teaching bangsal i - tinea cruris (1)

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Isriyanti Silonde C 111 11 350Winda Merlysa Allorerung C 111 11 115

Anggisani Syawal A C 111 11 102

Nur Izzati Nabila Suriali C 111 11 858

Azrin Nurfarain !ainal Abidin C 111 11 8"3

Nurul Nadia Ari#n C 111 11 85$

Mod %adzley &a'ar C 111 11 833

Mua((ad Sya(il )ozlan C 111 11 81*

Mi+dad (od suberi C 111 11 82,

-a.z -azwan C 111 11 88*

BAGIAN ILMU KESEHATAN KULIT DAN KELAMIN

FAKULTAS KEDOKTERAN

UNIVERSITAS HASANUDDIN

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PATIENT’S IDENTITYPATIENT’S IDENTITY

   Name : Dian Ayu Prai!i

  Re"#r$ N#% : &'()*(+,

  A-e : .+ year/ #0$

  Maria0 Sau/ : Sin-0e

  A$mi//i#n : (

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ANAMNESISANAMNESIS

  12ie3 1#m40ain: B0a"5 4a"2 #n 2e ri-2(0e3

 6u#"5 an$ 6a"5 #3 2i-2

  Anamne/i/

S2e 2a$ e74erien"e$ i /in"e a6#u !# !ee5/ a-#%Iniia00y8 i a44eare$ #n 2e ri-2 6u#"5% T2en /4rea$ #

2e 0e3 6u#"5 an$ 6a"5 #3 2e 2i-2% Paien’/ "2ie3

"#m40ain i/ 2e a44earan"e #3 60a"5 4a"2 a""#m4anie$

 6y "#m40ain/ #3 i"2in-8 n# 4ain an$ n# num6ne//%

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1URRENT STATUS1URRENT STATUS

(16 November 2015) Genera0 1#n$ii#n : Mi0$

 A!arene// : 1#m4#/ meni/

  Nurii#na0 Sau/ : G##$

 Hy-iene : G##$

 Via0 Si-n/ ( BP : ).9,9 mmH-

( Pu0/e: ,.7minue

( RR : .; 7minue( Tem4: '*%& <1

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-ead / Nor(oeal efor(ities / 4

Sy((etrial fae/ 6eft 7 )igt-air/ Straigt ard re9o:ed

 eye / <:sotal(us=<notal(us / 4=4 (o9e(ent /Nor(al

eye>s lid/ <de(a alebra 4

Con?unti9a / Ane(is 4 on?unti9a In?etious 4Slera / Iterus 4 @uil / Iso:or 25 ((= 25 ((

 ear / Boi / 4 earing /Nor(al

  Serete 4

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Nose / <istais 4 Serete / 4

 Mout / li / dry 4 Bonsil / B14B1-yere(esis 4

teets/ Caries dents 4 %aring / -yere(esis 4

Du(/ bleeding 4 tongue / witis 4 iere(esis 4 

ne: / 6y( nodes/ No enlarge(ent  Byroid/ No enlarge(ent  ES/ ) F 1 (-2G  Hlood 9essels/ Nor(al

 Sti' ne:/ 4

 Bu(or / 4

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Cest / Insetion/ Sy((etrial left 7 rigt

  %or(/ Nor(oest sy((etrial left and rigt  Bere does not aear 9ene:tasi

 Ma((ary = S/ Nor(al  ICS/ Sy((etrial left 7 rigt widened i(ression 4

  Gter 4@ul(onary / Insetion/ e9elo(ent of sy((etrial rigt andleft est

 isneu 4 taynea 4 est retration 4

 @alation/ %re(itus on?eture/ Sy((etrial left 7rigt Benderness/ 4 @erussion/ 6eft 6ung/ Sonor rigt lung/ Sonor

  6ung4li9er li(its/ ICS EI anterior detra  )igt beind lung boundary/ As ig CE

 B J detra @ul(onary left rear boundary/ As ig CE B

JI sinistraAusultation/ Be sound of breating/ EesiularAdditional sound/ ron:i 4 = 4 Weezing 4 = 4

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Car / Insetion/ Itus ordis does not aear @alation/ Itus ordis was not alable te trill 4 @erussion/ dull -eart uer li(it/ ICS III sinistra)igt eart border/ 6inea arasternalis detra ICS IE6eft eart border/ 6inea (idla9iularis te left ICS EAusultation/ H& I = II/ @ure regularadditional sound/ Noise 4

