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EFEKTIVITAS KRIM PELEMBAB CERAMIDE DALAM PENGOBATAN ERUPSI PAPULAR PRURITIK PENDERITA HIV/AIDS

AYU WIKAN SAYEKTI, dr. Dwi Retno Adi Winarni, Sp. KK(K).; Dr. dr. Satiti Retno Pudjiati, Sp.KK(K)

2021 | Tesis-Spesialis | DERMATOLOGI DAN VENEREOLOGI

Latar belakang: Erupsi Papular Pruritik (EPP) merupakan salah satu manifestasi kulit pada penderita HIV/AIDS yang sering ditemukan. Erupsi papular pruritik dikarenakan disregulasi imun terutama dominasi sitokin sel limfosit Thelper (Th2) berupa peningkatan interleukin-4 yang menyebabkan penurunan sintesis ceramide (CER) sehingga mengakibatkan gangguan fungsi sawar kulit. Pelembab adalah produk topikal yang dirancang untuk meningkatkan dan mempertahankan fungsi sawar kulit. Tujuan: Membuktikan krim pelembab CER efektif menurunkan transepidermal water loss (TEWL), meningkatkan hidrasi kulit, menurunkan jumlah lesi dan rasa gatal dibandingkan krim pelembab non-CER serta memiliki efek samping yang sama dengan krim pelembab non-CER pada penderita EPP. Metode Penelitian: Penelitian dengan desain eksperimental buta ganda. Subyek penelitian adalah penderita HIV/AIDS dengan EPP yang berobat di RSUP Dr. Sardjito. Pengolesan krim pelembab CER dan non-CER masing-masing pada lengan bawah berbeda sisi selama 3 minggu. Analisis hasil dengan uji T tidak berpasangan atau uji Mann-Whitney dengan kemaknaan p < 0,05. Hasil Penelitian: Krim pelembab CER menurunkan nilai TEWL sebesar 3,56 +-2,38 g/m2/jam; menaikkan nilai hidrasi kulit sebesar 16,39 +- 7,19 a.u.;menurunkan lesi kulit sebesar 0,79 +- 4,95; menurunkan rasa gatal sebesar 1,54 +-0,78 dan tanpa menimbulkan efek samping. Krim pelembab non-CER menurunkan nilai TEWL sebesar 1,57 +- 2,00 g/m2/jam; menaikkan nilai hidrasi kulit sebesar 12,03 +- 6,88 a.u.; menurunkan lesi kulit sebesar 1,42 +- 3,00; menurunkan rasa gatal sebesar 1,17 +- 0,70 dan juga tanpa menimbulkan efek samping. Kesimpulan: Krim pelembab CER efektif dan lebih efektif dibandingkan krim pelembab non-CER dalam menurunkan TEWL. Krim pelembab CER efektif dan lebih efektif dibandingkan krim pelembab non-CER dalam meningkatkan hidrasi kulit. Krim pelembab CER dan non-CER memiliki efektifitas yang sama dalam menurunkan jumlah lesi. Krim pelembab CER dan non-CER memiliki efektifitas yang sama dalam mengurangi rasa gatal. Krim pelembab CER dan non-CER tidak menimbulkan efek samping.

Background: Pruritic Papular Eruption (EPP) is one of the most common skin manifestations in HIV/AIDS patients. Pruritic papular eruptions are due to immune dysregulation, especially the dominance of Thelper lymphocyte cytokine (Th2) in the form of an increase in interleukin-4 which causes a decrease in ceramide synthesis (CER) resulting in impaired skin barrier function. Moisturizers are topical products designed to improve and maintain skin barrier function. Objective: To prove that CER moisturizing cream is effective in reducing transepidermal water loss (TEWL), increasing skin hydration, reducing the number of lesions and itching compared to non-CER moisturizing creams and having the same side effects as non-CER moisturizing creams in patients with EPP. Research Methods: Double blind experimental design. The research subjects are HIV/AIDS sufferers with EPP who seek treatment at RSUP Dr. Sardjito. The application of CER and non-CER moisturizing cream on the forearm on different sides for 3 weeks, respectively. Analysis of the results with the unpaired T test or the Mann-Whitney test with a significance of p < 0.05. Results: CER moisturizing cream decreased the TEWL value by 3.56 +- 2.38 g/m2/hour; increase the value of skin hydration by 16.39 +- 7.19 a.u.; decreased skin lesions by 0.79 +- 4.95; reduce itching by 1.54 +- 0.78 and without causing side effects. Non-CER moisturizing cream decreased the TEWL value by 1.57 +-2.00 g/m2/hour; increase the value of skin hydration by 12.03 +- 6.88 a.u.; decreased skin lesions by 1.42 +- 3.00; reduce itching by 1.17 +- 0.70 and also without causing side effects. Conclusion: CER moisturizing cream is effective and more effective than non-CER moisturizing cream in reducing TEWL. CER moisturizing cream is effective and more effective than non-CER moisturizing cream in increasing skin hydration. CER and non-CER moisturizing creams have the same effectiveness in reducing the number of lesions. CER and non-CER moisturizing creams have the same effectiveness in reducing itching. CER and non-CER moisturizing creams do not cause side effects.

Kata Kunci : Erupsi papular pruritik, pelembab ceramide, TEWL, hidrasi kulit, jumlah lesi, rasa gatal, efek samping, Pruritic papular eruption, ceramide moisturizer, TEWL, skin hydration, number of lesions, itching, side effects

  1. SPESIALIS-2021-435572-abstract.pdf  
  2. SPESIALIS-2021-435572-bibliography.pdf  
  3. SPESIALIS-2021-435572-tableofcontent.pdf  
  4. SPESIALIS-2021-435572-title.pdf