HUBUNGAN POLA DIET DENGAN DERAJAT KEPARAHAN VITILIGO BERDASARKAN SKOR VITILIGO AREA SCORING INDEX (VASI)

YEFTA, Dr. dr. Sunardi Radiono, Sp.KK(K); dr. Dwi Retno Adi Winarni, Sp.KK(K)

2021 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar Belakang: Vitiligo adalah kelainan kulit dan membran mukosa ditandai makula dan bercak depigmentasi berbatas tegas akibat kerusakan melanosit. Vitiligo bersifat multifaktorial. Berbagai mekanisme kerusakan melanosit pada vitiligo yaitu genetik, autoimun, stres oksidatif, mediator inflamasi dan nutrisi atau diet. Konsumsi pola makan yang tidak sesuai merupakan faktor penting penyebab sejumlah penyakit kulit termasuk vitiligo. Penilaian pola diet dan derajat keparahan vitiligo menjadi aspek yang perlu diperhatikan dalam strategi tatalaksana pasien. Tujuan: untuk mengetahui perbedaan pola diet antara pasien vitiligo dan non vitiligo; mengetahui hubungan antara pola diet dengan derajat keparahan vitiligo berdasarkan skor Vitiligo Area Scoring Index (VASI) serta mengetahui pola diet yang paling mempengaruhi kejadian vitiligo. Metode: Penelitian menggunakan rancangan potong lintang. Subyek diambil dari RSUP Dr. Sardjito yang memenuhi kriteria inklusi dan eksklusi. Penilaian pola diet dengan Lembar Penilaian Pola Gaya Hidup Pasien Vitiligo. Analisis korelasi dilakukan untuk mengetahui pengaruh pola diet terhadap derajat keparahan vitiligo. Analisis multivariat digunakan untuk mengetahui pola diet yang paling mempengaruhi kejadian vitiligo. Hasil: Jumlah subyek vitiligo dan non vitiligo masing-masing 29 orang dengan rentang usia 18-60 tahun. Hasil penelitian menunjukkan terdapat perbedaan bermakna rerata skor pola diet antara kelompok vitiligo dan non vitiligo dengan nilai p=0,016 (p<0,05), dan terdapat hubungan yang bermakna antara skor pola diet dengan derajat keparahan vitiligo berdasarkan VASI (p=0,004) dengan nilai r = -0,517 (kekuatan korelasi sedang). Individu dengan konsumsi multivitamin, makanan laut (seafood), ikan air tawar dan susu sapi rendah (<= 2-3 kali/bulan) memiliki risiko lebih tinggi untuk terjadi vitiligo. Kesimpulan: Terdapat perbedaan yang bermakna skor pola diet kelompok vitiligo dan kelompok non vitiligo; terdapat hubungan antara skor pola diet dengan derajat keparahan vitiligo berdasarkan VASI serta pola diet rendah zinc, vitamin D, vitamin B12 dan asam folat mempengaruhi kejadian vitiligo.

Background: Vitiligo is an acquired disorder of the skin and mucous membranes characterized by well-defined macules and depigmented spots and occurs as a result of damage to melanocyte cells. Vitiligo is multifactorial. Various mechanisms of melanocyte damage in vitiligo are genetic, autoimmune responses, oxidative stress, formation of inflammatory mediators and nutrition or diet. Consumption of an inappropriate diet is an important factor causing a number of skin diseases including vitiligo. Assessment of diet and the severity of vitiligo are aspects that need to be considered in patient management strategies. Purpose: To determine differences in dietary patterns between vitiligo and non-vitiligo patients; determine relationship between dietary patterns and the severity of vitiligo based on the Vitiligo Area Scoring Index (VASI) score and determine the diet patterns that most influence the incidence of vitiligo. Methods: This study using a cross sectional design. Subjects were taken from Dr. Sardjito hospital who has met the inclusion and exclusion criteria. Assessment of diet patterns with the Patient Life Style Pattern Assessment Sheet (PLSPAS) for Vitiligo. Correlation analysis was performed to determine how dietary patterns influence the severity of vitiligo. Multivariate analysis was used to determine the diet pattern that most influenced the incidence of vitiligo. Results: This study included 29 vitiligo and non vitiligo subjects with range age between 18-60 years. The results showed that there was significant difference in the mean score of dietary patterns between the vitiligo group and the non vitiligo group with p value = 0.016 (p <0.05), and there was significant association between dietary pattern score and degree of vitiligo severity based on VASI (p = 0.004) with r = -0.517 (moderate correlation strength). People with low consumption of multivitamins, seafood, fish and cow's milk (<= 2-3 times/month) have a higher risk of developing vitiligo. Conclusion: There was significant difference in the diet pattern score of the vitiligo group and the non vitiligo group; there was relationship between the diet pattern score and the vitiligo severity score based on VASI; and low diet of zinc, vitamin D, vitamin B12 and folic acid affects the incidence of vitiligo.

Kata Kunci : vitiligo, pola makan (diet), derajat keparahan vitiligo, vitiligo area severity index (VASI)