Referat Miliaria Affan Buku FKUI

DAFTAR ISI

DAFTAR DAFTAR ISI................... ISI.................................. ............................. ............................. .............................. ............................. ............................. ..................................... ...................... 1 PENDAHULU PENDAHULUAN...... AN.................... ............................. ............................. ............................. .............................. ............................. .............................. ................ ........... 2 TINJAUAN TINJAUAN PUSTAK PUSTAKA........... A......................... ............................. .............................. ............................. ............................. ............................. ............................ .............. 3 A.

Definisi.... Definisi................... ............................. ............................. .............................. ............................. ............................. .............................. ..............................3 ...............3

B.

Sinonim..... Sinonim.................... ............................. ............................. ............................. ............................. .............................. ........................................... ............................ 3

C.

Etiopto!e Etiopto!enesis nesis.............. ............................. ............................. ............................. .............................. ............................. ............................. .......................3 ........3

D.

"nifests "nifests K#inis....... K#inis...................... ............................. ............................. .............................. ............................. ............................. ...........................$ ............$ 1.

"i#i%i "i#i%i K%ist#in K%ist#in &S'(min). &S'(min)............... ............................. .............................. ............................. ................................. ................... $

2.

"i#i%i R' R'*% & prickly+  prickly+heat )........................ )...................................... ............................. .............................. ............................, .............,

E.

"i#i%i "i#i%i P%of'n(...... P%of'n(.................... ............................. .............................. ............................. ............................. ..................................... ...................... .......... -

F.

Di!nosis Di!nosis (n Di!nosi Di!nosiss Bn(in!....... Bn(in!...................... ............................. ............................. ............................. .............................. ................  1.

"i#i% "i#i%i i K%ist K%ist#in #in... ....... ........ ......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... ............. ................. ................. .......... ..

2.

"i#i% "i#i%i i R'*%.. R'*%....... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... ............ ............... ................. ...............11 ......11

3.

"i#i%i "i#i%i P%of'n(........ P%of'n(....................... .............................. ............................. ............................. .............................. ..............................11 ...............11

/.

Komp#i0s Komp#i0si.......... i........................ ............................. ............................. ............................. .............................. .............................................. ............................... 11

H.

Te%pi. Te%pi................ ............................. ............................. .............................. ............................. ............................. .............................. ............................. ................... .....11 11

I.

P%o!no P%o!nosis sis..... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... ......... ......... ............ ...............12 ........12

DAFTAR DAFTAR PUSTAK PUSTAKA........ A...................... ............................. ............................. ............................. .............................. ............................. ................................. ................... 13

PENDAHULUAN

"i#i%i me%'p0n pen0it t' 0e#inn n! *eni!n (n se%in! te%(i p( 0on(isi  pns se%t 0e#em**n n! tin!!i se%t 0on(isi n! mene**0n 0e%in!t *e%#e*i4n.

1

Bn0 0s's n! t%nsien (n psien *isn men5%i pen!o*tn 4n 'nt'0  men!o*ti %s !t#. Ti(0 (i0en# (n p%e(isposisi se0s'# m'p'n %s p( pen0it ini. Se%in!0#i te%(i p( neontes (en!n (n %i6t pns pem0in se#im't t' p0in te*# n! (in!!p se*!i pen5et's mi#i%i. P( 'si (e6s se%in! (i4'*'n!0n (en!n imo*i#issi t' o#4%! *e%t. Be*e%p st'(i men'n'0n o%n! Asi men(e%it #e*i4 se(i0it mi#i%i (%i p( 0'#it p'ti4.

