BACKGROUND: Melasma is a common chronic acquired hyper melanosis. It has significant impacts on appearance, psychosocial and emotional distress, hence reducing the quality of life of the affected patients. Melasma quality of life scale (MelasQoL) is a new quality of life (QoL) questionnaire consists of 10 questions, scored from 1 to 7, with higher index scores indicating poor QoL. The severity of melasma can be assessed by the Melasma Area and Severity Index (MASI) score. AIM: We aimed to determine the correlation between the severity of melasma (MASI score) and quality of life. MATERIAL AND METHODS: This was a cross-sectional analytic study involving 30 subjects with melasma. The diagnosis was made based on history, clinical features and by Wood’s lamp examination. MASI score was determined to assess the severity of melasma. Subjects answered 10 items of MelasQol questionnaire. All collected data were processed and statistically analysed by Spearman correlation test to determine the association of MASI score with MelasQoL. Association of quality of life with clinical pattern and depth of lesion were analysed by Mann Whitney test. RESULTS: There was no significant correlation between MASI score and MelasQoL (p = 0.797; r = 0.049). Likewise, there was no association of quality of life with clinical pattern type (p = 0.12) and depth of lesion (p = 0.92). CONCLUSION: There was no significant correlation between the MASI score and quality of life.

Background: Passion fruit is used commercially for consumption and in beverages. This plant exhibits various pharmacological properties and possesses a complex phytochemistry. In recent years, this plant has been shown to have potential antimicrobial activity. The seeds contain a high amount of piceatannol, which exhibits an inhibitory effect on Propionibacterium acnes. Therefore, the seed extract of purple variant, Passiflora edulis Sims var. edulis, may have potential antibacterial activity against P. acnes. Aim: To evaluate the antibacterial activity of P. edulis Sims var. edulis seeds extract on P. acnes. Methods: Seed extract was prepared by maceration and dissolved in DMSO in multiple concentrations. Propionibacterium acnes was cultured in Brucella blood sheep 5% agar for 24 hours and the agar disc diffusion method was used to evaluate the inhibitory effect of each concentration (1.25%, 2.5%, 5%, 10%, 20%, and 40%), in comparison with clindamycin and erythromycin. Zones of inhibition at 24 hours were measured and documented, then analyzed to obtain the mean inhibition zone (MIZ). The Mann–Whitney test was conducted to compare the antibacterial activity of the extract, clindamycin and erythromycin. A serial dilution assay of five different concentrations (5%, 10%, 15%, 20%, and 25%) in brain–heart infusion broth was performed to determine the minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC). Results: After 24 hours, all concentrations of P.edulis Sims var. edulis showed an inhibitory effect against P. acnes, with MIZs for of each concentration of 1.25% 6 mm, 2.5% 6.83 mm, 5% 8.5 mm, 10% 10.08 mm, 20% 14 mm, and 40% 16 mm. Clindamycin revealed comparable antibacterial effect to 5% seed extract, with an MIZ of 8 mm. However, erythromycin was found to be superior to the seed extract, with a 22.67 mm MIZ (p< 0.05). The serial dilution assay revealed an MIC of 20% and MBC of 25%. Conclusion: Seed extract of P. edulis Sims var. edulis had good antibacterial activity against P. acnes, and the effect increased with the concentration.

Introduction: Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles with polymorphic lesions, consisting of comedones, papules, pustules and nodules with varying degrees of severity. Stress is one of the triggers of acne vulgaris. Peripheral nerves release substance P in response to stress. Substance P causes proliferation and differentiation of sebaceous glands and increases lipid synthesis in sebocytes. Purpose: To determine the correlation between stress scale and serum substance P level in acne vulgaris. Patients and Methods: This study was an observational analytic study with a cross-sectional design involving 30 patients with acne vulgaris and 30 controls. History taking, dermatological examination and the Holmes−Rahe stress scale questionnaire were performed with each patient to evaluate stress scale, followed by taking blood samples to assess substance P serum levels using the ELISA test. The collected data were analyzed using the Spearman correlation test. Results: In both groups, the majority of subjects were 23– 27 years old (36.7%) and most of them were female (76.7%). The majority in the acne vulgaris group had low scores on the stress scale, represented by 17 patients (56.7%). The main cause of stress in the acne vulgaris group was a major change in sleeping habits (66.7%). In the acne vulgaris group, the highest mean value of serum substance P level in high stress scale group was 168.2 pg/mL. There was a positive correlation between stress scale and serum substance P level in acne vulgaris with moderate strength and this was statistically significant (r = 0.446; p = 0.014). Meanwhile, stress scale and serum substance P level in controls were not correlated and this was not statistically significant (r = − 0.090; p = 0.636). Conclusion: There was a correlation between stress scale and serum substance P level in acne vulgaris.

