Background: The skin undergoes degenerative and metabolic changes with aging, increasing susceptibility to dermatological conditions. Xerosis cutis, characterized by rough, scaly skin on the lower legs, is the most common cause of pruritus in elderly patients, with a prevalence of 38–85%. Treating xerosis cutis is challenging due to its multifactorial causes, especially in the elderly. Moisturizers remain the primary and most effective treatment, providing convenience and efficacy. This study aimed to evaluate the effects of QV Intensive Moisturizing Cleanser™️ and QV Intensive Cream™️ (Ego Pharmaceuticals, Australia), which contain humectants, emollients, and occlusives. Case Illustration: This observational case series involved six elderly subjects (>60 years) with xerosis cutis. Exclusion criteria included medications that cause dry skin, use of topical moisturizers within 2 weeks, or oral supplements (hyaluronic acid, vitamin C, and ceramide) within 4 weeks before the study. Over four weeks, subjects used only the specified cleanser and moisturizer on affected skin. Improvement was assessed subjectively using the Smoothness, Redness, Roughness, Cracking (SRRC) score, the Dermatology Life Quality Index (DLQI), and the 5D Pruritus Scale. Objective measures included transepidermal water loss (TEWL) via Tewameter® TM300 and skin capacitance (SCap) via Corneometer® CM825 (Courage+Khazaka Electronic GmbH, Germany). Discussion: All subjects showed improvement in SRRC, 5D Pruritus Scale, DLQI, TEWL, and SCap after four weeks of cleanser and moisturizer use, with no side effects or irritation observed. Conclusion: Cleansers and moisturizers containing humectants, emollients, and occlusives were found to be safe and effective for treating xerosis cutis in geriatric patients.

Background: Superficial dermatomycosis, predominantly caused by dermatophytes, affects approximately 20–25% of the global population. However, non-dermatophytic fungi, such as Cladophialophora species (sp.), can also cause similar cutaneous infections. Although less common, these organisms are particularly concerning in immunocompromised individuals. Case Illustration: A 66-year-old immunocompromised male presented with widespread pruritic and erythematous patches, initially misdiagnosed as tinea corporis. Despite receiving standard antifungal therapy, his condition persisted. Further investigation through fungal culture identified Cladophialophora sp., which was resistant to common antifungal agents such as fluconazole, itraconazole, and ketoconazole. However, the fungus was sensitive to terbinafine, which has been successfully used to treat extensive superficial dermatomycosis. Discussion: This case highlights the ability of non-dermatophytic fungi, especially Cladophialophora sp., to cause extensive superficial dermatomycosis, especially in immunocompromised patients. The patient’s compromised immune system likely contributed to the extensive nature of the lesions. In this case, antifungal resistance may have been exacerbated by prior unsupervised self-medication and environmental exposure. Conclusion: We report an immunocompromised patient with inadequate prior antifungal treatment who developed extensive superficial dermatomycosis caused by Cladophialophora sp., a deep mycosis pathogen resistant to multiple azoles, highlighting the role of host immunity and inappropriate unsupervised therapy in disease severity and antifungal resistance.

Background: Skin cancer is among the most common malignancies, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. In Indonesia, it ranks third after cervical and breast cancer. This study aimed to analyze the demographic, clinical, and treatment patterns of skin cancer cases at Dr. Pirngadi General Hospital, Medan, Indonesia from 2019 to 2023. Methods: A retrospective descriptive study was conducted using medical record data of all skin cancer patients treated from 2019 to 2023. Variables analyzed included age, sex, occupation, lesion site, skin cancer type, and treatment modality. Data were analyzed using univariate statistics and presented as frequency distributions. Results: A total of 106 patients were included, most aged >50 years (73.6%) and male (60.4%). Outdoor occupations, such as farming (23.6%) and entrepreneurship (23.6%), were the most common. Lesions were predominantly located on the face (93.4%). BCC was the most frequent type (90.6%), followed by SCC (7.5%) and melanoma (1.9%). Excisional surgery was the main treatment (51.9%), followed by excision with skin flap reconstruction (48.1%). Conclusion: Skin cancer in this study was most prevalent among older males with outdoor occupations, with the face being the most frequent lesion site. BCC was the predominant type, and excisional surgery remained the primary treatment. These findings provide an updated epidemiological overview to support prevention and early detection efforts in Indonesia.

