Anda di halaman 1dari 5

Artikel Asli

KORELASI ANTARA RESPONS PIGMENTASI AKIBAT PAJANAN


MATAHARI DENGAN DERAJAT PARUT AKNE VULGARIS

Istiana Fiatiningsih, Kristiana Etnawati, Agnes Sri Siswati

Bagian/SMF Ilmu Kesehatan Kulit dan Kelamin


FK Universitas Gadjah Mada/RSUP dr. Sardjito Yogyakarta

ABSTRAK


  

       

  

 


     
    
     


   
 

  

 
    
peningkatan produksi matriks metaloproteinase yang mendegradasi kolagen sehingga terjadi
    
 


 

  
  
pigmentasi kulit.


    
  

         
 

   
 

              
 !"#$

  


     
 
 % & '()) 
 *
  
 
 
    
 
 
 
 
     
  

+

     
  -
 
01
 
0112
  
  230, 0 ,4++60  ,7348 dan
hitung morfologi parut.
3
 4#
    
 5
   
 3
 6""7
 
  
  
 
01+8"""#98"$:!-  
0111
+8""""98"$;!-
 
 
+<=3>-     + '

 '?'   '-
     
 
  
 
  
 
 
parut akne.

Kata kunci: Pajanan sinar matahari, respons pigmentasi, parut akne, parut makula

ABSTRACT
='
' '

'  
  ' 
 

?'
 @
   
(''
'    3  
?
 '

 '


   
  increases production of matrix metalloproteinase that
degrade extracellular matrix collagen causing of atrophic scar formation. Sunlight exposure cause
melanogenesis resulting in skin pigmentation.
C
   


'
  
*

  
?


 
 
  * '
'
@
 ='
'     
'
!"#$
*' '
   @

@




'

@ ())% & ' 

without using cosmetic products containing whitening, sunscreen and acne medication in the last
 3  
?
*



' 

+
?
   
?

-

01@
 
0111@
<='
3'> '  +<=3>- '
count were measured.
D 

*

 '
@
*


?'
5
 3
 '
  


*

'
  
*


01@
+8"""#8"$:!- 
0111@
+8""""
Koresponsdensi : 8"$;!-* <=3> '  ''+ '
 '?' '-

 
C
   
?


  
  '

* '
'
   
  
 
!"#$%!!"&$'$
severity.
(!"#$%!
)*+ ,- . /0  Keywords: Sunlight exposure, skin pigmentation, acne scars, macular scars

51
L2)( )N$O!C !"#:97#77

PENDAHULUAN ,  , ;<+ -  + < ;   .



3, ;< +.
, 
,, ,+

, 2<.,<
,<++.? ,E& Penelitian
<, 
 + 2+ <+, , ,, +, ,#,=+  , , - 
?,,  .  7, <<   ,,
2 <
   ,> < +,=+2 <


<
<+ < +
,+
 , +8 .

, 2<., +, ,
,, <+,
 2  2, ,?? ,,
 < 1  , 22,
 < , 2 <
,.
,
@ <  ,   <
,  
+ ,  ;< + ,
? , <+,+ < <  +
+< 2  BAHAN DAN CARA
,-+  + ,  + ., 

<2., A , @ ,  ,, ,<,, ,0,,
,, ,
+ <  < <,,+, 2 2  ,,< 
+<2? #,

<, ,,, ;< +
, +   ,2 ,,, <,,+ ,  ?  ,,.,+, 2  2 + ,+6+
 ,2<,+ +
+  +,+ +  + , dapat 3++C
<='
< 3
-20 
<,
?
 &$B +<+ ,  , + <  ?  , 4 
 <  DJ , J ,
 A 
,<,,
<
@+ <
   
+ ,, D,
 ,  + , ,,<,R 
< . 2 +< ,
 
+
 <  ,  + 2 +  !%"B  ,,  ? 
, 2 ,, + <2<, . @ ,2,
,,%&%B+ ,'EB,2  B5 Pasien akne sampel dilakukan secara consecutive samplingJ 2 
 ,, 
<  
2 +  2.2 +  ?
 <  2 2+.?<.
?,, . , 2 ,
, 2,,, 
< 
< ., 2.+ , ? +
,+
 , +  +
,+
 , + << 
.

