referat besar dermatitis numular

NUMMULAR DERMATITIS

By:FUAD TRY KHALAS 110 210 0124NUR RAHMY 110 210 0084IKA NOVI ASTUTI 110 210 0105

PEMBIMBING:dr. Eman Arif Rahman

SUPERVISOR:dr. Sri Rimayani, Sp.KK

Numular dermatitis is an inflammation of the lesions were settled, with complaints of itching, which is characterized by lesions resembling coins, circular or oval lesions are sharply demarcated. Early lesions such as papules and plaques that are usually accompanied papulovesikel easily broken.

• Numularis dermatitis in adults occur more frequently in men than women. Peak incidence at the age between men and women is about 50-60 years old. Rarely occurs in children, the incidence generally increased with increasing age.

• Predilection area in the lower limbs, body, including the arms and back of hands.

• Numular dermatitis usually causes are unknown.

• There are several factors that contribute Nummular Dermatitis :

– Stafilococcus and Micrococcus allegedly played a role,

for example Stafilococcus aureus– Contact dermatitis has a role, for example allergic to

nickel, chromium, cobalt, as well as irritation with wool and soa

– Emotional stress and beverages that contain alcohol.– Environment with low humidity– Bathing with soap repeatedly so that the skin becomes

dry

ACUTE

CHRONIC

vesicles and papulovesikel, then enlarges and extends to the side, forming erythematous macular lesions and plaques that resemble coins demarcated

Gradually ruptured vesicles, exudation occurs then dries into yellowish crusts.Itching can occur in minimal to severe.

dry, scaly, and lichenified

Diagnosis

1. Anamnesis

2. Physical Examination

3. Additional Examination– Laboratorium Examination– Histopatology Examination

(A). Pruritus, round, nummular (coin), erythematous, on arm.

(B). Close-up image, inflammatory lesions, such as plaque consisting of confluent,

papulovesicular, serous fluid-filled lesions that lead to crusting and usually yellow.

Differential Diagnosis

• Neurodermatitis

Atopic dermatitis

• Alergic Iritation Dermatitis

Alergic Contact Dermatitis

Management

• Emollient or moisturizer for dry skin after take a bath

• Topical corticosteroid, first class example betamethasone dipropionate ointment, cream 0,05% and second class example example fluocinonide ointment cream/gel 0,05% twice in a day.

• Tar ointment 2-5% a day

• Systemic therapy, we can use systemic antibiotic, example cephalexin or dicloxacillin, 125-500 mg 4 x/day, for children 25 mg/kgBB/day if it cause of Staphylococcus aureus.

• For itchy or if pruritusnya worse given antihistamine

Prognosis

In patients with dermatitis numular of an observation of a number of patients, it was found that 22% cured, 25% were cured for several weeks to years. And 53% are never free of lesions except still in treatment.

Thank You