The efficacy of intense pulsed light and heat energy therapy compared to benzoyl peroxide gel 2.5% in the treatment of mild and moderate acne vulgaris

The use of technology-based light therapies such as intense pulsed light and heat energy(IPL) provides an alternative therapy for patients with acne. However, clinical evidenceis required to evaluate the efficacy and safety of the IPL. This study aimed to evaluate theefficacy of IPL compared to benzoyl peroxide (BP) as standard therapies in patients withacne vulgaris. The study was conducted with randomized controlled trial parallel designinvolving patients with mild and moderate acne vulgaris. Acne severity was determined bythe method of Combined Acne Severity Classification (CASC). Statistical analysis usingrepeated measurement analysis of variance was conducted to assess the reduction inlesions and number of P. acnes in each group followed by independent t-test to compareof both groups. A p value <0.05 was considered significant. Sixty-two patients withmild and moderate acne vulgaris were enrolled in this study and treated with IPL (32patients) and with BP gel 2.5% (30 patients). Two patients from the IPL were droppedout. All subjects showed improvement in acne lesions. Reduction of the number ofnon-inflammatory lesions at IPL therapy group was not significantly different than theBP gel 2.5% at week 2 (p=0.705) and 4 (p=0.186). Reduction in the numberof inflammatory lesions in the IPL treatment group was not significantly different than BPgel 2.5% at week 2 (p=0.604) but significantly higher at week 4 (p=0.003). Thereduction of P. acnes colonization in the IPL group was significantly higher than BP gel2.5% group at week 2 (p=0.000) and 4 (p=0.000). In conclusion, the efficacy of IPLin the reduction of the number of inflammatory lesions and the P. acnes colonization isbetter than BP on patients with acne vulgaris

The effect of mangan and lithium on peripheral blood mononuclear cell viability after exposure of narrowband ultraviolet B in psoriasis patients

Psoriasis is a chronic and recurrent inflammation skin disease characterized with hyperproliferation of keratinocytemediated by T cell lymphocytes. Climatotherapy (bathing and sunbathing) at Dead Sea is model therapy which iseffective for moderate and severe psoriasis. However there are group of psoriasis patients who are not responsiveto climatotherapy. The success of the model therapy was based on the influence of ultraviolet irradiation whichcauses depletion of lymphocytes, macrophages, and dendritic cells of the skin. Patients who are not respond toclimatotherapy shown to have higher level of mangan (Mn) and lithium (Li) serum than responsive patients. Manganand Li were suspected influenced the viability of peripheral blood mononuclear cells (PBMC). The aim of the study isto evaluate the effect of Mn and Li levels on the viability of PBMC in the serum of psoriasis patient after exposureof narrowband UVB (NB-UVB). The PBMC were isolated from 6 psoriasis patients using Histopaque. Then the cellsisolate wasincubated in RPMI medium with 0.02 to 0.08 μmol/LMn and 0.08 to 0.1 μmol/L Li for 3 days. After thatthe cells were irradiated once with 1/3 to 2 minimal erythem dose (MED) of NB-UVB. The PBMC viability wasmeasured 3 hours after irradiation with MTT assay and read with ELISA plate reader. The results showed thatincreased levels of Mn and Li or combination did not affect on the viability of PBMC at 1/3 to 1 MED UV-UVB. Butat higher irradiation dose (2 MED), the higher level of Mn and Li had negative affect in the viability of PBMC afterirradiation. It could be concluded that the Mn and Li level in the serum did not affect the viability of PBMC afterirradiation of NB-UVB. It was suggest that other cellular component that involved in the development of psoriasislesions, such as dendritic cells, fibroblasts, macrophages, and keratinocyte, were associated with Mn and Li levels.Key words: psoriasis – mangan – lithium - peripheral blood mononuclear cel

The efficacy of captopril and 5-fluorouracil combination in the proliferation and collagen deposition of keloid fibroblast

Keloid is a benign fibroproliferative tissue growth that exceeds the initial wound margins. Captopril has been tested in vitro to reduce fibroblast proliferation and collagen deposition; thus, it has potential for use in the treatment of keloids. Meanwhile, 5‐fluorouracil (5‐FU) has already been used in keloid management. This study aimed to determine the efficacy of the combination of captopril and 5‐FU in keloid fibroblast cultures. Keloid tissues were cultured up to passages 4–7. The study consisted of a control group, captopril in various concentrations (10‐2, 10‐3, 10‐4, and 10‐5 mol/L), 5‐FU 1 mg/mL and a combination of captopril at various concentrations with 5‐FU 1 mg/mL. After 144 hours of treatment, fibroblast proliferation and collagen deposition were measured. The study showed a significant decrease in the mean index of fibroblast proliferation and collagen deposition in the group receiving captopril in various concentrations (10‐2, 10‐3, 10‐4, and 10‐5 mol/L) and the 5‐FU group against the control group (p<0.05). In the combined‐dose group, captopril at a concentration of 10‐2 mol/L and 5‐FU showed a significant reduction in fibroblast proliferation and collagen deposition compared to the 5‐FU group and the captopril at the same dose (p<0.05). In conclusion, the combination of captopril 10‐2 mol/L and 5‐FU 1 mg/mL is better at reducing fibroblast proliferation and collagen deposition in keloid fibroblast cultures than captopril or 5‐FU as a single therapeutic agent