 , +6,7  ,<,,   Chromameter4S" 
) 
  , ++
 <  ,  2 <  .< + 0   ,0,  
,@ ,<< ,<,
 

+  
, 2  ,  ,, ,-+ , terpajan matahari (dahi) dan area non-pajanan matahari
2  2.,
  + , 8 + ., ?  <+, 7 ,, +2, 8
 ,
    
-  ,
- < 
 + 2+ <+& Pajanan matahari W  2W,  WW2WJ 2  , <,.
,  ,,<, + < ;   7J8  <
,  ? 
 < , ,<<  ,,+ <='


, 22< 
+ + ,  , ++, ,.+, Scarring Classification 734821 , . <,  -  

 , + < 10 @ , + <   <


, +
,+
 < @ ,,34<< 2 + ,< 
+
-
 -  ,, <, <  ,0 .  <+, MN3 

 < ,?<.
 < @ ,, 

 <  
< *
+
?  '
' ' - +   2A., 2  + < > - ,, 7, E8  - + , 7, 8
JEE#E     
  <,, <, <  ,<< 
 <   - 2    '
J

 7, 8

 , +< 2 


?,,J+ 0 <,   -, + ,,  +
 <   .

+ 

<  7, 8 ,
2?  -14
 < .
6>  7,%8 ,, ? ?<.
@?,, + J 
,  , 22, lesi meliputi: lesi 1-10 (nilai 1), lesi 11-20 (nilai 2), dan lesi

2 , <,2 2  ,+ ,


,=+ X7,8@ ,, 2 ,? ?  ,,7E#
, 2 , <reactive oxygen species 7O8,, %8 ? + ,7!#E'8 ? 2  7E&#%8213,++
 , 22, <+,MN32
+   , +  +  +   ,<,, ,++ 2;    <+#Y+

 + <
<, +  ,   +15 Oksidasi <, < , .<.<2<,,; 2 <+? ,+ ,
 
, ,+ 2<  .
?,, . , , ;+  2+,  ,0 ? A , ? 
 .,, 
mediator inflamasi dan kemoatraktan sel proinflamasi 7<<   ,, 3+8 .
  ? 
 <  , 
,, 
2< <
+ +,=+ +, @ + +  ,, ,  ,, pZ$ ?  + 
 ,
,-+ , 2  2., ,   , <.
+ + <,, <, <  , .< .<2<,, ,   ?<.

, 2<.,  + ,  + ., 2 +  2<


 < 
?,, . ,<<  ,, +
,+
 , +
 616,17  ,, ? 
 < , 2 + ,34,. <,
@?,, J  ,, ,
<+  +  -  
 <   ,, ,  ,, p<0,05 dan
 
,+  7@8  . -2 2+ ,   , +   < ,.<2<,, ,, 6+ , +7 8@ ,  ,
pada kulit manusia secara in vivo, <
,
+  +<. + <?<  .    )  < +    ,
,
  ,  +  ,18@ ,, ,  + ,; + +?.  
  ,  . + + + <  <
,
, 22

 <  6 , <


?,, +J+ ,,
 HASIL PENELITIAN
2 - ,  -

, 2<.,<,
,
,
 +  +  @+ ,
+02 . + , ,?< , Karakteristik subjek
<, < ,., 
?,, .  
, 2<., Penelitian ini dilakukan di Poliklinik Ilmu Kesehatan
<  ,<  +
<,  ,
,  , < , ,@  ?   + 

52
Q
  
  
      
 
I Fiatiningsih, dkk. derajat parut akne vulgaris

2<, <,#O 2  E M


 , 'E
+ , ,  b<2<,, ,   +
,+
 , +
?,,
;< +  ?  ,, ., +,  2  
.  .  ,, ? 
 < , <<  ,,+ 
2 + ,  ,<+, +<+
,  , , 34
Lima pasien tidak dapat diikutkan dalam analisis karena w + ,<? +
 ,.<2<,,,  
  ,
, + .,.,!% 
+ ,, +
,+
 , +
?,, .  .
 ? 
 < 
,+++  +   + +<2? 
,  ,
  , <<  ,,34
 . 2 E
. 
 2 E

Tabel 1.   +  +<2?  ,  ;< + ,   ,<.   
inklusi dan eksklusi di Poliklinik Ilmu Kesehatan Kulit dan
 ,@  ?   
  <,#O 2 
E

