Download - Pioderma
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PIODERMAPIODERMA
Dr. Brahm U. Pendit, SpKK
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Definisi & predisposisiDefinisi & predisposisiInfeksi kulit yang disebabkan oleh Staphylococcus dan/atau Streptococcus
Faktor predisposisi– Higiene– Daya tahan (gizi kurang, anemia, peny. kronik,
keganasan, dsbnya)– Penyakit kulit lain
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KlasifikasiKlasifikasi
Pioderma primer– Terjadi pada kulit normal– Satu jenis kuman
Pioderma sekunder– Sudah ada penyakit kulit– Lesi tak-khas– Disebut impetigenisata
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IMPETIGOIMPETIGO
Pioderma terbatas di epidermis (pioderma superfisialis)
Klasifikasi– Impetigo krustosa (impetigo kontagiosa, impetigo
vulgaris)– Impetigo vesikobulosa (cacar monyet)– Impetigo neonatorum
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Impetigo KrustosaImpetigo Krustosa
Biasanya karena Streptococcus ß haemolyticusAnakWajah,yi periorifisium (mulut, hidung)Tanpa gejala sistemikEritema & vesikel yg cepat pecah krusta kuning maduPenyulit glomerulonefritis (<5%)DD/ Ektima
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Impetigo vesikobulosaImpetigo vesikobulosa
Biasanya disebabkan Staphylococcus aureusAnak/dewasaKetiak, dada, punggungSering bersama miliariaTanpa gejala sistemikEritema, bula, bula hipopion, erosi dg skuama kolaret
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Impetigo neonatorumImpetigo neonatorum
Varian impetigo vesikobulosa pada neonatusLesi seperti impetigo vesikobulosa tetapi generalisataDemamDD/ Sifilis kongenital
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FolikulitisFolikulitis
Radang folikel rambutBiasanya disebabkan Staphylococcus aureusFolikulitis superfisialis (impetigo Bockhart): tungkai bawah; papul/pustul eritematosa dgn rambut di tengah; multipelFolikulitis profunda: ada infiltrat subkutis, mis. sikosis barbeDD/ Tinea barbe
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Furunkel/KarbunkelFurunkel/Karbunkel
Radang folikel rambut dan jaringan di sekitarnyaMultipel = furunkulosisKarbunkel = furunkel yang menjadi satuBiasanya disebabkan oleh S. aureusNodus eritematosa yg nyeri abses pecah fistulaAksila, bokong
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EktimaEktima
Ulkus superfisial dg krusta di atasnyaStreptococcus ß haemolyticusKrusta tebal kuning dg ulkus dangkal di bawahnyaTungkai bawah
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ErisipelasErisipelas
Infeksi akut streptokokus di epidermis & dermisGejala konstitusiTungkai bawah (trauma)Eritema merah cerah, batas tegas, tepi meninggi, tanda-tanda radang akutDapat timbul edema, vesikel, bulaLeukositosis
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SelulitisSelulitis
Serupa dgn erisipelas tetapi juga mengenai subkutisInfiltrat difus di subkutis dg tanda radang akutBila mengalami supurasi menjadi flegmon
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Abses multipel kelenjar keringatAbses multipel kelenjar keringat
Infeksi kelenjar keringat oleh S. aureusAnakNodus eritematosa, multipel, bentuk kubah, indolenPredisposisi: keringat , imunitas DD/ furunkulosis
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Hidradenitis supurativaHidradenitis supurativa
Infeksi kelenjar apokrinBiasanya oleh S. aureusPubertas, dewasa mudaKetiak, perineumPredisposisi: trauma/mikrotrauma, hiperhidrosis, deodoranGejala konstitusi, leukositosisNodus meradang abses fistula sinus multipelDD/ skrofuloderma
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PengobatanPengobatan
Sistemik– Penisilin: ampisilin, amoksisilin, oksasilin, kloksasilin,
dikloksasilin, flukloksasilin, amoksisilin-asam klavulanat, ampisilin-sulbaktam
– Linkomisin, klindamisin– Makrolid (eritromisin, roksitromisin, klaritromisin)– Sefalosporin
Topikal– Basitrasin, neomisin– Asam fusidat, mupirosin