TINJAUAN PUSTAKA A. Definisi

2

"i#i%i (#4 0e#inn 0'#it *e%'p e%'psi pp'#o7esi0'#% m'#tip#e non7o#i0'#% 1+3 mm n! (ise**0n o#e4 0e#'%n 0e%in!t e0%in 0e epi(e%mis t' (e%mis 0i*t  pe54n ('0t's 0e#en% 0e%in!t e0%in n! te%s'm*t. B. Sinonim

Bin! 0e%in!t 0e%in!t *'ntet #i0en t%opi0's t'  prickly heat. C. Etiopatogenesis

Te#4 (i0et4'n o#e4 *n0 pene#iti *46 *#o0 me0ni0 o#e4 0e%toti0+p#'! (%i mse%si st%t'm 0o%ne'm 0i*t 0e%in!t n! *e%#e*i4n se*!i ptofisio#o!i p%ime%. "te%i 0e%toti0+p#'! n! me%'p0n pene** p%ime% (i (#m 0%osi%in!i'm 0e#en%  e0%in te%se*'t men'n'0n  periodic acid-schiff &PAS) n! positif (n (istse %esisten n! *e%s# (%i coil secretory 0e#en% e0%in. A( n! men!t0n *46 mi#i%i (#4 infe0si's 0%en (n pe%n *0te%i 0'#it se*!i !en pene**. S't' st'(i men'n'0n in(i7i(' (en!n mi#i%i t' 4i(%si n! *e%#e*i4n p( st%t'm 0o%ne'mn memp'ni (ensits o%!nisme %esi(en ti! 0#i #e*i4 *n0 te%'tm stfi#o0o0's 0o!'#se ne!tif. Den!n (n

tem'n+tem'n

te%se*'t

(i*'t post'#si

*46

stfi#o0o0's

epi(e%mi(is men!4si#0n mte%i# PAS+ positive extracellular polysaccharide substance &EPS) n! *e%sift #en!0et (n #e0t n! mem*#o0 ('0t's 0e#en% e0%in t' stfi#o0o0's epi(e%mi(is men!e#'%0n to0sin n! me%'s0 ('0t's 0e#en% e0%in (n epite# 0e#en%  e0%in men!e#'%0n mte%i !#i0op%otein n! PAS+ positive (n mem*#o0 ('0t's. Bi# 0on(isi #em** (n pns t' 0ti7its *e%#e*i4n 0n me%n!sn! 0e#en% te%'s men!4si#0n 0e%in!t n! *e%#e*i4n. A0n tetpi (n ('5t#+*#o50!e mene**0n 0e%in!t 0e#'% (%i ('0t's 0e epi(e%mis t' (e%mis (n mene**0n p%oses inf#msi. D. Manifestas Kinis

Be%(s%0n #et0 s'm*tnn (i (#m s#'%n 0e#en% e0%in !m*%n 0#inis mi#i%i (i*!i men(i 3 !%'p 8

!. Miia"ia K"istaina #S$%amina& 3

Lesi s'pe%fisi# *e%'p 7esi0e# s'*0o%ne# n! e%ni4 m'(4 pe54 (n simtomti0 0%en #e54 0e*o5o%nn (i st%t'm 0o%ne'm. Dpt *e%0o#esensi (n ti(0 te%(i p%oses inf#msi. Bisn te%(i p( neont's &'si $ min!!') 6#'p'n  pe%n4 (i#epo%0n 3 0s's (en!n mi#i%i 0%ist#in. Ci%n 7esi0e# n! men(i t'%*i( (ise*'t mi#i%i p'st'#os. P( peme%i0sn 4istopto#o!i te%#i4t 7esi0e# int% t' s'*0o%ne# n!  *e%4'*'n!n (en!n ('0t's 0e#en% e0%in tnp ( se# inf#msi (i se0it%n.

/m*% 1 8 "i#i%i 0%ist#in '. Miia"ia R$("a # prickly)heat &

"i#i%i enis ini s'm*tnn te%(i (i #pisn (#m epi(e%mis 0e%in!tn  *e%mi!%si 0e #pisn epi(e%mis t' (e%mis se4in!! menim*'#0n %e0si inf#msi. Lesi (itn(i (en!n m0'# t' pp'# e%itemtos &1+$ mm) (en!n 7esi0e# p'n0tt (itsn (n e0st%fo#i0'#e%. P( 0s's n! #e*i4 #'s (n 0%onis #esi (pt men(i  p'st'#e. "i#i%i %'*% (ise%ti 0e#'4n %s pns t' pe%i4 (n !t#. P( peme%i0sn 4istopto#o!i te%#i4t (n spon!iosis (n 7esi0e# spon!ioti0  (#m st%t'm m#pi!i n! *e%4'*'n!n (en!n ('0t's 0e#en% e0%in. Ditem'0n inf#msi pe%i('0t#.

