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REFLEKSI KASUS : TINEA CRURIS

Ivan Firmansyah112011101029

SMF ILMU BEDAHRSD dr. SOEBANDI JEMBER

2015

Pembimbing :dr. !n"#"n H$%&i"di' S(.))



ANATOMI

http: h!spita"s#$nm#%&$ '$rn s(in)anat!my#shtm"



*EFINISI

*%rmat!+t!sis Tin%a in,%(si -am$r s$p%r+sia"pa&a ($"it -am$r (%ratin!+"ia s%p%rti

Trichophyton, Epidermophyton . &an sp%si%sMicrosporum #

Tin%a Cr$ris : &%rmat!+t!sis pa&a ar%as%"an/(an/an. /%nita". p$'is. p%rin%$m. &an ($"it

p%riana"

Sin!nim : eczema marginatum, jockey itch,ringworm of the groin, dhobie itch



E I*EMIOLO I ETIOLO I

- I10 3 hin//a 20 3 p!p$"asi &$nia t%rin,%(si !"%hin,%(si -am$r ($"it

- La(i4"a(i 55 6anita- S%rin/ t%r-a&i pa&a !ran/ yan/ ($ran/

m%mp%rhati(an (%'%rsihan &iri ata$ "in/($n/ans%(itar yan/ (!t!r &an "%m'a'

Eti!"!/i :1. Trichopyhton rubrum2. Epidermophython uccosum

. Trichophyton mentagrophytes!. Trichopyhton tonsurans



ATO ENESIS

In($'asi 7410 hari

1# ERLEKATAN

2# ENETRASI

8# RES ON E AMU

1# ERLEKATAN A*A KERATIN4 m%"%6ati '%r'a/ai rintan/an $nt$( m%"%(at

pa&a -arin/an (%ratin sinar U . s$h$. (%"%m'a'an.(!mp%tisi &%n/an ;!ra n!rma" &an sphin/!sinyan/ &ipr!&$(si !"%h (%ratin!sit#

2# ENETRASI- sp!ra '%r(%m'an/ m%n%m'$s strat$m (!rn%$m&%n/an (%<%patan yan/ "%'ih <%pat &aripa&a pr!s%s

&%s=$amasi#- %n%trasi &i'ant$ ! s%(r%si pr!t%inas%. "ipas% &an%n>im m$<in!"iti(- Tra$ma &an mas%rasi 'ant$ p%n%trasi -am$r (%(%ratin!sit#

8# RES ON E AMU-. *%ra-at in;amasi stat$s im$n p%n&%rita

&an vir$"%nsi !r/anism% yan/ t%r"i'at#-. R%a(si hip%rs%nsitivitas tip% I . ata$ "e#ayed

Type $ipersensiti%ity ?*@T-. In,%(si prim%r in;amasi %rit%ma &an

s($ama yan/ &ihasi"(an !"%h p%nin/(atan

p%r/antian (%ratin!sit#-. %rt$m'$hannya p!"a ra&ia" &i strat$m

(!rn%$m tim'$"nya "%si ($"it &%n/an 'atasyan/ -%"as &an m%nin//i ?rin/6!rm #



ATOFISIOLO I

Fa(t!r vir$"%nsi &ari &%rmat!+ta

Fa(t!r tra$maFa(t!r s$h$ &an (%"%m'apan

K%a&aan s!sia" s%rta ($ran/nya (%'%rsihan

Um$r &an -%nis (%"amin



*IA NOSIS

ANAMNESIS

mBFISIK

mBENUN A

N

- Rasa /ata" (%m%rahan pa&a s%"an/(an/an.'!(!n/. s%(itar an$s m%nin/(at -i(a

'anya( '%r(%rin/at#- T%mpat tin//a" yan/ '%ri("im "%m'a'

- K%'iasaan : pa(aian (%tat. '%rt$(ar pa(aian&%n/an !ran/ "ain. a(ti, '%r!"ahra/a

- R * : m%n&%rita &ia'%t%s m%""it$s K%"$hansama

- Ri6ayat p%(%r-aan : tahanan p%n-ara.t%ntara. at"it !"ahra/a. santri

- Ma($"a %rit%mat$s &%n/an <%ntra"

h%a"in/ &i "ipatan in/$ina". &ista" "ipatpaha. &an pr!(sima" &ari a'&!m%n'a6ah &an p$'is#- T%pi "%'ih a(ti, t%r&iri &ari pap$"aata$ p$st$"a- Kr!nis : ma($"a hip%rpi/m%ntasi&%n/an s($ama &iatasnya &an &is%rtai"i(%ni+(asi- Ar%a s%ntra" 'iasanya hip%rpi/m%ntasi&an t%r&iri atas pap$"a %rit%mat$syan/ t%rs%'ar &an s%&i(it s($ama- %nis &an s(r!t$m -aran/ ata$ ti&a(t%r(%na

