mini poster neurodermatitis

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7/23/2019 Mini Poster Neurodermatitis http://slidepdf.com/reader/full/mini-poster-neurodermatitis 1/24 OLEH:  AINIL MAKSURA 111 2015 0041 FAKULTAS KEDOKTERAN UNIVERSITAS MUSLIM KEDOKTERAN 2015 MINI POSTER NEURODERMATITIS

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Page 1: Mini Poster Neurodermatitis

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O L E H :

 A I N I L M A K S U R A 1 1 1 2 0 1 5 0 0 4 1

F A K U L T A S K E D O K T E R A N

U N I V E R S I T A S M U S L I M K E D O K T E R A N

2 0 1 5

MINI POSTER 

NEURODERMATITIS

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IDENTITAS PASIEN

Nama : Tn. S

Umur : 69 tahun

Jenis kelamin : Laki-laki

 Alamat : Jl. BTN Minasa Upa blok A1 no. ! A"ama : #slam

Suku : Makassar

No. $M : 11%&9!

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 ANAMNESIS

'U: luka pa(a kaki kanan (an kiri

)ialami se*ak kuran" lebih 1 tahun +an" lalu,

aaln+a han+a luka keil +an" san"at "atal, hilan"timbul (an ti(ak menentu. 'a(an" keluar (arah

akibat (i"aruk (an a"ak n+eri. $ia+at aler"i

makanan (an obat-obatan (isan"kal. $ia+at kontak

lama (en"an air atau bahan iritan tertentu ti(ak a(a.

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• Sakit rin"an / 0ii Baik / 2omposmentis

• 3emeriksaan tan(a 4ital:

T): 1&!/9! mm5"

Na(i: %!/menit

3ernapasan: /menit

Suhu: &6,& (era*at 2

KEADAAN UMUM

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•  Anemis 7-8, #kterus 7-8, sianosis 7-8

• Thoraks : )alam Batas Normal

 Ab(omen : )alam Batas Normal• kstremitas : )eormitas 7-/-8, e(ema 7-/-8,

eritema 7;/;8

• 'elen*ar Lime: )alam Batas Normal

PEMERIKSAAN FISIS

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PEMERIKSAAN STATUS DERMATOLOGIS

REGIO: 3e(is (etra et sinistra

EFFLORESENSI: 3lak hiperpi"mentasi, krusta(an ekskoriasi, likeniikasi (an se(ikit skuama

krusta (an ekskoriasi

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EFFLORESENSI

3lak hiperpi"mentasi,Likeniikasi (an se(ikit skuama

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NEURODERMATITIS

DIAGNOSA 

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Seoran" pria 69 tahun (atan" ke poli 'ulit (an 'elamin

$S#< (en"an keluhan luka pa(a kaki kanan (an kiri +an"

(ialami se*ak kuran" lebih 1 tahun +an" lalu, aaln+a

han+a luka keil +an" san"at "atal, hilan" timbul (an

ti(ak menentu. 'a(an" keluar (arah akibat (i"aruk (an

a"ak n+eri. $ia+at aler"i makanan (an obat-obatan(isan"kal. $ia+at kontak lama (en"an air atau bahan

iritan tertentu ti(ak a(a.

RESUME

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PENATALAKSANAAN

1. #nerson ream ; uson ream pa"i-sore

. 2ea(roil =!! m" & (( #

&. 2etiriine 1! m" 1 (( #

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PROGNOSIS

<un"sionam : (ubia a( bonam

 >itam : a( bonam

Sanationam : (ubia a( bonam

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NEURODERMATITIS

)#S'US#

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DEFINISI

 A(alah pera(an"an kulit kronis, +an" (itan(ai

(en"an kulit tebal (an "aris kulit tampak menon*ol

7likeniikasi8 men+erupai batan" ka+u akibat

"arukan atau "osokan +an" berulan" ? ulan" karena

 berba"ai ran"san"an prurito"enik.

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EPIDEMIOLOGI

Terserin" kelompok usia (easa &! ? =! tahun.

Neuro(ermatitis lebih serin" ter*a(i pa(a anita

terutama pa(a umur perten"ahan in(i4i(u.Jaran" ter*a(i pa(a anak-anak, karena pen+akit +an"

 bersiat kronis (an (ipen"aruhi oleh kea(aan emosi

(an pen+akit +an" men(asarin+a.

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ETIOPATOGENESIS

osinoil +an" berisi protein @ (an protein kationik 

Menimbulkan (e"ranulasi sel mast.

 Aktikan sel-sel sara berisi 20$3 7Calcitonin Gene- Related Peptide8 (an S3 7substance P) (i (ermis

$espon (ari a(an+a kea(aan emosional / stress.trauma mekanik, pen+akit kronik +an" men(asari

5istamin lepas (ari sel mast

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Lanjutan...

no(ular likeniikasi (anh+perkeratosis.

