BAGIAN ILMU KESEHATAN KULIT DAN KELAMIN FAKULTAS KEDOKTERAN UNIVERSITAS MUSLIM INDONESIA
REFERAT NOVEMBER 2013
MOLUSKUM KONTAGIOSUM
DISUSUN OLEH:
ZARAH ALIFANI DZULHIJJAH 1102090115
PEMBIMBING: dr SU!I NUGRAENI
BAGIAN ILMU KESEHATAN KULIT DAN KELAMIN FAKULTAS KEDOKTERAN UNIVERSITAS MUSLIM INDONESIA MAKASSAR 2013
1
MOLUSKUM KONTAGIOSUM
I.
Definisi
M"#$%&$' &"()*+,"%$' -MK. '/r$*&*( /(*&,) *(+ r,(+*( (*'$( (*'$( d**) d**) /r&/' /r&/'*( *(+ + '/(*d '/(*d,, /(* /(*&,) &,) ,(4/&%, ,(4/&%, ,r$% ,r$% *(+ *(+ '/(*d, '/(*d, '*%*#*6 *d* *(*&7*(*& K*r*&)/r,%),& /(*&,) ,(, *,)$ /r'$&**( 6*#$%8 *$#
/r/()$&
&$*6
*(+
,*%*(*
d,%/r)*,
/r,)/'
-d/r'*),),%
'"#$% '"#$%&$' &$'. . P*%,/( P*%,/( d*( &/#$*r &/#$*r+*( +*(( (** '/r*%* '/r*%* )/r+*(+ )/r+*(++$ +$ "#/6 "#/6 #*'*( #*'*(** /r*#*(*( /(*&,) ,(, %/* /(*&,) ,(, ,%* /r)*6*( %/#*'* /r$#*(7 $#*( *6&*( /r)*6$(7)*6$( M"#$%&$' &"()*+,"%$' /r#$ d,/r6*),&*( *d* ,(d,,d$ d/(+*( ,'$("&"'r"'*,% d*( d/r'*),),% *)",&8 d,'*(* '*%* ,(4/&%, '/(*d, #/,6 /&%)r,' P/(*&,) ,(, '/($#*r '/#*#$, 6$$(+*( %/&%$*# *+, "r*(+ d/*%* (*'$( ),d*& *+, *(*&7*(*& 1; I(4/&%, '/#*#$, %/&%$*# *+, *(*&7*(*& ,%* %** )/r*d, *d* &*%$%7&*%$% /#/
II.
Epidemiologi
T,+* &/#"'"& $)*'* *(+ )/r&/(* *d*#*6: *(*&7*(*&8 d/*%* *(+ *&),4 *&),4 %/<*r* %/<*r* %/&%$*# %/&%$*#88 d*( "r*(+7 "r*(+7"r* "r*(+ (+ d/(+*( d/(+*( ,'$("% ,'$("%$r $r/%,8 /%,8 )/r$)*' )/r$)*'** '/r/&* '/r/&* )/r,(4/&%, )/r,(4/&%, HIV1; Pr/*# Pr/*#/(%, /(%, ,(4/&% ,(4/&%,, MK )/#*6 )/#*6 '/(,(+ '/(,(+&*) &*) %/<*r* %/<*r* %,+(,4,&*( d*#*' //r** d/&*d/ ,(,8 )/r<*)*) /(,(+&*)*( 11 &*#, #,*) *%,/( d*)*(+ d/(+*( ,(4/&%, ,(, d*#*' 2 d/&*d/ P/(,(+&*)*( ,(, )/r*d, *d* %/#$r$6 $'#*6 /(*&,) '/#*#$, 6$$(+*( %/&%$*# R*)*7r*)* *r,*%, /rd*%*r&*( #"&*%, d*( d,/r&,r*&*( ,(4/&%, %$7&#,(,% #/,6 $'$' )/r+*d, 2
d*r, d*r,* *d* d* &#,( &#,(,% ,% P*%,/ P*%,/( ( *(+ *(+ )/r,( )/r,(4/& 4/&%, %, Human Immunodeficiency Virus '/',#,&, r/%,&" ),(++, )/r&/(* ,(4/&%, *(+ #*'*8 d*( *%,/( *(+ '/',#,&, r,**) r,**) *)", d**) '/',#,&, #/%, *(+ #/,6 *(*& *(*& d*( '*%* ,(4/&%, *(+ #*'*1; Tr*(%' Tr*(%',%, ,%, d**) d**) )/r*d, )/r*d, '/#*#$ '/#*#$,, &"()*& &"()*& &$#,) &$#,) *)*$ *)*$ &"()*& &"()*& '/'r*( '/'r*( '$&"%*8 *)*$ ,* 6$$(+*( %/&%$*# H*(d$& '*(d,8 &"#*' r/(*(+ d*( *& '*(d, )/#*6 d,#*"r&*( %/*+*, %$'/r ,(4/&%,8 d*( ,(d,,d$7,(d,,d$ *(+ )/r#,*) "#*6r*+* *(+ '/(+6*r$%&*( &"()*& *r*& d/&*) -<"()"6: +$#*). $+* ,%* '/(*d, r/%,&" ),(++, A$)",(&$#*%, d*( &"/(/r,%*%, $+* '/'*,(&*( /r*(*( /(),(+ *d* /(/*r*( #/%, 1;
III.
