severity index Putti Fatiharani Dewi; Ambar Aliwardan; Arie Kusumawardani
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 4 No. 1 (June 2021)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/x6wxtf63

Background: Psoriasis is a chronic inflammatory disease of the skin affecting patients of all ages, both males and females. Currently, the psoriasis area and severity index (PASI) method is the gold standard in assessing the severity of psoriasis. Phototherapy narrowband ultraviolet B (NBUVB) is one of the modalities of psoriasis therapy which is relatively safe and effective for repairing psoriasis lesions. Patient satisfaction with phototherapy, which can be assessed using a questionnaire, serves to determine the patient's motivation in carrying out routine therapy. Objective: This study was designed to determine the correlation between the level of NBUVB phototherapy satisfaction with PASI improvement. Method: The study subjects were 22 plaque-type psoriasis vulgaris patients who underwent NBUVB phototherapy from May 2018 to October 2018 in the dermatovenereology outpatient clinic of Dr. Moewardi Hospital Surakarta. Subjects filled in the Treatment Satisfaction Questionnaire for Medication (TSQM) included questions about satisfaction with NBUVB phototherapy, and PASI scores were measured before and after NBUVB phototherapy. Results: The data were analyzed with the Pearson correlation test with a significance value of p <0.05. There are significant differences between PASI before and after giving 24 times phototherapy with a value of p<0.05. Conclusion: There was a significant correlation between the degree of PASI improvement and the global patient satisfaction with NBUVB phototherapy

Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris Lidjaja, Lifesia Natali; Muhammad Eko Irawanto; Nur Rachmat Mulianto; Arie Kusumawardani; Ivani; Vrenda Alia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 10 (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.v8i10.1104

Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV. Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity. Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05). Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.

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