Photoaging

Photoaging. Pembimbing : Dr. dr. Satya Wydya Yenny , Sp.KK (K),FINSDV,FAADV Oleh: dr. Afifah Alfyanita dr. Deasy Archika Alvares dr. Fitria Putri dr. Rendra Darmasatria.

Penuaan intrinsik Penuaan yang terjadi seiring bertambahnya usia Penuaan ekstrinsik Penuaan yang dipengaruhi oleh faktor lingkungan.

Apoptosis Intrinsic Aging Repeated cell divisions Loss of Telomere Teiomere Disruption Of telomere loop 5'...TTAGGG...3' Exposure ofTTAGGG overlap Activation Senescence of p53 Extrinsic Aging UV Thymine dimers DNA coding mutations Cancer or Aging.

TABLE 109-1 Histologic Features of Aging Human Skin Epidermis Flattened dermal-epidermal junction Variable/decreased thickness Variable cell size and shape Occasional nuclear atypia Fewer melanocytes Fewer Langerhans cells Dermis Atrophy (loss of dermal volume) Fewerfibroblasts Fewer mast cells Fewer blood vessels Shortened capillary loops Abnormal nerve endings Appendages Depigmented hair Lossofhair Conversion of terminal to vellus hair Abnormal nail plates Fewerglands.

TABLE 109-2 Functions of Human Skin That Decline with Age Barrier function Cell replacement Chemical clearance DNA repair Epidermal hydration Immune responsiveness Mechanical protection Sebum production Sensory perception Sweatproduction Thermoregulation Vitamin D production Wound healing.

Photoaging. penuaan kulit yang diakibatkan oleh paparan sinar UV superposisi kerusakan kronis pada penuaan intrinsik Radiasi UVC diblok oleh lapisan ozon dan memiliki sedikit pengaruh pada kulit UVB berpenetrasi hanya sampai ke epidermis UVA berpenetrasi hingga ke dermis sehingga berperan photoaging 6.

UVB UVA Near IR Epidermis Dermis Subcutis. Gambar 3. Penetrasi relatif radiasi sinar matahari ke dalam kulit manusia terkait dengan fungsi panjang gelombang. 14.

Gambar 4. Model efek radiasi sinar matahari pada kulit. 14.

50. Hipotesis terbentuknya solar scar.

Glogau Classification of Photoaging.

A. B. C. D.

Tabel 2. Gambaran kulit yang mengalami photoaging. 2 KLINIS HISTOLOGI Kering (kasar) Peningkatan kepadatan stratum korneum, peningkatan ketebalan lapisan sel granuler, pengurangan ketebalan epidermal, pengurangan isi musin epidermal Keratosis aktinik Nuklear atipikal, hilangnya keteraturan, maturasi keratinosit yang progresif; hiperplasi dan/atau hipoplasi epidermal ireguler; inflamasi dermal yang jarang Pigmentasi ireguler Freckle Pengurangan atau peningkatan jumlah melanosit hipertrofi, positif-DOPA kuat Lentigo Pemanjangan rete ridge epidermal; peningkatan jumlah dan melanisasi melanosit Hipomelanosis gutata Pengurangan jumlah melanosit atipikal Hiperpigmentasi ireversibel difus ( bronzing ) Peningkatan jumlah melanosit positif -DOPA dan peningkatan isi melanin per unit area dan peningkatan jumlah melanofag dermal.

Tabel 2. Gambaran kulit yang mengalami photoaging ( lanjutan ) Keriput Garis permukaan halus Tidak ada yang terdeteksi Kernyit yang dalam Kontraksi septa pada lemak subkutaneus Pseudoskar stelata Tidak adanya pigmentasi epidermal, gangguan kolagen dermal dan berfragmen Elastosis (nodul halus dan/atau kasar) Agregasi noduler dari bahan fibrosa dan amorf pada dermis papiler Inelastisitas Dermis elastotik Telangiektasia Pembuluh darah ektatik sering disertai dinding atrofi Venous lakes Pembuluh darah ektatik sering disertai dinding atrofi Purpura (mudah memar) Eritrosit ekstravasasi dan peningkatan inflamasi perivaskuler Komedo (maladie de Favre et Racouchot) Ektasia orifisium folikuler pilosebaseus Hiperplasi sebasea Hiperplasi konsentrik kelenjar sebaseus a Karsinoma sel basal dan karsinoma sel skuamosa juga terjadi pada kulit yang mengalami photoaging tetapi tidak seperti isi tabel , hanya mengenai sejumlah kecil individu ..