BACKGROUND: Acne vulgaris is a chronic inflammatory skin disorder that commonly found in pilosebaceous units which can have an impact on the patient’s psychological burden. The relationship between dermatology and mental health is increasingly understood by the evidence shows that functional integrity and microbes in the gastrointestinal tract may play a role in mediating skin inflammation and emotional behaviour. The gut-brain-skin theory was first described in 1930 by Stokes and Pillsbury, became the basis of many current studies that look for clinical implications of the relationship between the gastrointestinal tract, brain and skin in acne vulgaris. Probiotics are live microorganisms which can provide a healthy effect to the hosts when consumed in adequate amounts. AIM: To determine the effect of oral probiotic on the interleukin-10 serum levels in acne vulgaris and also to determine the side effect of oral probiotic on acne vulgaris. METHODS: This is a pre-experimental clinical study with a pretest-posttest design involving 33 subjects with acne vulgaris. The subjects in this study were measured for IL-10 serum levels before and after oral probiotic was given for 30 days. This research has been approved by the Health Research Ethics Commission of the Faculty of Medicine, Universitas Sumatera Utara. RESULTS: This study found an increase in serum IL-10 levels after oral probiotic in acne vulgaris. The value of serum IL-10 levels before oral probiotic administration was 5.27 ± 1.49 pg/ml, while the value of serum IL-10 levels after oral probiotic administration was 6.19 ± 1.68 pg/ml) with p values obtained through Wilcoxon test was 0,0001 (p < 0.05). The side effect of oral probiotic found in this study is bloating that was found in 2 subjects within the first week using oral probiotic. CONCLUSION: Oral probiotic trigger elevated IL-10 serum levels of acne vulgaris. This study supports previous studies that suggested oral probiotic can be considered as adjuvant acne vulgaris therapy and its side effect is quite safe and tolerable.

Purpose: Bacterial activity and inflammation both influence acne vulgaris (AV) formation. Cutibacterium acnes is considered as an actor involved in inflammation of AV. Besides Cutibacterium acnes, other microbiomes found in AV may also play a role in the pathogenesis. This research was conducted to overview microbiomes found in non-inflammatory and inflammatory lesions of AV. Patients and Methods: An observational descriptive study with cross-sectional approach was designed. Sample collection was performed with 40 subjects with AV. In every patient, both non-inflammatory (closed comedone) and inflammatory (pustule) lesion samples were collected by swab. Afterward, bacterial culture was performed, continued by bacterial identification. Results: In non-inflammatory lesions, the growth of nine bacterial species was observed from 40 samples. In an anaerobic culture, Cutibacterium acnes (17,5%) was identified. In aerobic cultures, different bacterial species were found including Staphylococcus epidermis (52.5%), Staphylococcus hominis (12.5%), Staphylococcus haemolyticus (7.5%), Micrococcus luteus (7.5%), Leuconostoc mesentroides (7.5%), Staphylococcus aureus (5%), Kocuria varians (5%), and Staphylococcus vitulinus (2.5%). In inflammatory lesions, nine bacterial species were found, in which was the anaerobic culture we identified Cutibacterium acnes (25.0%). Aerobic cultures have revealed the growth colonies of Staphylococcus epidermidis (42.5%), Staphylococcus hominis (22.5%), Staphylococcus aureus (12.5%), Staphylococcus haemolyticus (10.0%), Leuconostoc mesentroides (5.0%), Staphylococcus cohnii (2.5%), Staphylococcus arlettae (2.5%), and Dermacoccus nishino-myaensis (2.5%). Two mixed bacterial growths were observed in non-inflammatory lesions, while four mixed bacterial growths were found in inflammatory lesions. Conclusion: Differences in bacterial isolates were observed both in non-inflammatory and inflammatory lesions of AV.

Cryolipolysis is a non-invasive fat reduction method that is capable of reducing subcutaneous fat significantly without damaging surrounding tissues, by applying cold temperature to induce adipocyte apoptosis. Most of the clinical studies in cryolipolysis were conducted in the Caucasian population, and only a few numbers in Asian, who has darker skin with Fitzpatrick skin type III to V. Higher rate of pigmentary changes were reported with the use of cryotherapy in darker skin. Therefore, this report is aimed to provide a comprehensive review regarding utilisation, efficacy and safety profiles of cryolipolysis among Asians. Currently, there are only four clinical trials conducted exclusively in an Asian population. Two studies were conducted in Korea, whereas others in China and Thailand. Cryolipolysis was performed in the abdomen, arm, inner thighs, and submental regions. The reported side effects were mild and transient, including erythema, hematoma, numbness, and pain. There were no pigmentary changes reported. Although only limited data available, those studies have proved that cryolipolysis utilisation among Asians or darker skin types provides the same efficacy and safety profiles as in Caucasians. Therefore, cryolipolysis might be proposed as the first treatment choice for Asian patients who opted to do body contouring.