Subjek Jumlah (Persentase


+7 ,87,^+8 20 (17-27)
 ,+ ,
Laki-laki !7"'%'8
Perempuan &7$E8
 2+,  ,0 ? A
 64 (84,21)
 E7E$!&8
Gambar 1.  b<2<,, ,   +
,+
 , +
?,,  . 
Derajat keparahan akne
7,  W
yE,  WW2W
y8 ,,
M ?  ,, "7E$&8  ? 
 < , <<  ,,+ <='
3' 
M ? + , E'7%'8 Classification 
+<2? , ;< +@ ,D<
M ? 2  `+, 2  "7""!8  + . ,< , ,@  ?   
Derajat parut akne
  <,#O 2 E7+,6,?
Z${? +
M ?  ,, E!7!8 Spearman)
M ? + , $7%&!"8
M ? 2  %7!'&8 b<2<,, ,   +
,+
 , +
?,,
b <, -  
 <  .  ,, ? 
 < , <<  ,,. <,
Makula eritematosa 62 (81,58)  -  
 < ,
<.

 , + 7"EE8 Berdasarkan uji korelasi Spearman, didapatkan
<.

 , + E7E8 .<2<,, ,   +
,+
 , +
?,,  . 
('
 ' !7&EE8
<<   ,, ,    W , ,    WW2W
Boxcar %$7'$$8
Rolling scars '7%'"8  ,, ? 
 < , <<  ,,. <, -  
 +
,+
 , +7  qM8 parut atrofi ( '
 '?' ') tetapi tidak
Delta L* 'q"E$ 
 , .<2<,,  ,, . <,  -  
 < 
Delta a* !%qE! <7 2 8
M  2W E$qE%
M  WW2W &!qE Tabel 2.  b<2<,,,   +
,+
 , +
?,, .  ,,
 ? 
 < , <<  ,,. <, -  
 < , 
w + ,<? <+#Y+
 ,; 2 
+<2? , ;< +@ ,D< + . ,< 
,  , @    ?    
   <,#
jenis kelamin (p=0,001) dan derajat keparahan akne O 2 E
7
y8 2 2  + 0  2 ,
   

 ? 
 < , + ,,; 2 <+, 2+, Hitung morfologi parut akne
Variabel
  ,0  ? A   2 2  + 0  2 , ME MHiper MHipo Ice-pick Boxcar Rolling
Berdasarkan analisis post hoc ,,<?,,#Y. ,  Nilai delta p=0,674 p=0,452 p=0,128
yWW p=0,001**
yE&WW

 , ; 2  ? ,+  , 2 2  + 0  L* y"& r=0,087 r=0,176 y" y! r=-0,226
2 ,
   
  ? 
 <  ,,#+ , Nilai delta p=0,547
y&E!
yE&% p=0,004** p=0,001** p=0,082
7
yE8,  
 ?  ,,#2  7
yE8 L*a*b r=0,070 r=-0,012 r=0,150 y y$& r=0,201
M
 ,?<; 2  ? 
 .,, 2 2  ME:<  {Mhiper:<.

 , +{Mhipo: makula
+ 0  2 ,
   
  ? 
 <  ,,# .

 , +{WW+,6,
Z${? +
 ,
+ ,7
y8 ? 
 <  ,,#2  7
y8
, ? + ,#2  7
yE8

$
L2)( )N$O!C !"#:97#77

DISKUSI     ,<,,
    W  2W,
Parut akne pada penelitian ini didapatkan pada   WW2W!@
,  ,,
 ,.<2<,,
EB +<+ ,  ;< +
 + <  ?  ,  2 2,, < <+ ,   ,    W  ,,  ? 
@
,  , + 2 <, 
, 2.A
 < 
 <  ,  , <<   ,, +  34 7
yE{
,  
  ?
 &$B +<+ , 4 + ,,  y%8<
<, ,,. <, -  
 < 0 #
0
India pada 76,4% kasus akne,5,
"&B+<+,  7
y{ y"82 (0 7
yE{ y!8 ,+0 +
 @ ,0+22 Parut akne pada penelitian ini dijumpai 7
yE&{ y%8N  WW2W?<2 .<2<,,

#7"'%'B8,

<,7$EB8b+  ,, ? 
 .,
 < , ,<<  ,,

,  , + 2 <,  ,<,?<, , 2 ; + +  34 7


y y&8 <
<,  ,, . <,
 <b , ,
 < , ?<



<,  -  
 < 0 #
07
y" y8,2 (0 
57% dan laki-laki 48%, di India dijumpai parut akne 7
yE y$&8 b+
,  , ,  ,<,?<,



<,+ 2 + 'EB,#E!&B5 dan .<2<,, ,   ?<.
?,,  .  , << 
D, +
 ,
 < , E"B


<,,  ,, +
,+
 , + <   ,,  ?,
 < 
EEB
#24  6 +
<, 6+ , + .
M ? 
 < , 

,  ,, 2,. @+ ,,  ,, 
<  
0 , <,2 + 
 ? + ,7%&!"B8<  ?  ,,7!B8  ,
 ,
 <  .

