PPT Sindrom Stevens-Jonhson

7/24/2019 PPT Sindrom Stevens-Jonhson

1/21

ELIKE OKTORINDAH PAMILANGAN

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Sindrom Steven!"on#on


2/21

S$en%rio 14

An%$ &%$i!&%$i 13 t%#'n dir%(%t di RS den)%n $e&'#%n

me&e*'# *%d% $ed'% &en)%n+ ,%d%n %t%+ ,o$on)+ d%n$ed'% *%#% ete&%# min'm o,%t e-%$ 2 #%ri .%n) &%&'/


3/21

R'm'%n M%%&%#

An%$ &%$i!&%$i 13 t%#'n me&e*'# *%d% $ed'%

&en)%n+ ,%d%n %t%+ ,o$on)+ d%n $ed'% *%#%ete&%# min'm o,%t e-%$ 2 #%ri


4/21

Mind M%*

RM

An%mnei

P

PP

D

DD

Etio&o)i

P%to)enei

E*idemio&o)i

Ge-%&%

K&ini

Pen%t%&%$%n%%n

Kom*&i$%

i

Pro)noi


5/21

Hi*otei

An%$ &%$i!&%$i 13 t%#'n did')% menderit%

Sindrom Steven "o#non


6/21

An%mnei

Identit% P%ien %n%$ &%$i!&%$i 13 t%#'n

Ke&'#%n t%m% me&e*'# ,'&%e5 *%d% $ed'%&en)%n+ ,%d%n %t%+ ,o$on)+ d%n $ed'% *%#%ete&%# min'm o,%t

Ri(%.%t Pen.%$it Se$%r%n) RPS5 Se-%$ $%*%nm'&%i+ i6%t ert% ,er%tn.%+ &o$%i+ #','n)%nn.%(%$t' e#%,i m%$%n o,%t+ d%n 6%$tor &%in .%n)mem,'%t $e&'#%n &e,i# ,er%t %t%' &e,i# rin)%n/

Ri(%.%t Pen.%$it D%#'&' RPD5 A*%$%#e,e&'mn.% *ern%# men)%&%mi $e-%di%n .%n)%m% %t%' %d% tid%$n.% ri(%.%t %&er)i o,%t7

Ri(%.%t Ke&'%r)%+ Ri(%.%t Soi%& d%n $e,i%%%n/


7/21

Pemeri$%%n ii$

Ke%d%%n 'm'm T%m*%$ %$it ,er%t

Ke%d%r%n Com*o Menti Terd%*%t &ei me&e*'# ,'&%e5


8/21

Pemeri$%%n Pen'n-%n)

Pemeri$%%n 8io*.

Pemeri$%%n L%, &e'$oitoi+ eoino9&i%5

Pemeri$%%n E&e$tro&it : %d%n.% )%n))'%n 6'n)i *d or)%n .) ter$en%

K'&t'r D%r%# : menent'$%n -eni $'m%n *en.e,%,


9/21

or$in) Di%)noi

Sindrom Steven!"o#non SS"5

Sindrom .%n) men)en%i $'&it+ e&%*'t &endir diori9i'm+ d%n m%t% den)%n $e%d%%n 'm'm,erv%ri%i d%ri rin)%n %m*%i ,er%t; $e&%in%n*%d% $'&it ,er'*% eritem%+ vei$e&


10/21

Sindrom Steven "o#non


11/21

Di=erenti%& Di%)noi

SSJ NET

Keadaan Umum Ringan-Berat Berat

Kesadaran Compos mentis Menurun

Tanda Nikolsky (-) ()

Epidermolisis (-) ()

NekrosisEpidermis

(-) ()

!rognosis "e#i$ #aik "e#i$ #uruk


12/21

Etio&o)i

Pen.e,%, 't%m% %&er)i o,%t+ &e,i# d%ri >0?

