52759510 Contoh Lapkas Stroke Hemoragik Lapkas Bukit Hutabarat
LAPKAS NEURODERMATITIS
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Transcript of LAPKAS NEURODERMATITIS
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Oleh : Fransisca maria novianty sato(1061050178)
Pembimbing : dr. Heryanto Syamsuddin,Sp.KK
LAPORAN A!"!
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#$%N&A!
• Nama : &n' !
• "sia : 75 tahn
• enis elamin: Pria
• Alamat : *ilincin+
• !, : a-a
• A+ama : #slam
• !tats : .eni,ah
• Pe,er/aan : Pensinan PN!• Penii,an &era,hir : !.A
• &an++al Pemeri,saan : 7023016
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%L"4AN "&A.A
• atal aa ,ea ltt ann++n+ ,a,i se/a, hari!.R! '
%L"4AN &A.A4ANBercak keputihan pada lutut dan punggungkaki kanan sejak 6 tahun SMRS.
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Ri-ayat enya,it se,aran+
• Pasien atan+ en+an ,elhan +atal aa,ea ltt an n++n+ ,a,i ,anan se/a, hari !.R!9 sema,in lama irasa,an sema,in+atal sehin++a meniml,an l,a aan++n+ ,a,i ,anan a,iat +ar,an yan+ila,,an asien9 erarah9 nanah ()9 nyeri(;)' elhan ini irasa,an asien ertama ,alimncl !e/a, 6 tahn yan+ lal imana asien
men+elh,an aanya erca, er-arna,emerahan yan+ san+at +atal aa ,ealtt an n++n+ ,a,i ,anan yan+ timlmenaa,'
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Ri-ayat enya,it se,aran+
• atal timl tia, menent -a,tnya anleih irasa,an ila asien sean+ anya,i,iran' i,a +atal9 asien selal
men++ar,nya' Lama ,elamaan erca,aa ,ea ltt an n++n+ ,a,i,anan irasa,an leih melear9 meneal9
,asar an er-arna leih tihianin+,an ,lit se,itarnya' Pasienmen+a, ,elhan hanya timl i tematit sa/a'
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Ri-ayat enya,it se,aran+
• Pasien ernah eroat ,e o,ter eeraa,ali se/a, 6 tahn lal 9 ieri sale9 tetaiasien la nama salenya' .enrt
asien ,elhan er,ran+ ,eti,a i erisale tetai tia, hilan+ ' !e,aran+ asiensean+ tia, men++na,an sale
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Ri-ayat enya,it ahl
• Ri-ayat 4iertensi9 $. isan+,al
Ri-ayat enya,it ,elar+a
• &ia, aa yan+ menerita ,elhan seertiasien
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Riwayat Alergi
Ri-' Aler+i isan+,alRiwayat Pengobatan
• Pasien ernah eroat se,itar 6
tahn lal selama eeraa ,ali ,eo,ter9 ieri sale tetai asienla nama salenya9 ,elhan
er,ran+ tetai tia, hilan+'
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S!A!"S #ENERA$IS
Kepala : t.a.k Mata : t.a.k
Leher : t.a.k
Telinga : t.a.k Hidung : t.a.k
Mulut : t.a.k
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S!A!"S #ENERA$IS
PAR" %AN!"N#
Inspe&si : t'a',Inspe&si : t'a',Palpasi : t'a',
Palpasi : t'a',
Per&usi : t'a',Per&usi : t'a',
Aus&ultasi : t'a',Aus&ultasi : t'a',
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S!A!"S #ENERA$IS
A'()MEN
EKS!REMI!ASInspe&si : t'a',Atas : t'a',
Palpasi : t'a',
Per&usi : t'a',a-ah : t'a',
Aus&ultasi : t'a',
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S!A!"S (ERMA!)$)#IS
• $o&asi : #enu de*tra et sinistra,dorsum pedis de*tra
• E+ouresensi : li&eni&asi, s&uama,e&s&oriasi .