Etiologi
M"#$ M"#$%& %&$' $' &"() &"()*+ *+," ,"%$' %$' d,%/ d,%/* *&* &*( ( "#/6 "#/6 #/, #/,6 6 d*r, d*r, /'* /'*)) ),/ ),/ "=,r$% *(+ /r6$$(+*(8 M!V71 %*'*, M!V7>8 d*( *r,*(7*r,*((* M/%&,$( r""r%, d*r, ,(4/&%, d,%/*&*( "#/6 /r*+*'(* #/)*& +/"+r*4,%8 d, %/#$r$6 d$(,* ,(4/&%, M!V71 '/r$*&*( *(+ *#,(+ %/r,(+ P*d* *(*&7 *(*& %//)$#(* %/'$* ,(4/&%, d,%/*&*( "#/6 M!V71 3; M!V '/r$*&*( "=,r$% *+ /%*r8 d*( /r/()$& %//r), *)* *(+ /r/#,&*%, d*#*' %,)" %,)"#* #*%' %'** d*#* d*#*' ' %/# %/# T/rd T/rd* **) *) // //r* r** * &/%*' &/%*'**( **( +/(" +/("', ',& & d/(+ d/(+*( *( "=,r$% *(+ #*,((* D*( ,*%*(* 273 +/( %*'* d/(+*( *<<,(,* d*( *r,"# *r,"#** ,r$% ,r$% T/rd* T/rd**) *) /'*) /'*) %$7), %$7),/ / d*r, d*r, M!V )*, )*, %/'$*( %/'$*(* * ,d/(), ,d/(),& & %/<*r* &#,(,% 9?@ d*r, /(*&,) /(*&,) d, A'/r,&* A'/r,&* S/r,&*) S/r,&*) d,%/*&*( d,%/*&*( "#/6 M!V ),/ 11; T/#*6 d,)/#,), '*%* ,(&$*%, )/r*d, *()*r* 27 ',(++$ 18>;
IV.