 , + ,  2. ,
, ? 2  7!'&B8 <
   
+ ,,  2,,, 
 <  ,% ,  ,  ,,
 D,  , <,  
+
 <   ,,  ?  - 
?,, . @
,  ,,
 < <
,,
%&%B ? + ,'EB, ? 2   .

 , + ?<

 "EEB +<+ @?,,
B5+ ,,+ <D 
 ,
 <  ,,  .  , <<   ,, +
,+
 , +   
 ?  ,,#+ ,+ 2 + 'E&B25 Pada penelitian W,  WW2

,  ,, 2 .<2<,,
, -  
 <  
< <,
&%$B  ,,
 <  
< 
2 .<2<,, ,,
 < 
 ,,<  'E$'B<.

 , +  - @ <  
 <   ,<,?<,
<2.,
"EEB , < .

 , + EB + ,,  , < <  
 2 +

<2.,A ,28 karena


 <  -&!!B ,,
 <  '
 ' dijumpai  ?  <+, + < <  ,<, + 2 +
,+

&EEB< ?'
'$$B,rolling scars .

2, + < <  , ,  0<
+ +

 %'"B  <


-
+ , ,   D,   ,  ,  , ++ < 0<
+ +;+  +;+< 
 ,
 ,
 < 0 #
0
,2, <%$!B
++ ,
,
 <  < .

 , + "%B26 + ,, < .

 , + ? 2 
,, ,
+ <D ?<

 < <.

 , ++ 2 +  ,+-   ,, + 2 +
,+ ,-+  <+,
%%B,
 <  6+ 2 + $'$B25 ? ,, + 
,, , ,
, .  + , 2 
w 2 
; +.+
,  ,, ,,
,  ,
+ +;+  +%& Makula eritema terjadi karena dilatasi
+ 2 <, 
  <,,,  ,
2 , ;+<  ++ 2 +
,+
, 2<.,<, 
  +  +<2? 
2 ,
,<,, +-+ .
  <+,  +%&  ,,
 <  <


 < , 
  - 2+<2? 
,  ,, .

 , + ?2 
,< <,,?<.
 ,
2 +

+ ,,2 2 @  ? ,  ,,2  <+, , + + 
+ +,=+
 <
,
<+  <?<, +  , 2<,
+ +
, 2<., <   ,,
Parut akne dapat terjadi karena kerusakan struktur  , ,
<+  <,  < ?
 , < 21 Pada
 +
+< , ; +2 -  ,
- < 
,  ,,
; ,+ ?,<.

 , +
2 
+ +,=+2  2.,
 +, + ., .,+ 2 + EB


<2., A , + <   <  <,'& J 2  ? ,+  , ,  ?  
 ., , 
w, -  ,  
, <.
+ +
2, 2 2  + 0  2 ,
   
  ? 
 < 
+ < < >
, 2<., <  + ,  , <+ 2  ,  b + 2<  <,, ? + 2 2+ ,
,-+ + 2< +.+ <, <
?,,J,  
, <. + +
,+
 , +2 
?,,
 ,,<+,=+2  2.,  .  .
 ? 
 < ,  , <
,  ,
@?,, +J

+ +
, 2<.,< ,   2 , ? ,+
 <  2 <  <
 <  
,  , 22,
,, ,
+ + ,-+ ,  ,, 
,  , , <, + 0  + A <
,<, 2 +   ,
-+  < +, @ <
,  , ,?< ,  ,,  ,
 <  2 < ,
 , 22,
 <   -E& @?,, J  ,2<,  , , ; 2 
,0<+,? ,+ ,,
+
,+
 , +< ,2 , <,
,  ? 
 .,, ,
  
, <. ?,
 ++
?,,J10 +
,+
 , +< <<  ,,
 < , 

54
Q
  
  
      