- Lamp$ D!!&- %m%ri(saan KO@ 10 3- K$"t$r &%n/an m%&ia S*A



*IA NOSIS AN*IN

1#Erytrasma2#Can&i&!sis int%rtri/in!sa

8#*%rmatitis S%'!r!i(7# s!riasis



ENATALAKSANAAN

@I IENE SANITASI FARMAKOLO IS

E*UKASI @I IENE SANITASI4 a/a &a%rah "%si t%tap (%rin/#

4 ar$(an &apat m%ny%'a'(an in,%(si#4 a/a (%'%rsihan ($"it (%rin/(an (%rin/at&%n/an han&$( &an m%n//anti pa(aian yan/"%m'a'#4 $na(an pa(aian &%n/an 'ahan m%ny%rap(%rin/at s%p%rti (at$n. ti&a( (%tat &an /antis%tiap hari#4 @in&ari p%n$"aran p%nya(it <$<i pa(aian &anhan&$( yan/ &i/$na(an p%n&%rita har$s s%/%ra&i<$<i &an &ir%n&am air panas#

KOM LIKASI LESI LUAS

SISTEMIK *AN TO IKAL

TO IKAL

F A

T I * A K



ENATALAKSANAAN

FARMAKOLO IS

KOM LIKASI ATAU A AL TERA I TO IKAL

1. &istemik

1. 'ntifungi (-. )o# azo#es ( ketokonazo#e, itrakonazo#e-. )riseofu#%in, Terbina*ne2. 'ntihistamin

2. Topika#

1. )o#. '##y#amines ( Terbina*n cr 1+, aftiine cr 1 +2. )o# 'zo#es ( -#otrimazo#e cr 1+, Miconazo#e cr 2 +,

#uconazo#e cr /,0+, &u#conazo#e cr1 +, Econazo#ecr1+, ketoconazo#e cr2 +

247min//$

INFEKSI RIMER. TAN A KOM LIKASI. LESI MINIMAL : TO IKAL 247 min//$

1. )o#. '##y#amines ( Terbina*n cr 1+, aftiine cr 1 +2. )o# 'zo#es ( -#otrimazo#e cr 1+, Miconazo#e cr 2 +,

#uconazo#e cr /,0+, &u#conazo#e cr1 +, Econazo#e cr1+,ketoconazo#e cr2 +



KOM LIKASI

r!/n!sis p%nya(it ini 'ai( &ia/n!sis &an t%rapiyan/ t%pat (%"%m'apan &an (%'%rsihan ($"it

s%"a"$ &i-a/a#

RO NOSIS





ANAMNESIS

K%"$han Utama

t$s4'r$nt$s m%rah yan/ t%rasa /ata" pa&a "ipatan paha (a

tim'$" 'r$nt$s m%rah &is%rtai rasa /ata" pa&a"ipatan paha (anan &an (iri s%-a( H1 '$"an yan/ "a"$#

asi%n m%n/%"$h tim'$" /ata" t%r$tama saat

'%r(%rin/at s%hin//a s%rin/ m%n//ar$(nya# A6a"nya'r$nt$s m%rah t%rs%'$t tim'$" '$"at s%'%sar (!in(%m$&ian m%n-a&i '%rtam'ah &is%(itarnya# asi%nm%n/a($ man&i &an m%n//anti <%"ana &a"am &$a (a"is%hari. &an ti&a( p%rnah '%r/antian pa(aian &%n/an!ran/ "ain. nam$n pasi%n s%rin/ m%n//$na(an <%"ana

Ri6ayat %nya(it S%(aran/



asi%n s%'%"$mnya p%rnah '%r!'at (% &!(t%r&an &i'%ri !'at sa"%p &an !'at min$m. nam$n pasi%nti&a( in/at apa nama !'atnya# S%t%"ah m%ma(ai !'att%rs%'$t s%"ama 2 min//$. (%"$han ti&a( '%r($ran/#K%"$han 'r$nt$s 4 'r$nt$s (%m%rahan &i &a%rah