4

/m*% 2 8 "i#i%i %'*% E. Miia"ia P"of$n%a

S'm*tn te%#et0 (#m se4in!! 0e*o5o%n 0e%in!t te%(i (i ppi## (e%mis. A0i*tnm tim*'# #esi pp'# n! 9 flesh+colored : mi%ip  goose-flesh  &0'#it *e#i*is). Lesi te%(pt (i (e%4 *(n #e4e% (n (e%4 #iptn. Bisn te%(i p( *i 'si 1 t4'n 6#'p'n '! (pt te%(i p( o%n! (e6s sete#4 men!#mi 0e%in!t *e%#e*i4n (i #in!0'n!n n! pns (n #em**. E%'psi (pt men!4i#n! t' *e%0'%n! sete#4  pen(e%it *e%( 0em*#i (i #in!0'n!n n! se'0. E%'psi mi#i%i p%of'n( #e*i4 t%nsien (%ip( mi#i%i %'*%. Bisn *e%t4n 0'%n! (%i 1 m sete#4 0e(n pns n!  *e%#e*i4n te%04i%. "i#i%i p%of'n( 5en(e%'n! te%*ts (i n!!ot *(n e0st%emits (n  *e%4'*'n!n (en!n 4ipe%4i(%osis t' n4i(%osis. Sein!0#i ( 0ompenssi 4ipe%4i(%osis (i fsi# (n 0si# n! %e#tif ti(0 (is(%i o#e4 pen(e%t. Ke%in!t n! ti(0 0e#'%  (pt mene**0m 4ipe%pi%e0si (n !e# heat-exhaustion *e%'p 0e#emt4n 0e#e#4n  p'sin! (n smpi 0o#ps. /e# ini se%in! te%(i p( tent% n! *e%t'!s (i i0#im t%opis se4in!! (i0e#n# (en!n isti#4 tropical anhidrotic asthenia . "i#i%i p%of'n( #e*i4 se%in! te%(i p( 'si (e6s (i*n(in!0n *i (n n0.

5

/m*% 3 8 "i#i%i p%of'n( Peme%i0sn 4istopto#o!i (%i #esi 6# (item'0n infi#t%te #imfo(it pe%i('0t# (#m  ppi## (e%mis (n epi(e%mis *!in *64. Te%#i4t (n PAS ; diastase eosinophilic cast  (#m #'men ('0t's. P( #esi #n't te%(i spon!iosis sep't% epi(e%mis (n  p%0e%toti0 4pe%0e%tosis 0%os%in!i'm. Se# inf#msi (i tem'0n (i (e%mis *!in  *64 (n te%(pt #imfosit (i (#m ('0t's e0%in.

/m*% $ 8 Pe%*e(n s0emti0 mi#i%i 0%ist#in %'*% (n p%of'n(. 6

F. Diagnosis %an Diagnosis Ban%ing !

Miia"ia K"istaina

Di!nosis mi#i%i (ite!0n 5'0'p (ite!00n (en!n menifestsi t' !m*%n 0#inis (en!n (i!nos *n(in! i mpeti!o *'#os. .