 
I Fiatiningsih, dkk. derajat parut akne vulgaris

KESIMPULAN E"<. .b4.  ,M .w b0 




@  

  
   '
@ 
   
M
 ,.<2<,,,  ?<.
?,, .  of different wave., + 0.!{E*E$"#%E
,<<  ,, +
,+
 , +7  W,   E$ ,  0.<,  +.  M) UV and pigmentation: Molecular
mechanisms and social controversies@ , 4  ,  +'{
WW2W8  ,,  ? 
 <  ,  <<   ,, + 
E*$&#E%
34+<='
3' > '  -,. <, E%O ;, 3 + +    ) + - ,0 +0 3 ~ <2 <+ 44
 -  
 <  67 '
 '?', dan rolling scars) @0  
? 
]

 '

 '   
+ 0 2 , ,, < ,.<2<,, . 
 ^>C
 '
V 

 '
@ 
D,; + M  %{E%*"#!
E!.2 < M ,0bw JM , w,  ,New
DAFTAR PUSTAKA   
 

'
V=  

<=  '

E )+ 4. <. Photodynamic therapy in the management of to Improve Outcomes in Acne Group. 330M  &{%*E#
acne: An update4 + M  E{&*EE#! S50
  ,Postacne scarring: A review of its pathophysiology and E'€<,€,~Y. J . ++. L ?
  
treatmentM  < {%*'$!#!E metalloproteinases in photoaging.D,; + M  
@ 0&{E"*
 - MPractical evaluation and management of atrophic acne scars 20-4
4,3 + . M  EE{"*$#! E&M< ) ++ , ,+ , 3 + b  +
"  ,3b , + ,434<,-- YA clinical evaluation of acne D
'Z)     '
' '
V=  &
' 

scarring and its incidence. 4,)(
M  E&&"{E&*#'  * ' ' 

' '
  '   '
 ' 
$ .<, N< 4=' '

  '  '
V(   '
 '
@  30 M J , !{'!*#
different from adolescent acne? M  J , 
E{!'*$# M +0.3 ~. 3     E&&! A comparison of current acne
"E grading systems and proposal of a novel system.D, M  E&&!{%*
%  Treatment of acne scarring0@+ < 4,N3EE{E&* 416-418
!$#&E E ,w ,3'
' V=]  @
' 
! @ ,+34 4. , 4) b 2 ,     23w grading system.M  < %{*E"$'#%%
Comparison of the epidemiology of acne vulgaris among Caucasian,
Asian, Continental Indian, and African American women.)3MJEE{ @ M , wJ +0. An epidemiological study of acne in female
$*E$"#% adults: Results of a survey conducted in France. )3MJE{E$*$"E#$
' b , Mw  3b  2 +   < , M4  ,3  <, 4   b , b 4., bb = ' 

4<,--  Y Inflammation in acne scarring: A comparison of the epidemiological study of acne vulgaris in Hong Kong adolescents. 30 
responses in lesions from patients prone and not prone to scar. w   M J , {'*E"#!
M  "{E$*!#'E " < ,J 2 +D4<,-- YPrevalence of facial acne in adults. J
& .2,3N <  J3Multimodal treatment of acne, acne scars, and ==' 2
E&&&{"E*$!!^'
pigmentationM  4,&{!*"$&#!E $. ‚<  ) . D3 N 33 R,33 Scarring and none
E4 . 4. Yw ,, < <0.Y 2  ' ' '
@  

]
'' 
  


3  


'Z)    
 
   D ‚@ +  &{'*#'
human skinD,; + M  
@ 0 &{E"*#$ %3 ,w.

M
'
@ =  
EEY 2 0. ,RY +<<4N,+.b  ,J South IndiaD,,M  
&{!$*!#'
Pigmentation effect of solar simulated radiation as compared with !  + N ~<R w~  + N w  ~ O  @ @

UVA and UVB radiation. @ , 4  ,  +'{E7"8*"'!# measurements of skin pigmentation in situ@ , 4  +"{E!*
&E 618-26
E  <0.w R 4 . ~<Rw~  '22 0,3,,<,R 4Mƒ3 0 JAcne scars: Pathogenesis,
3Mechanisms of skin tanning in different racial/ethnic groups in ' '   

M   +@ 0 E{E*E#E
response to ultraviolet radiation.D,; + M  ${E"*E%# &0 ,0 +0 ,N  , w0 <22> '  '

E<0.  .+.  ~<R ~  ,.<+  3   3 scars: A review with clinical and ultrasound correlation.M* + 
  Human skin responses to UV radiation: pigment in the 3@ @ ;w 
,<, ,Acne scars: Classification



 
' 2O= 
 
*


    

+3

 
 '

-)+ #ED,- 
facilitates apoptosis.3)w%{*)%#)& b  .0 &.E#!

55

Anda mungkin juga menyukai