Patogenesis
R*)* R*)*7r 7r*) *)** '*%* '*%* ,(&$ ,(&$* *%, %, *()* *()*r* r* 2 d*( d*( ',(++ ,(++$ $ d/(+ d/(+*( *( *r* *r*& & '/#*'*$, #/,6 d*r, $#*( I(4/&%, ,r$% d**) '/(/*&*( 6,/r#*%,* d*( 6,/r)r 6,/r)r", ", *d* *d* /,d/r' /,d/r',% ,% I(), I(), ,r$% ,r$% d,)/'$ d,)/'$&*( &*( d, %/'$* %/'$* #*,%*( #*,%*( 3
/,d/r',% P$%*) r/#,&*%, ,r$% d,)/'$&*( *d* #*,%*( %/# +r*($#/r d*( '*#,+, B*d*( '"##$%<$' /r,%, ,r,"( d/*%* d*#*' $'#*6 *(+ /%*r V,r,"( ,(, /r,%, %)r$&)$r %//r), &*()$(+ *(+ &** *&*( #,,d d*( &"#*+/( *(+ d,&/)*6$, d**) '/(+6*#*(+, r/*&%, ,'$("#"+,% "#/6 ,(d$& R"/&*( )/r*d, *d* /r)/(+*6*( /r)/(+*6*( #$&* d*( &/#$*r(* &/#$*r(* %/# *(+ )/#*6 )/r,(4/&%, )/r,(4/&%, ,r$% ,r$% M!V '/r*(+%*(+ )$'"r ,(*& d,%*',(+ #/%, <*<*r *(+ ,*%*(* (/&r"%,% d,%/r)*, ,r$% <*<*r *(+ #*,(>; V,r$% /r/#,&*%, d*#*' %,)"#*%'* d, %/# /,)/#8 d*( %/# *(+ )/#*6 )/r,(4/ )/r,(4/&%, &%, /r/# /r/#,&* ,&*%, %, %/*( %/*(*& *& d$* &*#, &*#, d*r, d*r, r*)*7r* r*)*7r*)* )* Ad* *(* *(*& & +/( M!V M!V *(+ *(+ d** d**)) '/r$ '/r$%* %*& & %,%)/ %,%)/' ' ,'$( ,'$(88 )/r' )/r'*% *%$& $& -1. -1. 6"'" 6"'"#" #"+ + d*r, d*r, &/* &/*( (*& *&*( *( 6,%) 6,%)"& "&"' "'*) *), ,,# ,#,)* ,)*%% ),(+ ),(+&* &*)) 1 r*() r*()*, *, /r*) /r*)88 d,'* d,'*(* (* d** d**)) /r,()/r4/(%, d/(+*( r/%/()*%, *(),+/( -2. 6"'"#"+ &/'"&,( *(+ '/(+6*'*) ,(4#*'*%, d*( -3. 6"'"#"+ +#$)*)6,"(/ /r"=,d/ *(+ d**) '/#,(d$(+, ,r$% d*r, *6** "&%,d*),4 d*r, /r"=,d* 1;
V.
Gejala Kl Klinis
M"#$%&$' M"#$%&$' &"()*+,"%$ &"()*+,"%$' ' %/r,(+ '/'/r#,6*)&*( '/'/r#,6*)&*( *$# *$# &/<,# '/r*6 '$d* '$d* *(+ *(+ d**) d**) '/'/% '/'/%*r8 *r8 ,*%*( ,*%*(* * '/'/%* '/'/%*rr 6,(++* 6,(++* 3 <' -C+,*( -C+,*()) '"## '"##$% $%<$' <$'. . S/,r, S/,r,(+ (+ /' /'/%* /%*r* r*(( ((* *88 /r' /r'$& $&** **( ( /() /()$& $& &$* &$*6 6 d*( d*( '"r4"#"+, %//r), '*)* &$<,(+ d**) %/'*&,( /#*% L/%, d**) '/',#,&, $'#, $'#,&*%, &*%,88 )/rd* )/rd**) *) %$%)*( %$%)*(%, %, %//r) %//r),, $),6 $),6 d*d,6 d*d,6 d**) d**) d,#,6* d,#,6*)) d/(+*( d/(+*( )/&*(*( P*d* &/*(*&*( *%,/( /r&/'*(+ //r** *$#8 %/r,(+ *d* )/'*) *(+ ,()/r)r,+,("%*8 %//r), *&%,##*8 4"%%* "#,)/*8 d*( *(++$# L/%, *d* +/(,)*# d*( /r,*(*# d**) /r&/'*(+ *d* *(*&7*(*& d*( *r*(+ *(+ '/',#,&, &*,)*( d/(+*( 6$$(+*( %/&%$*# L/%, ,(, d,+"#"(+&*( d*#*' cluster *)*$ *)*$ d*#* d*#*' ' /() /()$& $& #,(/ #,(/*r *r B,*% B,*%*( *( * '/r$ '/r$* *&* &*( ( 6*%, 6*%,## d*r, d*r, &"/(/ &"/(/r,%* r,%*%, %, *)*$ /r&/' /r&/'*( *(+*( +*( #/%, *d* *d* )r*$'* )r*$'* Er,)/' Er,)/'** d*( /&%/'* /&%/'* d**) '$(<$# d, %/&,)*r #/%, 6*# ,(, d,%/$) M"#$%&$' d/r'*),),% P*$# d**) '/(*d, /r,)/'*)"%*8 6*# ,(, d,/r<** '/r$*&*( r/%"( ,'$( d*r,
4
,(4/&%, ,(4/&%, P*%,/( d/(+*( d/(+*( %,(dr"' %,(dr"' ,''$("d/4, ,''$("d/4,%,/(%, %,/(%, d**) '/'/r#,6*) '/'/r#,6*)&*( &*( #/%, *(+ /%*r d*( /&%)/(%,4 *,& d, d*/r*6 +/(,)*# '*$$( /&%)r* +/(,)*# 1;
Gama! " M#l#s$#m $ontagios#m dengan lesi #mili$asi
D,&$), d*r, &/$%)*&**( 1
Gama! % M#l#s$#m $ontagios#m dengan lesi m#ltipel
D,&$), d*r, &/$%)*&**( 1
5
VI.