Pen(4'#'n Impeti!o *'#os impeti!o 7esi0o+*'#os t' 55% monet (#4 s#4

st' enis pio(e%m. Pio(e%m i#4 pen0it 0'#it n! (ise**0n o#e4 Stp4#o5o55's St%epto5o55's t' o#e4 0e('+('n. Se(n!0n impeti!o  *'#os sen(i%i (ise**0n Stp4#o5o55's '%e's.  *. F0to% P%e(isposisi 1) Hi!iene n! 0'%n!. 2) "en'%'nn ( t4n. "is#n8 0e0'%n!n !i
/e# K#inis Ke(n 'm'm ti(0 (ipen!%'4i. Tempt p%e(i0si (i 0si# ((

 p'n!!'n!. Se%in! *e%sm+sm mi#i%i. Te%(pt p( n0 (n o%n! (e6s. Ke#inn 0'#it *e%'p e%item *'# (n *'# 4ipopion. K(n! 0(n! 60t'  pen(e%it (tn! *e%o*t 7esi0e# *'# te#4 meme54 se4in!! n! tmp0  4n 0o#e%et (n (s%n msi4 e%itemtos. Ji0 7esi0e#=*'# te#4 pe54 (n 4n te%(pt 0o#e%et (n e%item m0 mi%ip

(e%mtofitosis.

P(

nmnesis

4en(0n

(itn0n

se*e#'mn te%(pt #ep'4. Ji0 ( (i!nosisn i#4 impeti!o *'#os.

7

p04

(. Pen!o*tn Ji0 te%(pt 4n *e*e%p 7esi0e#=*'# (ipe540n ##' (i*e%i s#p nti*ioti5 t' 5i%n ntisepti0. K#' *n0 (i*e%i p'# nti*ioti0 sistemi0. F0to% p%e(isposisi (i5%i i0 0%en *n0 0e%in!t 7enti#si (ipe%*i0i. 1) Sistemi0  Be%*!i o*t (pt (i!'n0n se*!i pen!o*tn pio(e%m. Be%i0't ini (ise*'t0n 5onto4+5onto4n ) Penisi#in / p%o0in (n semisinteti0n •

Penisi##in / p%o0in. Dosis 12 't pe% 4%i i.m. >*t ini ti(0  (ip0i #!i 0%en ti(0 p%0tis (i*e%i0n im. (en!n (osis tin!!i (n m0in se%in! te%(i so0 nfi#0t0ti0.

•

Ampisi#in. Dosis $ ? ,@@ m! (i*e%i0n sem se*e#'m m0n.

•

Amo0sisi#in. Dosis sm (en!n mpisi#in 0e'nt'n!n #e*i4 p%0tis 0%en (pt (i*e%i0n sete#4 m0n. J'! 5ept (i*so%*si (i*n(in!0n (en!n mpisi#in se4in!! 0onsent%si (#m p#sm #e*i4 tin!!i.

•

/o#on!n o*t penisi#in %esisten penisi#nse. n! te%ms'0  !o#on!n ini 5onto4n8 o0ssi#in

0#o0ssi#in

(i0#o0ssi#in

f#'0#o0ssi#in. Dosis 0#o0ssi#in 3 ? 2,@ m! pe% 4%i se*e#'m m0n. /o#on!n o*t ini memp'ni 0e#e*i4n 0%en '!  *e%04sit *!i Stp4#o5o55's '%e's n! te#4 mem*ent'0   penisi#inse.  *) Lin0omisin (n 0#in(misin Dosis #in0omisin 3 ? ,@@ m! se4%i. K#in+(misin (i*so%*si #e*i4 *i0  0%en it' (osisn #e*i4 0e5i# 0ni $ ? 1,@ m! se4%i pe% o%#. P( infe0si *e%t (osisn $ ? 3@@+$,@ m! se4%i. >*t ini efe0tif 'nt'0   pio(e%m (i smpin! !o#on!n o*t penisi#in %esisten penisi#inse. Efe0 

