PERBANDINGAN KADAR MALONDIALDEHID SERUM PADA BERBAGAI DERAJAT KEPARAHAN AKNE VULGARIS Studi pada Populasi Pria di Yogyakarta

Aprilina Dwi Sulistyowati, dr. Kristiana Etnawati, MPH, Sp.KK(K)

2013 | Tesis | S2 Ked.Klinik/MS-PPDS

Akne adalah penyakit kulit kronik inflamatif yang memiliki patogenesis multifaktorial diantaranya adalah hiperplasia sebasea, hiperkeratinisasi folikular, hiperkolonisasi propionibacterium acnes, dan inflamasi. Salah satu teori pemicu inflamasi pada akne yaitu stres oksidatif terutama peroksidasi lipid dengan hasil akhirnya malondialdehid (MDA). Stres oksidatif juga dipengaruhi oleh faktor lingkungan dan sinar ultraviolet (UV). Salah satu penelitian menunjukkan bahwa radiasi sinar UV di Yogyakarta termasuk yang tertinggi di Indonesia. Pengaruh UV yang tinggi akan meningkatkan peroksidasi lipid di kulit sehingga kadar MDA akan meningkat dan kemungkinan memperparah inflamasi pada akne. Penelitian ini dilakukan untuk membandingkan kadar MDA serum pada berbagai derajat keparahan akne vulgaris di Yogyakarta. Penelitian potong lintang, diskriptif, observasional dengan subyek adalah penderita akne pria dengan pengambilan sampel secara consecutive sampling. Derajat keparahan akne ditentukan dengan metoda combined acne severity classification (CASC). Analisis ststistik menggunakan uji one way analysis of varians dan uji korelasi Pearson’s dengan nilai kemaknaan p<0,05. Sebanyak 60 subyek penderita akne dikelompokkan menjadi 3 kelompok, yaitu akne derajat ringan, sedang dan berat. Masing-masing kelompok berjumlah 20 subyek. Kadar malondialdehid akne derajat ringan lebih rendah dibandingkan akne derajat sedang (p=0,002) dan derajat berat (p=0,000) serta akne derajat sedang lebih rendah dibandingkan akne derajat berat (p=0,000). Dijumpai korelasi kuat antara MDA dengan jumlah total lesi akne (p=0,000; r=0,714). Terdapat perbedaan bermakna kadar MDA serum pada berbagai derajat keparahan akne vulgaris di Yogyakarta dan korelasi positif kuat kadar MDA serum dengan jumlah total lesi akne vulgaris. Semakin tinggi kadar MDA serum, semakin tinggi jumlah total lesi akne.

Acne is an inflamative chronic skin disease which has multifactorial pathogenesis such as sebaceous hyperplasia, follicular hiperkeratinization, hipercolonization of Propionibacterium acnes, and inflammation. Oxidative stress especially lipid peroxidation in purpose is one trigger inflammation in acne vulgaris. Oxidative stress is also influenced by environmental factors and ultraviolet (UV) light. The UV radiation in Yogyakarta is relatively higher compare in other region. Effect of high UV will increase lipid peroxidation in the skin so that the malondialdehyde (MDA) as the outcome of lipid peroxidation will be increased and eventually lead to inflammation in acne. This research was conducted to compare the levels of serum MDA in various degrees of severity of acne vulgaris in Yogyakarta. An observasional, descriptive, and cross sectional study was conducted in Yogyakarta with a consecutive sampling method to achieve 60 male acne subject. The combined acne severity classification (CASC) method is used to determine the severity of acne. Statistical analysis uses one way analysis test of variance and Spearman's rho correlation test with a significance value of p<0.05. Sixty male acne subjects were divided into 3 groups, namely mild, moderate, and severe acne. Each of these group consists of 20 subjects. Mild acne showed MDA levels lower than moderate (p= 0.002) and severe acne (p=0.000) and moderate acne also lower than severe acne (p=0.000). There were strong positive correlation between MDA serum with acne lesion total count (p=0.000; r=0.714). There are significant differences in the levels of serum MDA in various degree acne vulgaris in Yogyakarta, also there is a strong positive corelation between MDA serum levels with acne lesion total count. The higher levels of MDA serum, the higher acne lesion total count.

Kata Kunci : Akne vulgaris, peroksidasi lipid, malondialdehid