Diagnosis
B/rd B/rd*% *%*r *r&* &*( (
*(*' *(*'(/ (/%, %,%8 %8
/'/ /'/r, r,&% &%** **( (
4,%, 4,%,%8 %8
d*( d*(
/'/ /'/r, r,&% &%** **( (
/($(*(+ %//r), 6,%)"*)"#"+, *(+ '/($($&&*( +*'*r*( %//r), Henderson-Paterson body8 body8 d** d**)# )#*6 *6 d,)/ d,)/+* +*&& &&*( *( d,*+ d,*+(" ("%,% %,% '"#$ '"#$%& %&$' $' &"()*+,"%$' P/(/+*&*( d,*+("%,% '"#$%&$' &"()*+,"%$' d**) d,#*&$&*( %/<*r* #*(+%$(+ P/(,#*,*( &*(d$(+*( ,(), '/(++$(*&*( /*r(**( G,/'%* d**) d,#*&$&*( d*( /*#$*%, 6,%)"*)"#"+, d**) d,#*&$&*( $#* 1; P*d* P*d* /'/r,& /'/r,&%**( %**( 6,%)" 6,%)"*)" *)"#"+ #"+,, '/'/r# '/'/r#,6* ,6*)&* )&*( ( /,d/r' /,d/r',% ,% *(+ *(+ 6,/r)r", 6,/r)r", d*( 6,/r#*%), 6,/r#*%),& & '"#$%&$' '"#$%&$' &"()*+,"%$ &"()*+,"%$' ' '/',#,&, '/',#,&, &*r*&)/r,%),& &*r*&)/r,%),& +*'*r*( 6,%)"*)"#"+, P*d* *+,*( *)*% #*,%*( *%*# d**) d,)/'$&*( /'/%*r*( %/# *(+ '/(+*(d$(+ ,(&#$%, ,()r*%,)"#*%', - Henderson Paterson body. body. 1;
VII. VII. Diag Diagno nosi siss &andin &anding g
D,*+("%,% D,*+("%,% *(d,(+ *(d,(+ $()$& '"#$%&$' '"#$%&$' &"()*+,"%$ &"()*+,"%$' ' )/r'*%$& )/r'*%$& /rr$<* /rr$<* $#+*r,%8 +r*($#"'* ,"+/(,<8 *'/#*("),< '/#*("'*8 *%*#
d,/ d,/r), r),' '*( *(+& +&*( *( *d* *d* *%, *%,/( /(7* 7*%,/ %,/( (
d/(+ d/(+*( *(
,''$("<"'r"',%/d1;
6
Gama! ' Ve!#$a (#lga!is
D,&$), d*r, &/$%)*&**( 3
VIII. VIII. Penatala Penatala$san $sanaan aan
P*d* $'$'(* /(*&,) ,(, d**) %/'$6 %/(d,r, )*(* &"'#,&*%, *d*
*%,/(
,'$("&"'/)/(
S//#$'
'/#*&$&*(
/(*)*#*&%*(**(
%/*,&(* '/(d,%&$%,&*( )/r#/,6 d*6$#$ d/(+*( &/#$*r+* *%,/( '/(+/(*, r/%,&" d*( &/$()$(+*( /(+"*)*( 1; a. Te!api api Topi Topi$a $all
B*(*& *6#, '/(++$(*&*( <*()6*r,d,( 08@ *)*$ 089@ #,$,d $()$& /(+"*)*( MK !*()6*r,d,( '/r$*&*( /&%)r*& d*r, %/r*(++*8 Cant Cantah ahar aris is
vesic vesicat ator oria ia88
*(+
'/r*(+%*(+
/%,&$#*%,
*d*
