EVALUATION OF A PSEUDOCERAMIDE

MOISTURIZER IN PATIENTS WITH

MILD-TO-MODERATE ATOPIC
DERMATITIS
Amelie Clementine Seghers. Spohie Cham Chai. Madeleine
Sheun Ling Ho. Yoke Chin Giam. Lucinda Tan. Carina Marie
Gronhagen. Mark Boon Yang Tang.

KEPANITERAAN KLINIK ILMU PENYAKIT

KULIT DAN PENYAKIT KELAMIN
RSAL MINTOHARDJO

Anita Damar Riyanti 030.10.034

PENDAHULUAN
1
Dermatitis
Atopik

Disfungsi
skin barrier

Pendekatan
terapetik

Penyakit kulit
inflamasi
kronis
berulang
kualitas hidup

Lemak (50 %
ceramide) dan
protein
stratum
korneum (5)

Memperbaiki
skin barrier
jumlah
ceramid pada
kulitnya

(1-4)
1.
2.
3.
4.
5.

Kim HY, Kwon EB, Baek JH, Shin YH, Yum HY, Jee HM, et al. Prevalence and comorbidity of allergic diseases in
preschool children. Korean J Pediatr. 2013;56:33842.
Leung DY, Bieber T. Atopic dermatitis. Lancet. 2003;361:15160.
Bieber T. Atopic dermatitis. N Engl J Med. 2008;358:148394.
Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and
demographic factors: a US population-based study. J Allergy Clin Immunol. 2013;132:11328.
Sajic D, Asiniwasis R, Skotnicki-Grant S. A look at epidermal barrier function in atopic dermatitis: physiologic
lipid replacement and the role of ceramides. Skin Ther Lett. 2012;17(7):69.

TUJUAN
2
Evaluasi
Keamanan dan
penilaian
keefektifan
fisiologis kulit
dewasa dan
dan
anak dengan DA
akseptabilitas
ringan-sedang di
subjek terhadap
iklim tropis
moisturizer

METODE
3

Prospective, 4-week, non-controlled open label

clinical trial

17. Ishikawa J, Shimotoyodome Y, Chen S, Ohkubo K, Takagi Y, Fujimura T, et al. Eucalyptus

increases ceramide levels in keratinocytes and improves stratum corneum function. Int J
Cosmet Sci. 2012;34(1):1722.

SUBJEK PENELITIAN
4

40 pasien RJ National Skin Centre,

Singapore
Kriteria Eksklusi
Kriteria Inklusi

DA (kriteria UK Working Partys

Group)

Usia 7 60 tahun

Stable, DA ringan-sedang (SCORAD)

Recent disease flare

Penggunaan terapi sistemik (Ab,

fototerapi, KS, imunosupresan)
dalam kurun waktu 4 minggu

DESAIN STUDI
5

Week 0

Week II

PF

Studi

Fisiologis
kulit
Adverse
event

Singapor
e
Iklim
tropis
tanpa

Week IV
Krim
2x/hari
Tidak
boleh
krim lain
Cleanser

Penilaian Klinis Derajat DA

(22-24)
6

SCORAD
index

TIS
(threeitemseverity)
scores

22. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European
Task Force on
Atopic Dermatitis. Dermatology 1993;186(1):2331.
23. Charman C, Chambers C, Williams H. Measuring atopic dermatitis severity in randomized controlled clinical trials:
what exactly are we measuring? J Invest Dermatol. 2003;120(6):93241.
24. Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of
scoring atopic dermatitis: the SCORAD index, objective SCORAD and the threeitem severity score. Br J Dermatol.

Studi Fisiologis Kulit

(25-26)

Hidrasi SK
Corneometer
CM 825
(Jerman)

TEWL
(transepiderma
l water loss)
Tewameter TM
300 (Jerman)

25. GmbH CE. Information and Operating Instructions for the Corneometer CM825. http:// www.couragekhazaka.de/index.php/en/products/ scientific/294-corneometer-2. Last Accessed May 09, 2012.
26. Fluhr JW, Kuss O, Diepgen T, Lazzerini S, Pelosi A, Gloor M, et al. Testing for irritation with a multifactorial
approach: comparison of eight noninvasive measuring techniques on five different irritation types. Br J Dermatol.

Penilaian Derajat DA
8

DLQI
(Dermatology
Life Quality
Index) (27,28)

POEM
(Patientoriented
eczema
measure)
(29,30)

Skor
subjektif
pruritus dan
insomnia

27. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)a simple practical measure for routine clinical use.
Clin Exp Dermatol. 1994;19(3):2106.
28. Lewis-Jones MS, Finlay AY. The Childrens Dermatology Life Quality Index (CDLQI): initial validation and practical
use. Br J Dermatol. 1995;132(6):9429.
29. Wolkerstorfer A, de Waard van der Spek FB, Glazenburg EJ, Mulder PG, Oranje AP. Scoring the severity of atopic
dermatitis: three item severity score as a rough system for daily practice and as a pre-screening tool for studies.
Acta Derm Venereol. 1999;79(5):3569.
30. Oranje AP. Practical issues on interpretation of scoring atopic dermatitis: SCORAD Index, objective SCORAD,

Analisis Statistik
9

Friedman test
SPSS versi 21
Nilai p < 0.05

10

HASIL PENELITIAN

11

12

13

DISKUSI

Perbaika
n derajat
DA

Kualitas
hidup

Pseudocera
mid
moisturizer

Skor
pruritus

14

Hidrasi
SK

Aman
5 % pruritus
minggu III
1 pasien berhenti
akibat facial rash
minggu IV
15

KESIMPULAN
16

Pemakaian
rutin
moisturizer
pseudoceram
ide

Aman dan
efektif
terapi
maintanan
ce DA
ringansedang

Studi perbandingan antara plasebo

atau krim standard dan krim
mengandunglemak peran lipidbased moisturizer pada terapi DA

18

THANK YOU