HUBUNGAN PENANDA INFLAMASI SISTEMIK DAN KADAR SERUM IMUNOGLOBULIN E TERHADAP DERAJAT KEPARAHAN DERMATITIS ATOPIK

ALDONA, WENTY SEPTA and Nopriyati, Nopriyati and Rusmawardiana, Rusmawardiana and Harahap, Debby Handayati (2025) HUBUNGAN PENANDA INFLAMASI SISTEMIK DAN KADAR SERUM IMUNOGLOBULIN E TERHADAP DERAJAT KEPARAHAN DERMATITIS ATOPIK. Masters thesis, Sriwijaya University.

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Abstract

Latar belakang: Dermatitis atopik (DA) merupakan penyakit inflamasi kulit kronik yang bersifat multifaktorial dan kompleks, dengan manifestasi klinis bervariasi sesuai derajat keparahan penyakit yang menurunkan kualitas hidup pasien secara signifikan. Penilaian derajat keparahan DA menggunakan indeks scoring atopic dermatitis (SCORAD) namun bersifat subjektif dan memerlukan pemeriksa terlatih. Pemeriksaan penanda inflamasi sistemik seperti rasio neutrofil-limfosit (RNL), eosinofil-limfosit (REL), eosinofil-neutrofil (REN) dan platelet-limfosit (RPL), serta kadar serum imunoglobulin E (IgE) diharapkan dapat menilai derajat keparahan DA lebih objektif. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan penanda inflamasi sistemik dan kadar serum IgE terhadap derajat keparahan DA. Metode: Penelitian ini merupakan observasional analitik dengan rancangan potong lintang dilakukan pada 36 pasien DA di poliklinik DVE RSMH Palembang periode April hingga Juni 2025. Derajat keparahan DA dinilai menggunakan indeks SCORAD, diklasifikasikan menjadi ringan-sedang dan berat. Penanda inflamasi sistemik ditentukan dari hasil pemeriksaan laboratorium darah lengkap, dan kadar serum IgE ditentukan dari hasil pemeriksaan laboratorium imunoserologi. Hasil: Terdapat hubungan signifikan REL dan kadar serum IgE terhadap derajat keparahan DA dengan rerata REL dan kadar serum IgE signifikan lebih tinggi pada kelompok DA berat (p<0,05). Analisis multivariat menunjukkan bahwa REL >0,217 dan IgE >418,65 IU/mL berisiko sebesar 22,3 kali dan 42 kali mengalami DA berat. Hal ini dikarenakan dominasi respons imun Th2 pada DA yang menghasilkan sitokin IL-4, IL-5 dan IL-13. Sitokin ini menginduksi proliferasi, aktivasi, dan migrasi eosinofil ke jaringan kulit, serta diferensiasi sel B menjadi sel plasma untuk memproduksi IgE secara berlebihan. Kesimpulan: Penanda inflamasi sistemik yang berhubungan signifikan dengan derajat keparahan DA adalah REL, dan kadar serum IgE juga berhubungan signifikan terhadap derajat keparahan DA. Rasio eosinofil-limfosit dan kadar serum IgE dapat dipertimbangkan sebagai pemeriksaan yang lebih objektif untuk menentukan derajat keparahan DA. Kata kunci: dermatitis atopik, penanda inflamasi sistemik, imunoglobulin E, SCORAD, rasio eosinofil-limfosit Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial and complex pathogenesis, characterized by various clinical manifestations depending on disease severity, which significantly reducing patients quality of life. Severity of atopic dermatitis is assessed using scoring atopic dermatitis (SCORAD) index, but it relatively subjective and requires trained assessors. Evaluation of systemic inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-neutrophil ratio (ENR) and platelet-to-lymphocyte ratio (PLR), along with serum immunoglobulin E (IgE) levels, is expected to enable more objective evaluation of AD severity. Objective: This study aims to analyze the association of systemic inflammatory markers and serum IgE levels with severity of AD. Methods: This analytic observational study with a cross-sectional design included 36 AD patients at the DVE outpatient clinic of RSMH Palembang from April to June 2025. Atopic dermatitis severity was assessed using SCORAD index, classified as mild-moderate and severe. Systemic inflammatory markers determined from complete blood count (CBC) results, and serum IgE levels obtained from immunoserological assays. Results: Significant association was found between ELR, serum IgE levels and AD severity, with the mean values of both ELR and serum IgE levels were significantly higher in severe AD group (p<0.05). Multivariate analysis showed that ELR >0.217 and serum IgE >418.65 IU/mL were 22.3-fold and 42-fold increased risk of having severe AD. The Th2-dominated immune response in AD is characterized by production of cytokines IL-4, IL-5, and IL-13. These cytokines induce eosinophil proliferation, activation, and migration into the skin, also promote B cell differentiation into plasma cells, for excessively produce IgE. Conclusion: Systemic inflammatory markers that showed a significant association with AD severity is ELR, and serum IgE levels were also significantly associated with AD severity. Both ELR and serum IgE levels may be considered as more objective evaluation for assessing AD severity. Keywords: atopic dermatitis, systemic inflammatory markers, immunoglobulin E, SCORAD, eosinophil-to-lymphocyte ratio

Item Type:	Thesis (Masters)
Uncontrolled Keywords:	dermatitis atopik, penanda inflamasi sistemik, imunoglobulin E, SCORAD, rasio eosinofil-limfosit
Subjects:	R Medicine > RL Dermatology > RL1-803 Dermatology
Divisions:	04-Faculty of Medicine > 11704-Dermatology and Venereology (Sp
Depositing User:	Wenty Septa Aldona
Date Deposited:	22 Jul 2025 07:28
Last Modified:	22 Jul 2025 07:28
URI:	http://repository.unsri.ac.id/id/eprint/179225

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