0arukan (an "osokan berulan"

pruritus

pelepasan me(iator (an akti4itasenim proteolitik.

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DIAGNOSIS

P!"#$!%&#:  leher, pun""un", (an ekstremitas

terutama per"elan"an tan"an, kaki, lutut, pubis,

 4ul4a, skrotum, perianal serta bokon".

E'$(!&!n&#: berukuran mulai beberapa milimeter -

m, terlihat plak (en"an ekskoriasi, se(ikit

eritematosa e(ema, likeniikasi, hiperpi"mentasi,

serta tampak berskuama.

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rosi (an ekskoriasi

Likeniikasi, hiperpi"mentasi

ritematosa, (ema

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PEMERIKSAAN PENUN)ANG

3emeriksaan U*i Tempel

3emeriksaan Laboratorium

5istopatolo"i

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DIAGNOSA *ANDING

)ermatitis atopik tipe (easa

3ruri"o no(ularis

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PENATALAKSANAAN

Nonmedikamentosa:

1. Hindari menggaruk lesi

2. Hindari gigitan serangga

Medikamentosa:

1. Antipruritus: antihistamin yang mempunyai efek sedatif (prometazin,

difenhidramin, hidroksizin). Antihistamin topikal yang dapat

diberikan yaitu krim doxepin ! "angka pendek (maksimal # hari)

2. $ortikosteroid topikal: kortikosteroid poten atau suntikan intralesi

%. &' (&ltraiolet ) atau *&'A (*soralen &ltraiolet A)

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PROGNOSIS

<un"sionam : (ubia a( bonam

 >itam : a( bonam

Sanationam : (ubia a( bonam

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KOMPLIKASI

Bisa berupa perubahan arna pa(a kulit +an"

permanen

Ter(apatn+a bekas luka akibat "arukan sampaiter*a(in+a ulkus karena serin"n+a pasien

men""aruk.

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DAFTAR PUSTAKA 

1. Sularsito SA, )*uan(a S. #lmu 3en+akit 'ulit (an 'elamin .=th.

e(. 3enerbit <'U#, Jakarta !!=. p. 19-1=&. 'oeni" T, Jones S0, $enie A,Tausk <A.Nonutaneous maniestations o skin.#n:<ree(ber" #M,isen AC,ol

',Austen '<, 0ol(smith LA, 'ATC S2,e(itors.<itpatrikDs )ermatolo"+ in 0eneral Me(iine, % the(. Ne Eork : M0ra 5ill !1.p.1=%-16

&. Sire"ar $S. Atlas Berarna Saripati 3en+akit 'ulit n(e(. 3enerbit buku ke(okteran 02, Jakarta,!1&.p.1&=-F

G. Murtiastuti ), r4ianti , A"usni #, et al. Atlas 3en+akit 'ulit (an 'elamin. n(e(. Airlan"""a Uni4ersit++ 3ress,Suraba+a, !1! p 11F-%

=. 5istopatolo"i Neuro(ermatitis. )iun(uh % A"ustus !1&.http://missin"link.us.e(u/lm/(ermatolo"+"lossar+/lihenHsimpleHhronius.htm

6. Lesi Neuro(ermatitis. )iun(uh % A"ustus !1&.http://4enasaphenama"na.blo"spot.om/!11/1!/neuro(ermatitis-sirkumskripta.html

F. Lihen Simple 2hronis. )iun(uh % A"ustus !1&.http://.(ermnet.om /pruri"oHno(ularis.pi

%. )ermatitis Atopik. )iun(uh % A"ustus !1&.http://.me(iinenet.om /(ermatitis atopi.pi

9. 3ruri"o No(ularis. )iun(uh % A"ustus !1&.http://.skinsi"ht.om /Lihensimplehroni.

1!. )eoto, $. 5e(i. <armakolo"i (an Terapi. (isi =. <'U#, Jakarta !!%. 3 F&-%F

11. $a(manesh M,Sharii M,Shaiei S. #ranian Journal o )ermatolo"+ 4ol 1G.no1.#ranian Soiet+ o )ermatolo"+.Srin"

!11 p" =-%1. Shul S, Met M, Siepmann ), et al.Antipruriti eia+ o hi"h-(osa"e antihistamine therap+. $esults o a

retrospeti4el+ anal+se( ase series. 5autart !!9I 6!: =6G-%

1&. Maa M,Journal o linial pharma+ an( therapeuti 4ol &% issue 1,p"16-%,<ebuar+ !1&.

1G. Stan(er S, Shurme+er 5<,Lu"er TA, eisshaar .Treatment o pruriti (isease ith topial alineurin inhibitors.Ther 2lin $isk Mana" !!6I p" 1&-%

1=. Siepmann ), Lu"er TA, Stan(er S.Antipruriti eet o +losporine miroemulsion in pruritus : results o a aseseries.J )tsh )ermatol 0es !!%I6 p" 9G1-6