Low CD4+ T cell counts are not risk factor for Malassezia species infection in HIV/AIDS patients

Human immunodefiiency virus (HIV) infection and aquired immunodeficiency syndrome (AIDS)cause a progressive depletion of CD4+ T cell populations accompanied by progressive impairmentof cellular immunity and increasing susceptibility to opportunistic infections. Seborrheic dermatitisis one of the most common skin opportunistic infections on HIV/AIDS patients. Malasseziaspecies is bilieved as the causative of seborrheic dermatitis. The aim of the study was to evaluatelow CD4+ T cell counts as risk factor for Malassezia sp. infection in HIV/AIDS patients. This wasan observational study with cross-sectional design conducted on HIV/AIDS patients who attendedin Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta and met the inclusion and exclusion criteria. Culture ofMalassezia sp. was conducted in Department of Microbiology and classified as high (>100 CFU/tape) and low (200 cells/mm3) and low (60 years were involved in the study. The number of Malassezia sp. colonyon subjects with high and low CD4+ T cell counts were 31.55 ± 26.21 and 25.2 ± 33.89 CFU/tape, respectively. No significantly relationship between between CD4+ T cell count and Malasseziasp. colony number was observed in the study (p=0.607; 95%CI=0.04-5.19; RP=0.452). Inconclusion, low CD4+ T cell counts is not risk factor for Malassezia sp. infection in HIV/AIDSpatients

The effect of mangan and lithium on peripheral blood mononuclear cell viability after exposure of narrowband ultraviolet B in psoriasis patients

ABSTRACT Psoriasis is a chronic and recurrent inflammation skin disease characterized with hyperproliferation of keratinocyte mediated by T cell lymphocytes. Climatotherapy (bathing and sunbathing) at Dead Sea is model therapy which is effective for moderate and severe psoriasis. However there are group of psoriasis patients who are not responsive to climatotherapy. The success of the model therapy was based on the influence of ultraviolet irradiation which causes dppletion of Iymj:>hocytes, macrophages, and dendritic cells of the skin. Patients who are not respond to climatotherapy shown to have higher level of mangan (Mn) and lithium (Li) serum than responsive patients. Mangan and Li were suspected influenced the viability of peripheral blood mononuclear cells (PBMC). The aim of the study is to evaluate the effect of Mn and Li levels on the viability of PBMC in the serum of psoriasis patient after exposure of narrowband UVB (NB-UVB). The PBMC were isolated from 6 psoriasis patients using Histopaque. Then the cells isolate was incubated in RPMI medium with 0.02 to 0.08 J.lmol/L Mn and 0.08 to 0.1 J.lmol/L Li for 3 days. After that the cells were irradiated once with 1/3 to 2 minimal erythem dose (MED) of NB-UVB. The PBMC viability was measured 3 hours after irradiation with MTT assay and read with ELISA plate reader. The results showed that increased levels of Mn and Li or combina~ion did not affect on the viability of PBMC at 1/3 to 1 MED UV-UVB. But at higher irradiation dose (2 MED). the higher level of Mn and Li had negative affect in the viability of PBMC after irradiation. It could be concluded that the Mn and Li level in the serum did not affect the viability of PBMC after irradiation of NB-UVB. It was suggest that other cellular component that involved in the development of psoriasis lesions, such as dendritic cells, fibroblasts, macrophages, and keratinocyte, were associated with Mn and Li levels. Key words: psoriasis - mangan - lithium - peripheral blood mononuclear cel

Successful Treatment of Actinomycetoma with Combination of Cotrimoxazole and Tetracycline

