Efikasi Klinis dan Histopatologis dari Teknik Chemical Reconstruction of Skin Scars (CROSS) Larutan Trichloroacetic Acid (TCA) pada Pasien Parut Akne

Abstract

Background: The application of Chemical Reconstruction of Skin Scars (CROSS) technique in the treatment patients with acne atrophic scars has been sufficiently developed but research has not been peiformed on the Indonesian. Objectives: To find out the clinical and histopathological efficacy c?f CROSS technique between 65% and 95% TCA solution in patients with acne atrophic scars. Methods: Double-blind randomized clinical controlled trial and involving 21 subjects who received CROSS technique with two different treatment o/TCA solution on each side face and an acne atrophic scar lesion without treatment as a control. Clinical repair was assessed based on the criteria of clinical repair according to Lee et al, whereas histopathological repair assessed based on the appearance of collagen semiquantitative{y and qualitatively. Side effect that occured assessed directly. Satisfaction of the su~ject assessed in accordance with the answer in questionnaire. Result: CROSS technique with 95% TCA solution provide histopathological repair better than 65% TCA solution and showed a statistically signfficant while clinical repair showed statistically non-signfficant. Side effect such as transient hyperpigmentation and erythema. Satisfaction with solution ofTCA 95% higher than solution of TCA 65% but not statistically significant. Conclusions: TCA (--:ROSS technique is one simple method of treatment in acne atrophic scars and providing clinical and histophatological repair well with minimum adverse events

Latar belakang: Pemakaian teknik Chemical Reconstruction of Skin Scars (CROSS) dalam penanganan parut atropi akne sudah cu/cup berkembang namun be/um pernah dilakukan penelitian terhadap orang lndonet1·ia. Tujuan: Untuk mengetahui efikasi klinis dan histopatologis dari teknik CROSS larutan TCA 65% dan lan,tan TCA 95% pada pasien parnt atropi akne. Metode: Uji klinis terkontrol acak tersamar ganda dan melibatkan 21 subyek yang mendapatkan 2 perlakuan teknik CROSS larutan TCA yang berbeda pada setiap sisi wajah dan satu lesi parut atropi tanpa perlakuan sebagai kontrol. Perbaikan klinis dinilai berdasarkan /criteria perbaikan /dints menu'rut Lee et al, sedangkan perbaikan histopatologis dinilai berdasarkan tampilan kolagen secara semikuantitat!l dan kualitat!f: Efek samping yang te,:jadi dinilai secara langsung. Kepuasan subjek di nilai sesuai dengan kuisioner. Hasil: Teknik CROSS /arutan TCA 95% memberikan perbaikan histopato/ogis yang lebih baik daripada lan,tan TCA 65% dan secara statistik menunjukkan perbedaan yang bermakna, sedangkan perbaikan k/inis secara statistik menunjukkan perbedaan yang tidak bermakna. Efek samping berupa hiperpigmentasi dan eritema bersifat sementara. Kepuasan subjek terhadap larutan TCA 95% lebih tinggi daripada larutan 65% namun secara statistik tidak bermakna. Kesimpulan: Teknik CROSS larutan TCA merupakan salah satu metode pengobatan parut atropi akne yang sederhana dan memberikan perbaikan klinis dan histopatoplogis yang baik dengan efek samping minimal