Penanganan. menentukan derajat keriput edukasi pasien pencegahan keriput lebih lanjut adalah penanganan yang utama Aplikasi topikal, terutama asam retinoat Antioksidan fotorejuvenasi intensed pulsed light (IPL) light emitting diodes (LEDs).

Elastosis Solaris. Diskolorasi kuning Permukaan seperti berkerikil Massa kompleks serat elastin yang mengalami degradasi , deteriorasi membentuk massa amorfik.

Lentigo senilis. disebut juga lentigo solaris makula berpigmen yang timbul setelah dekade kelima atau enam pada kulit yang rusak akibat sinar matahari Hingga 90% pasien tua memiliki 1 atau lebih lesi LS.

berupa makula kecoklatan dengan diameter sekitar 1 cm Diagnosis berdasarkan kriteria klinis , yaitu permukaan halus , warna heterogen coklat terang hingga coklat gelap , batas tidak tegas , ukuran > 5 mm, dan biasanya mengenai individu dengan usia > 50-60 tahun. 26.

Purpura Senilis. Hilangnya elastisitas kulit Melemahnya dinding kapiler Ekstravasasi eritrosit Trauma.

[Audio] Custom animation effects: text rebound (Intermediate) To reproduce the text effects on this slide, do the following: On the Home tab, in the Slides group, click Layout, and then click Blank. On the Insert tab, in the Text group, click Text Box. Drag to draw a text box on the slide. In the text box, enter text and select it. On the Home tab, in the Font group, do the following: In the Font list, select Corbel. In the Font Size box, enter 50. Click Bold. On the Home tab, in the Paragraph group, click Center. Select the text box on the slide. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click More WordArt, and then under Applies to All Text in Shape click Fill - Accent 1, Plastic Bevel, Reflection (first row, fifth option from the left). To reproduce the animation effects on this slide, do the following: On the View tab, in the Zoom group, click Zoom, and then in the Zoom dialog box, select 66%. On the Animations tab, in the Animations group, click Custom Animation. On the slide, select the text box. In the Custom Animation task pane, do the following: Click Add Effect, point to Entrance, and then click More Effects. In the Add Entrance Effects dialog box, under Subtle, click Fade. Select the animation effect (fade effect for the text box). Under Modify: Fade, do the following: In the Start list, select With Previous. In the Speed list, select Fast. Click Add Effect, point to Motion Path, point to Draw Custom Path, and then click Freeform. Press and hold SHIFT, and then do the following to draw the freeform line on the slide: Click the first point in the center of the text box. Click the second point on the right edge of the text box. Double-click the third and final point 2" beyond the left edge of the slide. In the Custom Animation task pane, select the custom path effect. Under Modify: Custom Path, do the following: In the Start list, select With Previous. In the Speed list, select Medium. On the slide, right-click the motion path on the slide, and select Reverse Path Direction. To reproduce the background effects on this slide, do the following: Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following: In the Type list, select Radial. Click the button next to Direction, and then click From Center (first row, second option from the left). Under Gradient stops, click Add or Remove until two stops appear in the drop-down list. Also under Gradient stops, customize the gradient stops that you added as follows: Select Stop 1 from the list, and then do the following: In the Stop position box, enter 0%. Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). Select Stop 2 from the list, and then do the following: In the Stop position box, enter 100%. Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 200, Green: 209, and Blue: 218..

retinoid meningkatkan sintesis kolagen mengurangi MMP Vitamin kemampuan antioksidan yang kuat Antioksidan mengurangi ROS yang timbul dari radiasi UVA Diet lemak tertentu mengurangi kadar mediator pro- inflamasi Perlindungan terhadap sinar matahari mengurangi konsumsi rokok.

TERIMA KASIH.