d/r'"/ d/r'"/,d ,d/r' /r'*# *# &/),&* &/),&* d,"#/%& d,"#/%&*( *( %/<*r* %/<*r* )",&* )",&*## *d* *d* &$#,) &$#,) O*) O*) ,(, 6*r$% d,"#/%&*( d,"#/%&*( d/(+*( d/(+*( 6*),76*), 6*),76*), d*( d,<$<, %/&,)*r %/&,)*r d$* %*'*, /(*' *' &/'$d,*( T,d*& d,*($r&*( $()$& /(++$(**( *d* **6 *)*$ d*/r*6 +/(,)*#8 d*( &/#$*r+* &/#$*r+* 6*r$% d,&"(%/#,(+ d,&"(%/#,(+ /r6$$(+ /r6$$(+*( *( d/(+*( d/(+*( r/%,&" r,(+*( d*r, r/*&%, /&%)r,' *)*$ /&*% #$&* P/(+"*)*( )/r*,
7
)",&*# )",&*# #*,((* #*,((* *,)$ retinoid cream, Imiquimod cream8 cream8 *%*' %*#,%,#*)8 cidofovir 8 *%)* %,#/r(,)r*) d*( tape stripping 1; M*r%*# JS d&& '/#*&$&*( /(/#,),*( *(+ '/($($&&*( KOH *)*$ ")*%,$' 6,dr"&%,d* )",&*# 10 @715@ d**) /r")/(%, '/(*d, /(+"*)*( *(+ /4/&),4 d*( *'*( *+, *%,/( *d* /(*(+*(*( $)*'* d*( '/(+$r*(+, r$$&*( *6#, &$#,) d*( r$'*6 %*&,) S/*+*, )*'*6*(8 KOH '/(*d, /(+"*)*( *#)/r(*),4 *(+ *(+ '$d*6 d,*#,&*%,&*( d,*#,&*%,&*( d*( %*6 $()$& /(+"*)*(8 /4/& %*',(+ ',(,'*#8 d*( '$r*6
5;
. Te Te!a !api pi Sist Sistem emi$ i$
Cimetidine "r*# "r*# )/#*6 )/#*6 '/($( '/($($&& $&&*( *( &/%$&%/ &/%$&%/%*( %*( A(*#,%, A(*#,%,%% d*r, d*r, Cochra Cochrane ne databa database se '/($($&& '/($($&&*( *( 6*(* 6*(* #,'* )/r*, *(+ *(+ /r&$*#,)*% /r&$*#,)*% ),(++,8 d,)/'$&*( 6*%,# ),d*& *d* %*)$$( ,()/r/(%, *(+ '/*&,(&*( /4/&),4,)*% d*r, /(+"*)*( '"#$%&$' &"()*+,"%$' K/*(*&*( *%,/( '/',#,6 /(+"*)*( <*()6*r,d,( )",&*# %/* d,r*%*&*( *#,(+ /4/&),4 d*( ),d*& %*&,) S*&,)8 /(++$(**( *(*%)/%, )",&*# d**) '/(+6,#*(+&*( r*%* %*&,) 1;
). Tinda$an
P/(+"*)*( P/(+"*)*( &"(/(%,"( &"(/(%,"(*#8 *#8 *,)$ *,)$ &$r/)*%/ &$r/)*%/ d*( &r,)")/r* &r,)")/r*,8 ,8 '/%&, '/%&,$ $( ( &/d$ &/d$** /(+ /(+" "*) *)*( *( ,(, ,(, '/' '/'/r, /r, r*%* r*%* %*&,) %*&,)88 /(+ /(++$ +$(* (**( *( *(*%)/%, )",&*# d**) '/(+6,#*(+&*( r*%* %*&,) 1;
8
Gama! * Te!api Mol#s$#m Kontagios#m
D,&$), d*r, &/$%)*&**( 1
DA+TA, PUSTAKA
9
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10