Background: Melasma is a common acquired pigmentary condition presenting as dark macules or patches on sun-exposed areas of the face. Conventional treatments rely on topical bleaching agents and sun protection, while additional adjuvant options such as chemical peels, dermabrasion, and laser procedures are often applied. However, recurrence is frequent, and overall therapeutic success remains modest, significantly affecting patient quality of life. Recently, tranexamic acid (TXA) has gained attention as a novel therapeutic approach. This review provides an overview of the available evidence on the efficacy of TXA, used as monotherapy or in combination regimens, for the management of melasma. Discussion: TXA has been investigated for administration via several routes, including oral, intradermal, and topical. The pathophysiology of melasma involves not only abnormal melanogenesis but also enhanced dermal vascularity and angiogenic activity. TXA acts by interfering with the plasminogen–plasmin system, thereby altering keratinocyte–melanocyte signaling and reducing melanogenesis. In addition, it demonstrates anti-angiogenic effects, leading to reduced vessel density and erythema. Clinical data suggest oral TXA generally yields superior outcomes compared to intradermal or topical approaches, although study results remain heterogeneous, particularly in trials combining multiple therapies. Conclusion: TXA appears to be a promising therapeutic option for melasma, with potential use as a stand-alone intervention or in combination with other modalities. Combination regimens often produce better clinical improvement than monotherapy. Nonetheless, standardized guidelines for the optimal use of TXA in melasma treatment remain lacking.

Background: Post-acne hypertrophic scars and keloids result from abnormal wound healing within the pilosebaceous unit. Ruptured microcomedones create wounds that can lead to prolonged inflammation, increased collagen synthesis, and fibrinolysis inhibition, resulting in elevated scar tissue in acne lesions. Vitamin D deficiency can lead to prolonged inflammation and damage to dermal collagen. High total cholesterol levels can lead to excessive sebum production, exacerbating inflammation and fibrosis. This study aimed to determine the association between serum vitamin D and total cholesterol levels with scar severity in patients with post-acne hypertrophic scars and keloids. Methods: This analytical cross-sectional study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia, among patients who met the inclusion and exclusion criteria. Scar severity was assessed using the Vancouver Scar Scale (VSS). Blood samples were collected for examination of serum vitamin D and total cholesterol. The data were analyzed statistically. Results: Chi-square test of serum vitamin D with VSS scores showed a significant association (p-value = 0.007), while total cholesterol with VSS showed no association (p-value = 1.000). Odd-ratio (OR) for serum vitamin D and VSS was 60, concluding that vitamin D deficiency increased the risk of high VSS by 60-fold in study patients. Conclusion: There was a significant association between serum vitamin D levels and VSS score, while there was no association between total cholesterol and VSS score. Deficiency of serum vitamin D is associated with a higher risk of developing a higher VSS score in patients with post-acne hypertrophic scars and keloids.

Background: Recent advances in laser and light-based technologies have introduced new options for both the stimulation of hair growth for alopecia and the reduction of unwanted hair growth. However, the clinical evidence remains varied, and treatment outcomes are influenced by factors such as device type, wavelength, and individual response. Ongoing evaluation of safety, efficacy, and standardization of treatment parameters is therefore essential. Discussion: This review provides an in-depth discussion of the principles, mechanisms, safety, and efficacy of lasers in promoting hair growth, as well as on lasers and light-based therapies used for hair removal. The mechanisms of laser-induced hair growth stimulation include the acceleration of vellus hair transformation into terminal hair. In contrast, lasers and light-based devices utilize melanin as a target chromophore for hair removal. Conclusion: Appropriate devices and techniques of lasers and light-based devices, whether used alone or in combination with other therapies, are beneficial for both hair growth and hair removal.

Background: Contact dermatitis is an immunologic reaction to irritants, allergens, and is commonly associated with cosmetics and skin-care products. Limited knowledge of this condition increases the risk of improper product use and delays preventive measures. Therefore, education plays a crucial role in fostering a comprehensive understanding of its etiology and prevention. This study aimed to evaluate the effectiveness of a video-based educational intervention in enhancing women’s knowledge regarding contact dermatitis related to cosmetics and skin-care products. Methods: This cross-sectional study collected primary data from 100 female academics aged 17–45 at Airlangga University, Surabaya, East Java, Indonesia. Knowledge of contact dermatitis was assessed using questionnaires administered before and after a video-based educational intervention. Knowledge levels were categorized as low (X < 16/20), medium (16/20 ≤ X ≤ 17/20), and high (X > 17/20). Data were analyzed using the Wilcoxon Signed Rank test (SPSS version 25) and summarized in tables. Results: The medium category (16 ≤ X ≤ 17) was the most common in the pretest (61 respondents) and increased in the post-test (88 respondents). The Wilcoxon Signed Rank Test showed a significant increase in post-test scores following the video-based intervention, with a p-value of 0.008 (p < 0.05). Conclusion: Video-based education significantly improved knowledge regarding contact dermatitis related to cosmetics and skin-care products among women.