8

smpin! n! (ise*'t (i 0ep'st0n *e%'p 5o#itis pse'(omem*%nos  *e#'m pe%n4 pen'#is tem'0n. Lin0omisin ti(0 (in'%0n #!i (n (i!nti (en!n 0#in(misin 0%en potensi nti*0te%i#n #e*i4 *es% efe0  smpin! #e*i4 se(i0it p( pem*e%in pe% o%# ti(0 te%##' (i4m*t o#e4 (n m0nn (#m #m*'n!. 5) E%it%omisin. Dosisn $ ? ,@@ m! se4%i pe% o%#. Efe0ti7itsn 0'%n! (i*n(in!0n (en!n #in0omisin=0#in(misin (n o*t !o#on!n penisi#in %esisten+penisi#inse >*t ini 5ept mene**0n %esistensi. Se%in! mem*e%i %s t0 en0 (i #m*'n!. () Sef#ospo%in P( pio(e%m n! *e%t t' n! ti(0 mem*e%i %espons (en!n o*t+o*t te%se*'t (i ts (pt (i!'n0n sef#ospo%in. A( empt !ene%si n! *e%04sit 'nt'0 0'mn positif+!%m i#4 !ene%si # '! !ene%si I. Conto4n sef(%o0si# (%i !ene%si I (en!n (osis 'nt'0 o%n! (e6s 2? ,@@ m! t' 2?1@@@ m! se4%i 2) Topi0# Be%m5m+m5m o*t topi0# (pt (i!'n0n 'nt'0 pen!o*tn  pio(e%m. >*t topi0# Antimi5%o*i# n! ti(0 (ip0i se5% sistemi0 !% 0e#0 ti(0 te%(i %esistensi (n 4ipe%sensiti7its 5onto4n i#4 *sit%sin neomisin (n m'pi%osin. Neomisin '! *e%04sit 'nt'0 0'mn ne!tif /%m. Neomisin n! (i ne!e%i *%t (i0t0n se%in! mene**0n sensitsi men'%'t  pen!#mn pen'#is %n! te%i(i. Te%misin (n 0#o%mfeni0o# ti(0  efe0tif *n0 (i!'n0n 0%en 4%!n m'%4 >*t+o*t te%se*'t  *e%*ent'0 s#p t' 0%im. Se*!i o*t topi0# '! 0omp%es te%*'0 5onto4n8 #%'tn  pe%mn!ns 0#i0's 1=,@@@. L%'tn %i7no# 1 (n o(i'm po7i(on , n! (i#%'t0n 1@ 0#i. n! te%04i% ini #e*i4 efe0tif 4n p( se*!in

9

0e5i# men!#mi sensitissi 0%en o(i'm. Ri7no# memp'ni 0e0'%n!n 0%en men!oto%i 0in.

*. Miia"ia R$("a

Di!nosis *n(in! mi#i%i %'*% (#4 e%item to0si0'm neoneto%'m &ETN). Lesi men!eni (( p'n!!'n! 64 e0st%emits p%o0sim# se%t te#p0 tn!n (n 00i. Ke#inn ini tim*'# p( 4%i 0e+3 t' 0e+$ smpi 4%i 0e+1$ 0e4i('pn ti(0  meme%#'0n te%pi 0%en p( 'si 2 min!!' 0n men!#mi %eso#'si spontn. J'! (i(i!nosis *n(in! (en!n fo#i0'#itis (n 0ne infnti#. ETN me%'p0n 0on(isi i(iopti0 n! se%in! te%(i (item'0n p( 4mpi% ,@+,  *i 5'0'p *'#n (n %n! te%(i p( *i 0'%n! *'#n. Pene** ETN ti(0 (i0et4'i. T%'m me0nis t' 0e#4i%n 5'0'p *'#n (i('! se*!i f0to% etio#o!i. F0to% !eneti0 #in!0'n!n t' %s m'n!0in memi#i0i pe%n p( etio#o!i. Lesi p( ETN (pt mene%'pi pio(e%m 0n(i(osis 4e%pes simp#e? T%nsient Neont# P'st'#% "e#nosis &TNP") (n mi#i%i tpi (pt (i*e(0n o#e4 0%0te%isti0 infi#t%t eosinofi# (n ti(0  (n o%!nisme p( pe6%nn. K'#t'% *0te%i (n m'% (%i #esi se%t pe6%nn /%m 0n mem*nt' 'nt'0 mem*e(0n ETN (en!n 0e#inn 0'#it n! #inn. Pe%#nn  pen0it ETN e#s (n ti(0 ( te%pi n! (i*'t'40n. +. Miia"ia P"of$n%a

