Background: Photoaging is a complex biologic process that affects various layers of the skin with the major damage seen in the connective tissue of the dermis. Although rarely fatal, photoaging can significantly contribute to a loss of quality of life; therefore, it deserves attention. Researchers are continually searching for new compounds to develop rejuvenation therapies. Nowadays, the stem cell population has been discovered, and it shows capability to rejuvenate the skin. Material and Methods: This was an analytic experimental research conducted on a total of 48 women who were randomised into two groups; 24 women received amniotic membrane stem cell-conditioned medium (AMSC-CM) and the other 24 women received normal saline (NS). We applied the drug for 3 times with an interval of 2 weeks. Microneedling was used to enhance epidermal penetration. We evaluated the progression of photoaging on weeks 0, 4 and 8, as well as the side effects. Results: The improvement in photoaging after treatment showed significant better effects with the AMSC-CM than with NS (p <0.05). There were minimal transient side effects in either of the study groups. Conclusion: AMSC-CM has the capability to improve clinical photoaging and is a promising option for rejuvenation therapy.

Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.

Background: Oral candidiasis is an infection due to the activity of Candida albicans in the oral cavity. Oral candidiasis is one of the most common opportunistic infections occuring among Human Immunodeficiency Virus (HIV)/Acquired immune deficiency syndrome (AIDS) patients. Due to increasing resistance and adverse effects to commonly used antifun¬gal drugs, many recent studies have examined the use of herbal essential oils as antifungal agents. In this study, essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin were examined for in vitro antifungal activ¬ity against Candida species. Aim: To evaluate antifungal activity of essential oil of Rosmarinus officinalis (Lamiaceae) and nystatin by comparing inhibition zone diameters. Methods: This study was an experimental laboratory study with a posttest only design conducted in Dr. Soetomo General Academic Hospital, Surabaya. Forty isolates consisted of 20 isolates of Candida albicans and Candida non-albicans were subjected to test for antifungal activity using the diffusion disk method using paper discs or blank discs and inhibitory zones were recorded. Results: Diffusion test results revealed stronger antifungal effect of nystatin against all analyzed Candida strains. This study showed the mean diameter of the inhibitory zone for Candida albicans formed by rosemary essential oil is 2.25 mm and the average inhibition zone formed by rosemary essential oil for Candida non-albicans is 1.5 mm. Conclusion: The antifungal activity of nystatin is stronger when compared to rosemary essential oil as seen from a greater inhibition zone than rosemary essential oil in the diffusion method.

Background: The long term use of antifungals for oral candidiasis (OC) in patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) causes some strains to be resistant to certain antifungals. HIV/AIDS are currently most common in men. Aim: To evaluate ketoconazole sensitivity on Candida species in male HIV/AIDS patients with OC. Method: This is an observational descriptive study at the Outpatient Unit and Inpatient Installation of the Infectious Disease Intermediate Care Unit (UPIPI) Dr. Soetomo, Surabaya. Samples were taken from HIV/AIDS male patients with OC using sterile swabs. The smear was cultured in CHROMagar Candida incubated at 37°C for 48-72 hours, and Sabouraud Dextrose Agar media for 48 hours at 28°C. Species identification were done using carbohydrate and Cornmeal test. Resistance test was done by disk diffusion method. Results: There were 23 research subjects with 40 isolates of Candida species growing in culture. The most common species was C. albicans in 23(57.5%) isolates, while Candida non-albicans were found in 17(42.5%) isolates. The sensitivity test results showed that 34 (85%) isolates were sensitive, while 2(5%) isolates were resistant to ketoconazole. All C. albicans (23 [100%]) and most Candida non-albicans species (11 [64%]) were sensitive to ketoconazole. Conclusion: Ketoconazole can be recommended as a treatment option for OC patients with HIV/AIDS due to the high sensitivity of both C. albicans and non-albicans to this drug.

People with a weakened immune system may develop the severe form of scabies called crusted scabies. We have two cases of female patients with history of using long-term oral corticosteroid and then developing scabies infection. The first patient had other comorbidities which caused her become more susceptible while the second patient had been diagnosed with bullous pemphigoid. Both patients complained thick crust on some parts of their bodies, accompanied with itchy papules. Based on microscopic examination from lesion scraping, we found the adult form of sarcoptes scabiei and crusted scabies diagnosis was established. The lesions were improving when they got combination of topical sulfur precipitate, salicylic acid, and permethrine 5%. Crusted scabies is characterized by hyperkeratosis and crusting of the skin due to the profuse proliferation of mites resulting from an altered host response. Combination of topical antiscabies and keratolytic can make the crusts thinner and improve topical absorption.