"ipatan t$'$h "ain &isan/(a". (%"$han 'r$nt$s4'r$nt$sm%rah &is%rtai sisi( yan/ t%'a" &isan/(a". (%"$han'r$nt$s4'r$nt$s (%m%rahan &is%rtai panas 'a&an&isan/(a"# K%"$han /ata" yan/ san/at h%'at sampai

panas s%p%rti t%r'a(ar &isan/(a"# Ri6ayatp%n//$naan -am$4-am$an $nt$( p%/a" "in$ &a"am -an/(a 6a(t$ yan/ "ama &isan/(a"#

Ri6ayat %nya(it S%(aran/



• Ri6ayat p%rnah m%n&%rita p%nya(it($"it yan/ sama &ia($i H 1 tah$nyan/ "a"$#

• Ri6ayat *ia'%t%s M%"it$s &isan/(a" #

Ri6ayat %nya(it*ah$"$

• Ti&a( a&a an//!ta (%"$ar/ayan/ m%mp$nyai (%"$han yan/sama s%p%rti pasi%n

Ri6ayat %nya(itK%"$ar/a

• O'at min$m &an sa"%panti-am$r &ari &!(t%rRi6ayat

%n/!'atan

• &isan/(a"Ri6ayat A"%r/i



• Keadaan Umum : <$($p• Kesadaran : CM• Status Gizi

– s%(aran/ : 8 (/ – Um$r : 10 tah$n – Tin//i 'a&an : 170 <m – IMT : 20 (/ m2

• Tanda Vital – T%(anan &arah : 100 G0 mm@/ – Na&i :JGB m%nit r%/$"ar. ($at

an/(at – %rna,asan :20B m – S$h$ a(si"a :8G. 0 C

– Da(t$ p%n/isian (api"%r :2&%ti(

EMERIKSAAN UMUM

• K%pa"a L%h%r : &'n

• Th!ra(s : C!r &an $"m! &'n

• A'&!m%n : &a"am 'atas n!rma"

• E(str%mitas : &a"am 'atas n!rma"

Kesimpulan: pemeriksaan umum dbn



EMERIKSAAN FISIK

Stat$s *%rmat!"!/isR%/i! In/$ina"is &%Btra

T%r&apat ma($"a %rit%mat$s m$"tip%". $($rann$m$"ar. '%r'atas t%/as. &%n/an s($ama ha"$s&i pin//ir "%si. Ma($"a hip%rpi/m%ntasi &i t%pi"%si#

T%r&apat pap$"a %rit%mat$s m$"tip"%. &%n/an&iam%t%r 0.140.8 <m. (%rin/. t%pi a(ti,. <%ntra"h%a"in/#





*IA NOSIS

*IA NOSIS AN*IN

Tin%a <r$ris Eritrasma

# Kan&i&iasis

1# Tin%a <r$ris*IA NOSIS KER A



LANNIN

LANNIN *IA NOSTIK

- %m%ri(saan KO@ 103-

K$"t$r &%n/an m%&ia S*A t%sr%sist%nsi anti,$n/i



LANNIN

LANNIN UMUM

4 An-$r(an a/ar m%n-a/a &a%rah "%si t%tap (%rin/#4 i"a /ata". -an/an &i/ar$( (ar%na /ar$(an &apat

m%ny%'a'(an in,%(si#4 a/a (%'%rsihan ($"it 'i"a '%r(%rin/at (%rin/(an&%n/an han&$( &an m%n//anti pa(aian yan/ "%m'a'#4 $na(an pa(aian yan/ t%r'$at &ari 'ahan yan/&apat m%ny%rap (%rin/at s%p%rti (at$n. ti&a( (%tat&an /anti s%tiap hari#4 Unt$( m%n/hin&ari p%n$"aran p%nya(it. pa(aian &anhan&$( yan/ &i/$na(an p%n&%rita har$s s%/%ra &i<$<i&an &ir%n&am air panas#



LANNIN K@USUS

Sist%mi( :a# Antimi(!ti( !ra" : K%t!(!na>!" 1 B 200 m/ haris%"ama 2 min//$#'# Antihistamin !ra" : L!rata&in 1 B 10 m/ haris%"ama 10 hari#4 T!pi(a" :Antimi(!ti( t!pi(a" : t%r'ina+n% <r%am 1 3 2 B 1s%"ama 247 min//$

LANNIN



RO NOSIS

$! a& vitam : a& '!nam$! a& ,$n<ti!nam : a& '!nam$! a& sanati!nam : a& '!nam



TERIMAKASI@