infeksi bakteri
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PENYAKIT KULIT YANG DISEBABKAN OLEH BAKTERIYunita Hapsari Bagian Ilmu Kesehatan Kulit dan KelaminFakultas Kedokteran Universitas Mataram
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PYODERMAInfeksi pada kulit, yang disebabkan oleh bakteri yg membentuk nanah atau piogenik dan mudah menularEtiologi :Staphylococcus S.aureusStreptococcus Streptococcus grup AKedua-duanya
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Faktor predisposisi :Daya tahan tubuh rendahHigiene individu kurangHigiene lingkungan kurangTelah ada penyakit kulit sebelumnya
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Klasifikasi pyoderma :PRIMERSEKUNDERImpetigo FolikulitisFurunkelKarbunkelParonikia Ektima ImpetigenisataHidradenitis supurativaIntertrigoUlkus
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IMPETIGOPyoderma superfisialEtiology : Streptococcus grup A S.aureus2 bentuk :BulosaNon-bulosa / krustosa
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Impetigo vesiko-bulosa, cacar monyetEtiology : phage group II S.aureus (strain 77 & 55) exfoliatin toxin type A and BClinical : newborn and older infantsVesicle flaccid bullae (rapid progression)Nikolsky sign (-)Bullae : clear yellow fluid dark yellow & turbidMargin : sharply demarcated w/o erythematous halow/i a day or two bullae rupture & collapseIMPETIGO BULOSA
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IMPETIGO BULOSA
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Lab : Pengecatan GramKultur histoPADD/ :Dermatitis kontakInsect biteErupsi obat tipe bulosaIMPETIGO BULOSA
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Complication :CellulitisLymphangitisBacteremiaOsteomyelitisSeptic arthritisPneumonitisSepticemiaSSSSIMPETIGO BULOSA
- IMPETIGO NON BULOSA/KRUSTOSAImpetigo kontagiosa, impetigo vulgaris, impetigo Tillbury Fox70% of cases of this form of pyodermaEtiology :Streptococcus group A pre-school aged children (
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Clinical finding:Pruritus; soreness; burning ; painlessCommonly on the skin of the face (around the nares) or extremities after traumaTransient pustule or vesicle honey-colored crusted plaque (2cm) w/i surrounding erythemaNo constitutional symptomsRegional lymphadenopathy (90%)
IMPETIGO NON BULOSA/KRUSTOSA
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IMPETIGO NON BULOSA/KRUSTOSA
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Lab : Gram stainCulture DD/ :Atopic dermatitisAllergic contact dermatitisVaricella Dermatophyte infectionIMPETIGO NON BULOSA/KRUSTOSA
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Complication :Untreated process may persist and new lesions over the course and for several weeksResolve spontaneusly except there is some underlying cutaneous diseaseErysipelasCellulitisBacteremiaMajor serious sequela acute post-streptococcal glomerulonephritisIMPETIGO NON BULOSA/KRUSTOSA
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MANAGEMENT OF IMPETIGOWashing (removal of dirt, crusts and debris by soaking with soap & water)Good hygienePharmacology: topical and systemicTopical & Systemic Antibiotic
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FOLIKULITISDef : a pyoderma that begins within the hair folliclesClassified : Depth of invasion : superficial and deepMicrobial etiology : bacterial, fungal, viral and parasite infestation
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FOLIKULITIS SUPERFISIALImpetigo Bockhart; follicular impetigoEtiology : S.aureusClinical finding:Location : scalp (children); beard area, axillae, extremities, buttocks (adults)A small, fragile, dome-shaped pustule infudibulum of a hair follicleDD/ : - gram-negative folliculitisPityrosporum folliculitisHerpes simplexDeep folliculitis sycosis barbae
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FURUNKELBoil / bisulDeep-seated inflammatory nodule that develops around a hair follicle, usually from a preceding, more superficial folliculitis and often evolving into an abcessEtiology: S.aureusClinical finding :Pain surrounding the lesionNodule (hard, tender, red folliculocentric) enlarge fluctuant abcess formation ruptureSingle/multiple
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Furunkel / Furunkulosis ?
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FURUNKELLab:LeukocytosisGram stain of pusCulture
ComplicationNot commonRecurrent furunculosis
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KARBUNKELLarger, more serious inflammatory lesion with a deeper baseExtremely painfulFever, malaiseLocation : nape of the neck, the back or thighsEfl : red, indurated, multiple pustules confluent
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MANAGEMENT OF FURUNCLE & CARBUNCLEWashing and hygieneLocalized local application of moist heatSystemic systemic antibiotic Incision and draining the lesions
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EKTIMAA cutaneous pyoderma characterized by thick crusted erosions or ulcerationEtiology: S.aureus &/ group A StreptococcusClinical finding:Poor hygiene & neglectLocation : lower extremities (children, DM, elderly)Efl: ulcer punched-out, indurated, raised, violaceous, granulating base slow to heal need several weeks of antibiotic treatments
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ERISIPELAS Soft tissue infection erysipelas & cellulitisUsually present at an antecedent lesion or siteLocal pain, variable degrees of erythema, systemic symptoms
- ERISIPELAS Distinct type of superficial cutaneous cellulitis with marked dermal lymphatic vessel involvementEtiology : group A -hemolytic Streptococcus (>>) ; S.aureus (
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SELULITISExtends deeper into the dermis and subcutaneous tissueEtiology : S.aureus and group A Streptococcus (>>)Clinical finding :Erythema, tenderness, painLack of distinctive margins between affected and normal skinDeeper, firmer form of tender indurationCrepitus on palpationBulla and necrosisRegional lymphadenopathy
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SELULITIS
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PENATALAKSANAANIstirahat tirah baring & elevasi tungkaiSistemik antibioticTopikal : kompres dingin dengan normal saline sterilIntervensi bedah
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