Di!nosis *n(in! mi#i%i p%of'n( (#4 pop'#% m'sinosis n! *e%'p pp'#  *e%*ent'0 0'*4 (is0%et se6%n 0'#it (n (en!n (imete% 2+$ mm. Um'mn 0e#inn ini men!eni o%n! (e6s p( 'si 3@+@ t4'n. Ke#inn ini #e*i4 se%in! te%(pt (i (o%s# tn!n (n %i+%i t'n!0i *64 #ipt 0si# (n *4'. ,. Kompi-asi

Komp#i0si n! se%in! te%(i p( mi#i%i (#4 infe0si se0'n(e% (n heat  intolerance. Infe0si se0'n(e% se*!i impeti!o t' *ses m'#tip#e n! (is0%et. Um'mn heat intolerance *e%0em*n! p( psien (en!n mi#i%i p%of'n( (n (#m *ent'0 *e%t n! (i0en# se*!i tropical anhidrotic asthenia. H. Te"api

10

T''n pen!o*tn p( mi#i%i (#4 men!4i#n!0n !e# (n men5e!4 te%(in 4ipe%pi%e0si (n !e# heat exhaustion. Den!n (emi0in (en!n (emi0in 4%'s (i4in(%i 4#+4# n! mene**0n te%s'm*tn m'% 0e#en% 0e%in!t e0%in. "is#n men!ont%o# pns (n 0e#em**n se%t pem*tsn 0ti7its te%'tm p( '(% pns se4in!! ti(0 me%n!sn! 0e#'%n 0e%in!t regular showering  mem0i p0in n! #on!!% t' p0in tipis n! mene%p 0e%in!t *e%( (i #in!0'n!n n! (in!in !%  ti(0 tim*'# 0e%in!t n! *e%#e*i4n (n 4in(%i pem0in o*t topi5# n! heavy cream t' powder. Dpt (i*e%i #osio n! men!n('n! 0#min sm *o%t t' ment4o#. P( neont's (in'%0n mem0i  superabsorbent disposable diaper  n! men!n('n! !e# *so%*en. Unt'0 mi#i%i 0%ist#in ti(0 pe%#' (i!'n0n pen!o*tn. H# ini (ise**0n 0on(isi it' simtomti0 (n (pt sem*'4 sen(i%i. Unt'0 mi#i%i %'*% (pt (i*e%i0n 0%im t' #osio 0#o%4e0si(in (en!n t' tnp si('m s#si#i0'm 1 3 0#i se4%i. Unt'0 0s's (en!n !t# *e%t (i*e%i0n topi5# 0o%ti0oste%oi( &*etmetson @1 2 0#i se4%i se#m 3 4%i. cold packs, (n nti4istmin. Ks's (en!n infe0si (pt (i*e%i0n nti*ioti5 topi5# t' sistemi0 'nt'0 stfi#o0o0's. Unt'0 mi#i%i p%of'n( (pt (i*e%i0n n4(%o's #no#in (n isot%etinoin. I.

P"ognosis

Ke*n0n psien (en!n (en!n mi#i%i mem*i0 (#m *e*e%p min!!' sete#4  *e%( (#m #in!0'n!n n! se'0.

11

DAFTAR PUSTAKA

1. /o#(smit4 LA. Diso%(e% of t4e E55%ine S6et /#n(s 8 "i#i%i. In 8 /o#(smit4 LA Kt< S# /i#54e%est BA P##e% AS Leffe# DJ o#ff K e(ito%. Fit
NA

i#son

BB.

"i##i%i.

2@@

Jn

2,.

A7i#*#e

f%om

8

4ttp8==666.eme(i5ine.5om=(e%m=topi52--.4tm 3. "o6( C" "5/in#e KJ Fo!#i A Le(en JJ. T4e %o#e of e?t%5e##'#%   po#s554%i(e s'*stn5e p%o('5e( * Stp4#o5o55's epi(e%mi(is in mi#i%i. J Am A5( De%mto#. 1GG,83382G+33.

12