• Penyebaran : bilateral, sir&umsrip
• Susunan : anular
• "&uran : pla&at
• 'entu& : teratur• 'atas : !egas
• !epi :!ida& a&ti-
• Permu&aan : !ida& rata
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en e=tra et sinistra9orsm eis e=tra
R%!".%
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R%!".%!eoran+ ria 75 tahn atan+ en+an ,elhan +atal aa ,ealtt an n++n+ ,a,i ,anan se/a, hari !.R!9 sema,in lamairasa,an sema,in +atal sehin++a meniml,an l,a aa
n++n+ ,a,i ,anan a,iat +ar,an yan+ ila,,an asien9erarah9 nyeri (;)' elhan ini irasa,an asien ertama ,alimncl !e/a, 6 tahn yan+ lal imana asien men+elh,anaanya erca, er-arna ,emerahan yan+ san+at +atal aa ,ealtt an n++n+ ,a,i ,anan yan+ timl menaa,' Lama
,elamaan erca, aa ,ea ltt an n++n+ ,a,i ,ananirasa,an sema,in melear9 meneal9 ,asar an er-arna leihtih ianin+,an ,lit se,itarnya' Pasien men+a, ,elhanhanya timl i temat it sa/a' Pasien ernah eroat ,e o,tereeraa ,ali se/a, 6 tahn lal 9 ieri sale9 tetai asien lanama salenya'
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R%!".%
• !tats ermatolo+i : li,eni>,asi9 s,ama9e,s,oriasi en+an enyearan ilateral9sir,msri9 ssnan anlar9 ,ran la,at9ent, teratr9 atas te+as9 tei tia, a,ti?
an erm,aan tia, rata
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$#ANO!#! AN$#N
Neroermatitis sir,ms,rita
Psoriasis
$#ANO!#! %RA
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P%.%R#!AAN enn/an+
• &ia, ila,,an emeri,saanenn/an+
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P%NA&ALA!ANAAN
1' Nonmei,amentosa – $ieri en/elasan ,eaa asien ah-a
+ar,an aat memerarahenya,itnya9 /ai hars ihinari
– .en/a+a ,eersihan – &erai sorti? aa si,olo+is asien
3' .ei,amentosa – &oi,al (etameta@one iroionate
0905 ; asam salisilat 2 ) – !istemi, (,lor?eniramin maleat 1= m+)
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PRONO!#!
• Bo a vitam : aonam
• Bo a ?nctionam : aonam
• Bo a sanationam : ia aonam
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PEM'AHASAN (AN !IN%A"ANP"S!AKA
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N%"RO$%R.A!
!#R".!R#P&A
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$%F#N#!#
Peraan+an ,lit ,ronis9 san+at+atal9 sir,mstri9 itanai
en+an ,lit teal an +aris ,littama, leih menon/olmenyerai ,lit atan+ ,ay'
A,iat +ar,an ata +oso,an yan+erlan+lan+ ,arena stimls
rrito+eni, yan+ ervariasi'
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%OPA&O%N%!#!
• elm i,etahi i+a rritsisea,an oleh enya,it yan+ menasariseerti :
– a+al +in/al ,ronis – Ostr,si salran eme
– Lim?oma ho+,in
– 4iertiroi
– Penya,it ,lit seerti ermatitis atoi,9+i+itan seran++a9 an ase, si,olo+isen+an te,anan emosi
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%ALA L#N#!
• !/e,ti? : atal• O/e,ti?
–Lesi iasanya tn++al
–A-al la, eritematosa9 sei,iteematosa9 lamat lan eemaan eritema men+hilan+9 a+ian
ten+ah ers,ama an meneal9li,eni>,asi an e,s,oriasiC se,itarhieri+mentasi
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%ALA L#N#!
• ",ran
–eeraa milimeter samai 3 cm
• Lo,asi –iasanya ten+,,9 leher9 len+an
a+ian e,stensor9 is9 vlva9
s,rotm9 erianal9 aha9 ltt9tn+,ai a-ah9 er+elan+an ,a,i9n++n+ ,a,i
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$ia+nosa neroermatitis
– Anamnesis
• erca,ilateral
• erca, yan+sema,inmeneal
• atal
– elainan ,lit
• .a,lahieri+menta
si• Li,eni>,asi
• !,ama
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P%NA&ALA!ANAAN
• Non mei,amentosa
–ar,an memerr,
,eaaan asien li,eni>,asi – &erai sorti? aa si,olo+is
enerita
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P%NA&ALA!ANAAN
• Anti rrits (e?e, seati?)
–4yro=y@ine9 ienhiramin9chlor?eniramin9 rometa@in)
• Pro, ter
• orti,osteroi toi,al anti inDamasi
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PRONO!#!
• Pro+nosis ter+antn+ aaenya,it yan+ menasari an
stats si,olo+i, enerita
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&%R#.A A!#4