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Seiring dengan bertambahnya usia seseorang, kulit sebagai jaringan terluar dari tubuh manusia akan memberikan gambaran paling terlihat dari proses penuaan. Penuaan kulit dipengaruhi oleh dua faktor yaitu faktor intrinsik dan faktor ekstrinsik. Faktor intrinsik terjadi secara alamiah dan berkaitan dengan proses degenerasi seluler. Faktor ekstrinsik berkaitan dengan pajanan sinar matahari, rokok, dan polusi udara. Penyebab utama penuaan kulit akibat faktor ekstrinsik berupa pajanan kronik sinar ultraviolet dikenal sebagai photoaging. Tanda klinis photoaging dapat bervariasi, namun yang sering ditemukan berupa perubahan pigmentasi dan keriput. Saat ini telah tersedia lebih dari 100 instrumen penilaian penuaan kulit menggunakan fotografi, dermoskopi, dan alat diagnostik multifungsi namun masih belum ada yang dianggap sebagai baku emas. Tinjauan pustaka ini bertujuan untuk membahas berbagai instrumen penilaian photoaging yang sering digunakan dalam praktik klinis sehari-hari dan karakteristik dari masing-masing instrumen tersebut.

Penuaan kulit merupakan fenomena biologis yang tidak dapat dihindari oleh manusia. Mekanisme yang mendasari penuaan kulit selalu berkembang sehingga penting untuk mengetahui mekanisme molekular terbaru, serta perubahan yang terjadi akibat penuaan agar klinisi dapat menentukan tata laksana yang tepat untuk mencegah dan mengobati penuaan kulit. Terdapat dua faktor yang berperan dalam terjadinya penuaan kulit, yaitu faktor intrinsik dan ekstrinsik. Faktor intrinsik adalah genetik, metabolisme sel, dan perubahan hormonal. Selain itu, terdapat faktor ekstrinsik seperti radiasi ultraviolet, inframerah, dan karsinogen lingkungan yang turut berperan pada penuaan kulit. Pemendekan telomer, stres oksidatif, disfungsi mitokondria, radiasi ultraviolet dan inframerah, peranan polusi udara dan rokok, peranan aryl hydrocarbon receptor (AhR), kerusakan deoxyribo nucleic acid (DNA), cellular senescence, perubahan hormon, pengaruh mikrobiota, vitamin D, akumulasi advanced glycation end products (AGEs), serta inflammaging memegang peranan penting dalam proses penuaan. Proses penuaan tersebut menyebabkan penurunan fungsi dan kapasitas kulit secara progresif yang berpuncak pada gangguan fungsi kulit dan kerentanan terhadap penyakit.

BACKGROUND: Dermatological emergency is a condition requiring immediate identification and treatment to reduce mortality and morbidity. There are several dermatoses resulting in emergency room (ER) visits frequently demonstrated by the geriatric population. However, there is a lack of data about elderly with dermatological presentation seen at the ER in Indonesia. AIM: This retrospective study aims to identify the prevalence of dermatological emergency cases in the elderly at three national referral hospitals in Indonesia within 3 years. METHODS: The sample was geriatric patients who came and/or were consulted by the ER to dermatology and venereology (DV) department. The data (e.g., age, sex, history taking, physical findings, and diagnoses) were collected from medical record from each hospital and presented as a descriptive data. RESULTS: This study showed that there were only 37% of all geriatric emergency dermatological consultations from 2017 to 2020. CONCLUSION: This study concluded that there were more than half non-emergent cases of 3-year period consultation. This condition may raise the need of better training about true emergency and standardized curricula of emergency dermatological presentations in geriatric patients.

Shannaz Nadia Yusharyahya,1 Valdi Ven Japranata,2 Ratih Wulan Kusumahapsari,2 Lili Legiawati,1 Rinadewi Astriningrum,1 Karin Rachmani,1 Chia-Yu Chu3 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia; 2Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia; 3Department of Dermatology, National Taiwan University and Taiwan University College of Medicine, Taipei City, TaiwanCorrespondence: Shannaz Nadia Yusharyahya, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jalan Diponegoro Nomor 71, Kenari, Senen, Jakarta Pusat, Indonesia, 10430, Tel/Fax +62 21 31935383, Email nadiayusharyahya@yahoo.comBackground/Purpose: COVID-19 pandemic has compromised healthcare services in dermatology and venereology. Given such circumstances, studies investigating the consultation pattern of related fields in hospitals were relatively scarce. The present study aimed to delineate such matter from tertiary hospital viewpoint.Methods: Details concerning referred patients from the emergency room, inpatient wards, intensive care unit, and nursery to the Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo Hospital were retrospectively collected from electronic health records. Cases admitted in the 17 months span before and during COVID-19 global outbreak were included. The obtained data were presented descriptively, and Chi-squared test was performed upon attributes of interest at a significance level of 0.05.Results: A slight increase of total consultation was found in the COVID-19 era with an initial reduction at the beginning (April–May 2020). One-time consultation was the most inquired to our department in both periods of which dermatitis was the most prevalent case and Gram staining was the most common examination. Topical antibiotics and emollient were the most prescribed medications before and during the outbreak, respectively. The conformity of initial-final decision, appropriateness of initial-final diagnosis, and consult response time were significantly different (p < 0.05) between the two groups.Conclusion: There were changes of the number of consultation requests in the pandemic era with statistically significant change of decision conformity, diagnoses, appropriateness, and consult response time. Although some changes appeared, the most prevalent diagnoses remained.Keywords: consultation pattern, COVID-19, dermatology, venereology