liken planus
DESCRIPTION
Liken PlanusTRANSCRIPT
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Liken PlanusDitandai dengan papul-papul merah biru,
skuama dan beberbentuk siku-sikuPred ekstremitas fleksor selaput lendir alat kelaminSangat gatalMembaik dalam 1-2 tahun
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EtiologiBelum diketahuiAda hipotesis yang mengatakan oleh virus,
berdasarkan : - initial lichenoma mendahului meluasnya
penyakit setelah beberapa bulan - trauma - penyembuhan setelah vaksinasi
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fokus endemik - pembiakan dari papul liken planus pada
membran korioalantoik
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Gejala KlinisGatal setelah satu/beberapa minggu
setelah lesi pertamaPredileksi kelainan pertama ekstremitas
bawah, fleksor pergelangan tangan / lengan bawah
Distribusi simetrikTerdapat fenomena Köbner
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Bentuk MorfologiHipertrofik plak verukosa merah coklat /
ungu, pada daerah tulang keringFolikular papul seperti duri pada kulit,
selaput lendir dan kulit kepala trias liken planopilaris
Vesikular dan bulosa
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Erosif dan ulseratif pada mukosa yang didahului oleh liken planus
Atrofi jarang
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HistopatologiPenebalan lapisan granulosumDegenerasi mencair membrana basalis dan
sel basalInfiltrat limfosit, histiosit
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Diagnosis Banding
PsoriasisGranuloma anulareLupus eritematosusDermatitis seboroikSkabies
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Pengobatan
Kurang memuaskanKortikosteroid setempat dan sistemikAsam retinoat krim 0.05%Fotokemoterapi
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Granuloma annulareBenign self limited diseaseAll age, infancy <<Etiology→ unknownPathogenesis → poorly understoodA localized ring of beaded papules on
extremities is typicalGeneralized,perforated,subcutaneus, and
patch subtype is also occurs
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Faktor predisposisi
Infeksi dan imunisasiPaparan sinar matahariObat-obatanDM dan penyakit tiroidKeganasan
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Gejala klinis
Khas : satu atau lebih papul dg pelebaran sentrifugal dan dan penyembuhan sentral
Asimptomatis, kadang dg gatal yang ringan dan rasa nyeri
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Pengobatan Menunggu sampai terjadinya resolusi
spontanPemberian Kortikosteroid topikal dg atau
tanpa oklusiTriamsinolon intra lesi
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Liken schlerosus et atropicus
Definisi :dermatosis dg inflamasi kronis pada daerah anogenital yang mengganggu kualitas hidup karena rasa gatal yang hebatbila lesi extragenital→ gatal -
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Epidemiologi Wanita >> laki-lakiDekade 5-6, anak <10 tahun
Etiologi UnknownDiduga bhubungan dg penyakit tiroid,
alopesia areata,anemia pernisiosa dan vitiligo
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Manifestasi KlinisPapul poligonal dan plak putih porselen dg
kulit yang rapuh dan atrofi, fisura,teleangiektasis,purpura, eritema dan berbagai derajat sklerosis
Ukuran dari bbrp mm s/d ukuran besar pada badan
Lesi pada anogenital→ gatal, nyeri, dispareuni,dysuria,tdk nyaman saat defekasi
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Manifestasi Klinis
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Pemeriksaan PenunjangHistopatologi :
gbrn epidermis yang atrofi dan sebuah infiltrat likenoid pada dermal-epidermal junctionhiperkeratotik epitelium, pelebaran pembuluh darah dermis
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Diagnosis bandingLesi genital
- ballanitis plasmacellularis- child abuse- dermatitis kontak- liken planus- neurodermatitis- vitiligo
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Diagnosis BandingLesi ekstragenital
- anetoderma- liken nitidus
- liken planus- morphea- tinea versikolor
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Pengobatan
KS topikal poten, mis clobetasolCalcineurin inhibitor, mis :
Tacrolimus dan pimecrolimus topikalSkin careTerapi retinoid sistemik
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Prognosis Pada umumnya baikMengalami penyembuhan sendiri, namun
pada kasus yang berat memerlukan pengobatan korikosteroid