dr. Farida Oesman SpPKdr. Elly Santosa SpPK

dr. Ninik Sukartini SpPKDepartment of Clinical Pathology

Medical Faculty, University of Indonesia

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SKIN DISEASES

• INFECTION• INFLAMMATION• AUTOIMMUNE

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DIAGNOSIS

• ANAMNESIS•CLINICAL FEATURES• LABORATORY ASSAY

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MICROORGANISM DISEASES

• FUNGAL

• VIRAL

• BACTERIAL

• CANDIDIASIS• TINEA• HERPES SIMPLEX• VARICELLA ZOSTER• IMPETIGO• FOLLICULITIS

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METHODE

BACTERIAL/FUNGALDETECTION• DIRECT (MICROSCOPIC)• ISOLATION• NUCLEIC ACIDSEROLOGY• ANTIBODY DETECTION• ANTIGEN DETECTIONOTHER• HEMATOLOGY

• ACUTE PHASE PROTEIN

• KOH : Candida, Trichophyton sp GRAM : S. aureus, S.epidermidis• CULTURE: blood agar, Sabouraud• PCR

• IgM, IgG

• LEUCOCYTE, DIFF, PLATELET COUNT• CRP

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ASSAY SPECIMEN

• MICROSCOPIC• ISOLATION• NUCLEIC ACID• SEROLOGY• HEMATOLOGY• ACUTE PHASE PROTEIN

• SKIN SCRAPING, HAIR, NAIL• SKIN SCRAPING, HAIR, NAIL• BLOOD• BLOOD• BLOOD• BLOOD

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• CULTURE• PCR

• ANTIGEN

POSITIVE

CONFIRMDIAGNOSIS

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ANTIBODYDETECTION

PRIMARYINFECTION

SECONDARYINFECTION

• IgM (+), IgG (-)• IgM (+), IgG (+)

• IgM (-) , IgG (+)• IgM (+), IgG (+)

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ASSAY BACTERIALINFECTION

VIRALINFECTION

• LEUCOCYTE COUNT• DIFFERENTIAL COUNT• PLATELET COUNT

INCREASED

NEUTROPHILIASHIFT LEFTINCREASED

DECREASED

LYMPHOCYTOSIS

DECREASED

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HYPERSENSITIVITY DISEASES

• TYPE I

• TYPE IV

• ATOPIC ECZEMA• ACUTE URTICARIA

• ALLERGIC CONTACT DERMATITIS

INFLAMMATION

HYPERSENSITIVITY REACTION

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ASSAY RESULT

TYPE I• IgE LEVEL• IgE SPECIFIC• EOSINOPHIL COUNTINFLAMATION REACTION• INFLAMMATORY CYTOKINE• ACUTE PHASE PROTEIN

• INCREASED• POSITIVE • INCREASED

• IL-4, IL-5, IL-10 ↑

• CRP ↑

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AUTOIMMUNESKIN DISEASE

SKIN DAMAGETRIGGERED BY

• AUTOANTIBODIES TO SKIN ANTIGEN

BULLOUS SKIN DISEASES• DEPOSITION OF

IMMUNE COMPLEXES VASCULITIS, SLE

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AUTOANTIBODIES DISEASES

SKIN ANTIGEN• EPIDERMAL INTER CELLULAR CEMENT• BASEMENT MEMBRANE

SYSTEMIC ANTIGEN• NUCLEAR

• PEMPHIGUS VULGARIS

• BULLOUS PEMPHIGOID

• SUBACUTE CUTANEOUS LE• DISCOID LE

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ASSAY RESULT

• AUTOANTIBODIES• COMPLEMENT LEVEL

• POSITIVE• DECREASED

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DISEASES ASSAY

• LE• STAPHYLCOCCAL SCALDED SKIN SYNDROME (SSSS) • TOXIC SHOCK SYNDROME (TSS)

• RENAL FUNCTION: CREATININE ↑• LIVER FUNCTION : SGOT ↑ SGPT ↑

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