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TE CHING B NGS LSC BIES


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Group NameYarianti

Nur Insani

Imiey Eleena

Efrem

Dwi Putri Mentari

Dian Fahmi

Uka

FitrianiFani Yusnita

Nur Asti


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PATIENT IDENTITY

Name : Musa HLGender : Male

Age : 46 years old

Marital Status : Married

Religion : Muslim

Address : Kel.Apeea Kec.Abuki

Kab.Konawe,Unaha

Job : -Admission Date : 30thMay 2014

Medical Record Number : 670163


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History TakingAnamnesis : autoanamnesis

Chief complaint : papule all over the body

Further Anamnesis :

papule all over the body, especially in the groin area,

accompanied by itching since 1 year ago. Initially thepapule appeared only in the groin area then appears

on the neck, head and then entire body. The itching

was perceived continuosly, especially at night.

Initially the papule was red then become blackish

spots.


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Current Status

Consciousness : Conscious (E4M6V5)

General Condition : Medium

Hygiene : MediumNutrition : Medium

Vital Sign

BP : 140.80mmHgPR : 83x/minutes

RR : 24x/minutes

T : 36,9 C


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Physical examination

Anemic (-), icterus (-), cyanoses (-)

Cor/ Pulmonal: S1 S2 normal, reguler,

Rh-/- Wh-/-

Abdomen: Normal, peristaltic (+)

Extremities: Edema (-)

Lymph nodes: Enlargement (-)


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DERMATOLOGY STATUS

Location : Regio Generalisata

Efflorescence :Papule

hyperpigmented scale.

Location : Dorsum pedis dextra

Efflorescence :Lichenification,crust,

Papule hyperpigmented, scale


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Before treatment


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After treatment


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Laboratory Result

RBC : 3,20 (106 /uL)

WBC : 6.34 (103 /uL)

HB : 8,9 (g/dL)

HCT : 29,3 (%)

PLT : 272 (103 /uL)

Ureum : 57 mg/dl

Creatine : 1,25 mg/dlSGOT : 23 U/I

SGPT : 62 U/I


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Resume

Patients 46 years complain there was

papule. papule all over the body,

especially in the groin area,accompanied by itching since 1 year

ago. Initially the papule appeared only

in the groin area then appears on theneck, head and then entire body.


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The itching was perceived continuosly,

especially at night. Initially the papule was

red then become blackish spots.


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Effects itching diminished but reappeared

later.

Family at home are also experiencing the

same complaints. Initially only daughter wholived in the dorm, complained of itching all

over the body and then spreads to the other

family


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DERMATOLOGY STATUS

Location : Regio Generalisata

Efflorescence :Papule

hyperpigmented scale.

Location :Dorsum pedis dextra

Efflorescence :Lichenification,crust,

Papule hyperpigmented, scale


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DIAGNOSIS

- Skabies

DIFFERENTIAL DIAGNOSIS

- Prurigo

- Pedikulosis korporis

- Dermatitis

PROGNOSIS

- Dubia


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R/ -Cetrizine 0-0-1

-as. Salisil 3%

-menthol 0,15-LCD 3%

-Lanolin 10%

-Diflucortolone valerate 20gr-Vaselin alb as 40 gr


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DISCUSSION

Scabies is a skin infestation caused by

penetration of the human parasite Sarcoptes

scabiei var. hominis into the epidermis.

Many factors that support the developmentof this disease, among others: the low

socioeconomic, poor hygiene, sexual

promiscuity that is its nature, fault diagnosis,and the development and ecologic

dermografik


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Crusted scabies (formerly called Norwegian

scabies) is found in individuals with

immunocompromised systems are

vulnerable (eg older people, people infectedwith HIV, and transplant patients) and those

with decreased sensory functions (such as

patients with leprosy or paraplegia).


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Skin disorders can be caused not only by

the scabies mite, but also by patients

themselves due to scratching. Itching is

caused by secretory and excretory.sensitization against mites which takes

about a month after infestation. At the time

of skin disorders dermatitis resembles thediscovery of papules, vesicles, Urtica, and

others


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Allergic reactions are sensitive to the mite

and its products showed an important role in

the development of the lesion and the onset

of itching. Allergic sensitivity to dust mites ortheir products seem to play an important role

in determining the development of lesions in

addition to the tunnel, and itching


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However, the immunological sequence of

events is unclear and requires further

explanation. Evidence suggests that both

immediate hypersensitivity and delayed typeinvolved.


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- Scratching may arise erosion, eskoriasis,

crusting, and secondary infections.

- Clinical symptoms of nocturnal pruritus,

attack humans as a group, there is a tunnel(kunikulus), and found mites.

- Eliminate the predisposing factors of this

disease can be eradicated and give a goodprognosis.


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MANAGEMENT

Topical1. Sulfur creep (Sulfur Presipitatum) of 4-20%ointment or cream 3 times a day

2. Emulsion Benzyl-benzoas (20-25%) is givenevery night three days3. Gama Benzene Chloride Hex (1%) in acream or lotion is given only once

4. Krotamiton (10%) in a cream or lotion5. Permethrin (5%) in the form of a cream givenonly once


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REFERENCE

Handoko, Ronny P. 2010. Ilmu Penyakit Kulit dan Kelamin.Jakarta : FK UI. pp 122-125

Wolf, Goldsmith, Katz, Gilchrest, Paller, Leffel. 2010.Fitzpatrick's Dermatology in General Medicine. EighthEdition. The McGraw-Hili Companies, United States of

America. pp 2029-2032Bolognia, Jorizzo, Rapini. 2008. Dermatology2nd ed.

Habif, Thomas P. 2004. Clinical Dermatology, 4th ed.Mosby, Inc. pp 498-505

Burns DA. Diseases caused by arthropods and other noxiousanimals. In: Rooks textbook of dermatology. 8th ed. Unitedkingdom. Willey-blackwell; 2010. p. 38.36 38.38.


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