Abstract
Background:
Inflammation is a protective mechanism by which the body neutralizes and eradicates harmful agents at the site of injury and conditions tissue repair. Malacca plants contain active metabolites that are believed to be able to cure inflammation.

Aim:
This study aims to test the formula of ethanol extract cream of Malacca leaves 10%, 15%, and 20% with a negative control group (without treatment) and a positive control group (treated with betamethasone cream) and its anti-inflammatory activity through observation of edema of the feet of male mice induced by carrageenan.

Methods:
The physical stability of the cream formula was evaluated every week for 3 weeks at room temperature storage (±29ºC) by observing organoleptic, pH, viscosity, adhesiveness, and spreadability. Furthermore, an in vivo test consisting of 5 treatments and 5 repetitions using the mouse hind paw edema method. The volume of edema was measured using a plestimometer 30 min after carrageenan administration and every day for 4 days of treatment.

Results:
The results of the study showed the most significant decrease in edema volume using 10% (F1) Malacca cream. Differential leukocyte counts showed that the percentage of eosinophils in group K1 was the highest and significantly different (P<0.05) compared to other groups (K2, F1, F2, and F3). The percentage of neutrophils in groups F2 and F3 increased, whereas that in group K2 decreased, and that in group F1 decreased significantly (P<0.05). The percentage of monocytes in the groups treated with K2, F1, F2, and F3 was higher than that in group K1. The percentage of lymphocytes in groups F1, F2, and F3 was higher than that in group K1. However, basophils were not found in all treatment groups.

Conclusion:
Ethanol extract of Malacca cream (Phyllanthus emblica) has been proven to have anti-inflammatory effects in mice after being induced by carrageenan with mechanisms such as inhibition of the NF-κB pathway, modulation of pro-inflammatory cytokines, activation of the antioxidant pathway, and inhibition of inflammatory enzymes. The most optimal potential as an anti-inflammatory and leukocyte regulation agent is shown in the administration of 10% Malacca cream.

Key words: Malacca leaf ethanol extract; Inflammation; Leukocyte differential; Plethysmometer; Phyllanthus emblica.