Background: Generalized pustular psoriasis (GPP) can be associated with human immunodeficiency virus (HIV) infection, making its management more challenging and complex. This case report aims to evaluate the effectiveness and safety of cyclosporine in HIV-associated GPP. Case illustration: A 31-year-old male with a six-year history of HIV on antiretroviral therapy presented with rapidly spreading erythematous plaques with scaling and patches, along with “lakes of pus”, involving 50% of the body surface area (BSA). He reported oral burning, dysgeusia, and odynophagia; tongue Gram stain showed budding yeast and pseudohyphae. The patient was diagnosed with GPP and oral candidiasis in the setting of HIV. Cyclosporine was started at 2.5 mg/kg/day and escalated to 5 mg/kg/day; supportive care included nystatin 4x400,000 IU (swish-and-retain), paracetamol 3x500 mg, 0.9% NaCl wet compresses to pustular areas, emollients for xerosis, and intravenous 0.9% NaCl for hydration. By day 9, BSA improved from 50% to 12% with no severe adverse effects, only fatigue and loss of appetite. Discussion: GPP, a rare severe psoriasis variant, may be exacerbated in HIV patients due to immune dysregulation and CD4+ T-cell decline. In this case, cyclosporine treatment and supportive care improved symptoms without severe adverse effects. Cyclosporine appeared effective with minimal infection risk compared to methotrexate. This case highlights the importance of tailored, cautious immune suppression to manage GPP in HIV and balancing efficacy with infection risk. Conclusion: Cyclosporine may be an effective option for managing GPP in HIV-infected patients with CD4+ decline when used cautiously with close monitoring for opportunistic infections.

Background: Skin aging is characterized by a gradual loss of tissue and organ function. Skin aging can be classified into two types: intrinsic aging, associated with the aging process itself, and extrinsic aging, which is linked to external factors. Microbotox—an intradermal injection of diluted botulinum toxin—has emerged as a promising technique for rejuvenation by improving skin texture, pore size, and sebum control. This review aims to provide a comprehensive overview of the microbotox technique in the context of skin aging, emphasizing its mechanisms, indications, and clinical outcomes. Discussion: In Asia, intradermal injection of botulinum toxin or microbotox has been widely adopted. The technique involves injecting microdroplets of onabotulinumtoxin type A (ONA) into the intradermal layer at lower concentrations compared to conventional methods. Microbotox is highly sought after for its ability to improve skin texture, address enlarged pores, control sebum, and rejuvenate the skin without the stiffness often associated with conventional botox. Conclusion: Microbotox provides multiple dermatological benefits, including improved skin texture, pore reduction, oil control, and fine line softening, with minimal side effects. As an intradermal technique, it offers a safer and subtler alternative to traditional botox. It provides rapid results lasting up to 3-4 months, making it a valuable tool in aesthetic dermatology. This has made microbotox one of the most popular skin rejuvenation treatments today.

Background: Snakehead fish (Channa striata, CS) has traditionally been used in Indonesia as a nutrient to promote wound healing. It contains protein highly similar to human protein, which may be involved in wound healing via biological pathways. We aim to determine the effectiveness of the topical 5% CS extract gel in promoting wound healing. Methods: A double-blind, placebo-controlled randomized clinical trial was conducted from June to August 2022 at the Department of Dermatology, Venereology, and Aesthetics of Dr. Mohammad Hoesin Hospital. We allocated 32 post-skin surgery participants with grade I acute superficial wounds on the face, neck, trunk, and extremities into 2 groups with one receiving 5% CS (n=16) and the other receiving placebo (n=16). Both groups applied the treatments twice daily. Assessments of wound healing using modified REEDA (redness, edema, ecchymosis, drainage, approximation) score, wound size, and adverse effects were done at follow-up days 1, 3, and 7. Results: Both groups showed REEDA score improvements on days 1, 3, and 7, with significant difference between both groups identified on day 3 (p=0.038). Wound size improved at each follow-up in all participants, with the 5% CS group being slightly better than the placebo group on day 3 (p>0.05). A mild adverse event was found in only one participant in the 5% CS group (3.1%). Conclusion: Both 5% CS extract gel and placebo had good safety profile and were effective in promoting wound healing. 5% CS extract gel was better at reducing REEDA score.