Background: Actinomycetoma is an infection of chronic granulomatous disease on the skin, subcutaneous tissue, fascia, and bone, occured after trauma because of bacteria innoculation. Clinical features seem painless nodules, abscess, fistula, and sinus  with granulated discharge.Gold standard treatment for actinomycetoma is cotrimoxazole. Combination therapy with other antibiotic is needed to prevent resistance and improve therapeutic efficacy. Purpose: To discuss successful treatment of actinomycetoma with combination of cotrimoxazole and tetracycline Case: A 19-years-old woman had complained of  chronic post-traumatic wounds since two years ago. Dermatological examination showed multiple painless nodules, sinus, and discharge on right dorsum pedis. Histopathological examination demonstrated sinus in dermis, suppurative granulomas, and SplendoreHoeppli phenomenon in dermis layer. Case Management: Combination therapy consist of cotrimoxazole 2x960 mg, that was given for 6 months and tetracycline 4x500 mg, that was given in the first 1 month.  No side effects and drug allergy during and/or post treatment was found. After clinical evaluation for 6 months, successful of treatment  was obtained and no recurrence was found. Conclusion: The combination therapy of cotrimoxazole for 6 months and tetracycline for 1 month was proven to be effective and no recurrence was found. Key words: actinomycetoma, cotrimoxazole, tetracycline

The role of Malassezia sp, sebum level and Trans Epidermal Water Loss (TEWL) toward the dandruff severity between hijab and non hijab wearing subjects

Dandruff is a common symptom in adolescence, which possibly due to increasing ofMalassezia sp. colonization, sebum level as well as skin hydration. Wearing hijab ispredicted to increase the humidity and sebum level lead to increase the number ofMalassezia sp. and dandruff severity. A case-control study was conducted on 19 femalewith dandruff who wear hijab and 19 female with dandruff who do not wear hijab, agebetween 18 and 27 years old. The dandruff severity was defined clinically using ascoring system (0-100), only subjects with minimum score of 28 will be included in thisstudy. The sebum and trans epidermal water loss (TEWL) levels were measured withSebumeter and Tewameter from Courage Khazaka. The Malassezia sp. was examinedusing microscopic examination of the squama and culture in the Saboraud medium.There were no significant differences found between hijab and non-hijab groups fordandruff severity. No difference found between two groups for sebum level, Malasseziasp. number microscopically, and Malassezia sp. colonization. Only TEWL level in hijabgroup that was found to be higher than non-hijab group. Wearing hijab does not increasethe dandruff severity, sebum level and colonization number of Malassezia sp. Wearinghijab is found to increase the TEWL level

Tinea corporis caused by microsporum canis in children with HIV

Introduction: Tinea corporis is a glabrous skin fungal infection mainly affecting children and immunosuppressed patients. The clinical feature of tinea in HIV patients shows mild inflammation that resembles other dermatoses. This report aims to establish the diagnosis and therapy choices promptly. Case: A 15-year-old boy with HIV and pulmonary TB came with complaints of itchy small red papules, exacerbated by sweating. These lesions extend almost all over the body. Dermatological examination of the chest, abdomen, back, arms and hands, and both legs showed multiple erythematous papules with annular configuration and the elevated border with scales over the erythematous base. KOH examination revealed the culture's long septate hyphae and colonies of the fungus Microsporum canis. Tinea corporis was diagnosed, and the patient was treated with oral griseofulvin and topical ketoconazole. Discussion: Microsporum canis is the third most common causative organism and is associated with 14% of cases of tinea corporis. These annular lesions resemble centrifugal erythema annular and generalized annular granulomas. A fungal culture examination was performed to confirm the diagnosis, and the tinea species were identified. Terbinafine, itraconazole, fluconazole and griseovulfin are the treatment options for tinea corporis with HIV. Conclusion: Definitive diagnosis and exact identification of the causative organism of tinea corporis could be determined by culture. Griseofulvin is still used to treat tinea, especially in liver function problems

Tinea corporis caused by microsporum canis in children with HIV

Tinea corporis is a glabrous skin fungal infection mainly affecting children and immunosuppressed patients. The clinical feature of tinea in HIV patients shows mild inflammation that resembles other dermatoses. This report aims to establish the diagnosis and therapy choices promptly. A 15-year-old boy with HIV and pulmonary TB came with complaints of itchy small red papules, exacerbated by sweating. These lesions extend almost all over the body. Dermatological examination of the chest, abdomen, back, arms and hands, and both legs showed multiple erythematous papules with annular configuration and the elevated border with scales over the erythematous base. KOH examination revealed the culture's long septate hyphae and colonies of the fungus Microsporum canis. Tinea corporis was diagnosed, and the patient was treated with oral griseofulvin and topical ketoconazole. Microsporum canis is the third most common causative organism and is associated with 14 of cases of tinea corporis. These annular lesions resemble centrifugal erythema annular and generalized annular granulomas. A fungal culture examination was performed to confirm the diagnosis, and the tinea species were identified. Terbinafine, itraconazole, fluconazole and griseovulfin are the treatment options for tinea corporis with HIV. Definitive diagnosis and exact identification of the causative organism of tinea corporis could be determined by culture. Griseofulvin is still used to treat tinea, especially in liver function problems. © 2022 Pakistan Association of Dermatologists. All rights reserved