{"id":1000,"date":"2016-09-13T14:36:55","date_gmt":"2016-09-13T14:36:55","guid":{"rendered":"http:\/\/doktermuslim.com\/?p=1000"},"modified":"2016-09-13T14:36:55","modified_gmt":"2016-09-13T14:36:55","slug":"dermatitis-numularis","status":"publish","type":"post","link":"https:\/\/doktermuslim.com\/dermatitis-numularis\/","title":{"rendered":"Dermatitis Numularis"},"content":{"rendered":"

DEFINISI<\/u><\/strong><\/h3>\n

Dermatitis numularis adalah lesi kulit berbentuk seperti koin (mata uang) dengan batas tegas, papulovesikel, kadang mudah pecah dan basah (oozing). Nama lain dari dermatitis numularis adalah ekzem nummular, ekzem discoid.<\/p>\n

Dermatitis numularis sering pada orang dewasa, pria, dan usia tua 55-65 tahun.<\/p>\n

\n

ETIOLOGI<\/u><\/strong><\/h3>\n

Sampai saat ini belum diketahui penyebabnya secara pasti. Diduga ada peran bakteri stafilokokus dan microkokkus. Disertai reaksi hipersensitivitas. Dalam diagnosis ini, singkirkan diagnosis dermatitis yang lain, seperti dermatitis kontak alergi dan dermatitis atopic.<\/p>\n

Dermatitis numularis, kulit cenderng kering, hidrasi stratum korneum cenderung rendah.<\/p>\n

\n

TANDA DAN GEJALA<\/u><\/strong><\/h3>\n\n\n\n\n\n\n\n\n\n
Tanda dan gejala dari dermatitis numularis adalah berupa rasa gatal di lesi.<\/td>\n<\/tr>\n
Lesi ditemukan vesikel, atau papulovesikel dengan ukuran 3 mm -10 mm.<\/td>\n<\/tr>\n
Lesi dapat membesar dan meluas, dengan karateristik berbentuk seperti koin logam, eritemoatisa<\/td>\n<\/tr>\n
Lesi berbatas tegas dengan edematosa, dan vesikel dapat pecah sehingga menjadi krusta kekuningan.<\/td>\n<\/tr>\n
Ukuran dapat mencapai 5 cm.<\/td>\n<\/tr>\n
Penyembuhan mulai dari tengah dan lesi lama berupa likenifikasi dan skuama.<\/td>\n<\/tr>\n
Jumlah lesi biasanya hanya satu tetapi juga bias banyak, bilateral dan simetris.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

HISTOPATOLOGI<\/u><\/strong><\/h3>\n

Pada pemeriksaan histopatologis didapatkan lesi spongiosis vesikel intraepidermal dengan sebukan sel radang limosit dan makrofag di sekitar vasa.<\/p>\n

Pada lesi kronis, dapat ditemkan akantosis teratur, hipergranulosis dan hyperkeratosis dan spongiosis ringan.<\/p>\n

Dapat pula ditemukan limfosit, makrofag di vasa.<\/p>\n

Limfosit terdiri dari sel T CD8 di epidermis, sedangkan di dermis dominan Sel T CD4.<\/p>\n

\n

DIAGNOSIS<\/u><\/strong><\/h3>\n

Dalam diagnosis dermatitis numularis, berdasarkan gambaran klinis. Diagnosis bandingnya meliputi : dermatitis atopic, Liken simpleks kronis, dermatitis kontak iritan, dermatomikosis.<\/p>\n

\n

TATALAKSANA<\/u><\/strong><\/h3>\n\n\n\n\n\n\n\n\n
Tatalaksana dari dermatitis numularis adalah dengan member pelembab atau emolien.<\/td>\n<\/tr>\n
Dapat diberikan steroid sebagai antiinflamasi.<\/td>\n<\/tr>\n
Apabila ada lesi eksudatif, dapat di kompres dulu dengan permanganas 1: 10.000.<\/td>\n<\/tr>\n
Antibiotic sistemik dapat diberikan apabila curiga infeksi sistemik,<\/td>\n<\/tr>\n
Steroid sistemik diberikan pada kasus berat dan refrakter.<\/td>\n<\/tr>\n
Untuk gatal, dapat diberikan antipruritus antihistamin golongan H1 seperti CTM, ceterizin, loratadin, hidoksisin HCl<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

REFERENSI<\/u><\/strong><\/h3>\n

Harting M, dkk. Dermal hypertrophies. Dalam: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ,editor. Fitzpatrick\u2019s Dermatology in General Medicine.<\/strong> <\/em>Edisi ke-7. New York: McGraw-Hill; 2008. h.550-6<\/p>\n","protected":false},"excerpt":{"rendered":"

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