Se,%)i%n $e@i& $%ren% in6e$i+ v%$in%i+*en.%$it graft-versus-host+ neo*&%m%+ d%n

r%di%i/SS" .%n) did')% %&er)i o,%t tererin)

! An%&)eti$?5

! K%r,%m%e*in 20?5

! "%m' 13+3?5


13/21

P%to)enei

Re%$i #i*erenitivit% ti*e II ito&iti$5 : )e-%&%re%$i tere,'t ,er)%nt'n) $e*%d% e& %%r%n(target cell): %%r%n 't%m%n.% i%&%# *%d% $'&it,er'*% detr'$i $er%tinoit : *%d% %&er)i o,%t

%$%n ter-%di %$tivit% e& T+ term%'$ CD4 didermi d%n CDB di e*idermi+ IL!> + -')% ito$in!ito$in .%n) &%in/ Ker%tinoit e*iderm%&men)e$*rei ICAM!1+ ICAM!2+ d%n MHC II/ TN

di e*idermi/


14/21

E*idemio&o)i

Iniden SS" d%n ne$ro&ii e*iderm%& to$i$NET5 di*er$ir%$%n 2!3? *er -'t% *o*'&%ieti%* t%#'n di Ero*% d%n Ameri$% Seri$%t/

m'mn.% terd%*%t *%d% de(%%/Die,%,$%n o&e# %&er)i o,%t/

P%d% de(%% im'nit% te&%# ,er$em,%n) d%n,e&'m men'r'n e*erti *%d% 'i% &%n-'t/


15/21

Ge-%&% K&ini

P%d% SS" terd%*%t trias kelainan+ .%it'

Ke&%in%n $'&it

Eritem%+ vei$e&+ d%n ,'&%/

Ke&%in%n e&%*'t &endir di ori9i'mM'$o% m'&'t 100?5+ &',%n) %&%t )enit%&

>0?5+ d%n &',%n) #id'n) B?5

Ke&%in%n m%t%

B0? di%nt%r% em'% $%'

tererin) $on-'n)tiviti $%t%r%&i/


16/21

Pen%t%&%$%n%%n

1/ Korti$oteroid KS5

De$%met%on den)%n doi 20!30 m)


17/21

Pen%t%&%$%n%%n

3/ In6' den)%n @%ir%n de$tro% >?+ N%C& 0+?d%n Rin)er &%$t%t den)%n *er,%ndin)%n 111

4/ P%ien dim%ndi$%n den)%n &%r't%n

*erm%n)%n% $%&i$' 1 10/000/ Lei *%d%,i,ir dio&e$%n $%n%&o) in or%,%e


18/21

Pen%t%&%$%n%%n

Non medi$%mento%

! Diet den)%n tin))i *rotein d%n rend%# )%r%m

! 8i&% *er&' di,eri$%n tr%n6'i d%r%#

! Men)#ind%ri o,%t!o,%t .%n) menim,'&$%n%&er)i o,%t *%d% *%ien tere,'t


19/21

Kom*&i$%i

Kom*&i$%i .%n) tererin) i%&%#,ron$o*ne'mi%/

Ke#i&%n)%n @%ir%n %t%' d%r%#+ )%n))'%n

$eeim,%n)%n @%ir%n e&e$tro&it d%n .o$/P%d% m%t% d%*%t ter-%di $e,'t%%n $%ren%

)%n))'%n &%$rim%i d%n ter-%din.% '&$'$orne% ert% d%*%t ter-%di e*i/

Tim,'&n.% -%rin)%n *%r't d%n $er'%$%n $'&it*erm%nen ert% d%*%t ter-%di in6e$i e$'nder/


20/21

Pro)noi

K%&%' ,ertind%$ te*%t d%n @e*%t+ m%$%*ro)noi @'$'* mem'%$%n/ 8i&% terd%*%t*'r*'r% .%n) &'% d%n &e'$o*eni%*ro)noin.% &e,i# ,'r'$/ P%d% $e%d%%n'm'm .%n) ,'r'$ terd%*%t ,ron$o*ne'moni%*en.%$it ini d%*%t mend%t%n)$%n $em%ti%n/


21/21

Keim*'&%n

D%ri %n%mnei+ *emeri$%%n+ d%n )e-%&% .%n)

tim,'&+ %n%$ &%$i!&%$i 13 t%#'n menderit%Sindrom Steven "o#non/

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