Sto(a Insetion/ %lat follow te (otion of breat Ausultation/ nor(al eristalsis i(ression @alation/ tu(or (ass 4 tenderness 4 6i9er/ Not alable  Sleen/ No alable Kidney/ Hallote(ent 4 @erussion/ Bi(ani F

Denitals / Not ea(ined

 Be anus and retu(/ )etal touer/ Not aliable

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Ha:s / Insetion/ Motion breat sy((etrialleft 7 rigt :yosis 4 lordosis 4

soliosis 4@alation/ %re(itus on?eture/

Sy((etrial left 7 rigt

Massa tu(or 4 tenderness 4 @erussion/6i(it lung rigt beind/ As ig CE B Jdetra left beind lung 6i(it/ As ig CE B@ain of word sinistra JI/ 4

Ausultation/ Eesiular ron:i 4 = 4

Weezing 4 = 4

<tre(ities/ wit in nor(al range

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DERMATOLOGI1AL STATUSDERMATOLOGI1AL STATUS  L#"ai#n: Re-i# G0ueu/ $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n 40a>ue

!i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%  L#"ai#n : 2i-28 4#/eri#r $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n8

/"a0in-8 er#/i#n

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PATIENT’S PHOTO1st DAY 

Ma"u0a 2y4er4i-menai#n 40a>ue !i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%

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Ma"u0a 2y4er4i-menai#n8 /"a0in-8 er#/i#n

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1URRENT STATUS1URRENT STATUS

(17 November 2015) Genera0 1#n$ii#n : Mi0$

 A!arene// : 1#m4#/ meni/

  Nurii#na0 Sau/ : G##$

 Hy-iene : G##$

 Via0 Si-n/ ( BP : ))9&9 mmH-

( Pu0/e: ,.7minue

( RR : .* 7minue( Tem4: '*%+ <1

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DERMATOLOGI1AL STATUSDERMATOLOGI1AL STATUS  L#"ai#n: Re-i# G0ueu/ $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n 40a>ue

!i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%  L#"ai#n : 2i-28 4#/eri#r $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n8

/"a0in-8 er#/i#n

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PATIENT’S PHOTO2nd DAY 

Ma"u0a 2y4er4i-menai#n 40a>ue !i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%

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Ma"u0a 2y4er4i-menai#n8 /"a0in-8 er#/i#n

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1URRENT STATUS1URRENT STATUS

(18 November 2015) Genera0 1#n$ii#n : Mi0$

 A!arene// : 1#m4#/ meni/

  Nurii#na0 Sau/ : G##$

 Hy-iene : G##$

 Via0 Si-n/ ( BP : ).9&9 mmH-

( Pu0/e: ,97minue

( RR : .; 7minue( Tem4: '*%* <1

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DERMATOLOGI1AL STATUSDERMATOLOGI1AL STATUS  L#"ai#n: Re-i# G0ueu/ $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n 40a>ue

!i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%  L#"ai#n : 2i-28 4#/eri#r $e7ra e /ini/ra

  Si=e : Variai#n

  E330#re/"en"e : Ma"u0a 2y4er4i-menai#n8

/"a0in-8 er#/i#n

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PATIENT’S PHOTO3rd DAY 

Ma"u0a 2y4er4i-menai#n 40a>ue !i2 rai/e$ e$-e/8 ery2ema#u/ 4a4u0e/8 /"a0in-

er#/i#n8 e7"#riai#n%

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Ma"u0a 2y4er4i-menai#n8 /"a0in-8 er#/i#n

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DIAGNOSISDIAGNOSIS

  Tinea 1ruri/

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DIFFERENTIAL DIAGNOSISDIFFERENTIAL DIAGNOSIS

1an$i$ia/i/P/#ria/i/ Tinea 1ruri/

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TREATMENTTREATMENT?)* N#@em6er .9)+

 Ora0

  Ke#5#na=#0e a6 .99m-.;2#ur#ra0

Ta5e i in 2e m#rnin-8 2e 0a4/e #3 . 2#ur/ 3r#m a3er

a5in- #2er $ru-/% Ta5e i #n an em4y /#ma"2 T#4i"a0

○ Sa0i"y0i" a"i$ 'C

○ Mi"#na=#0e "r .9-r 

a440y !i"e a $ay8 m#rnin- an$ e@enin-

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Treamen 3r#m Inerna0 Me$i"ine

$e4armen?)* N#@em6er .9)+ L#! /a0 $ie

 O. '0ier minue

 Ome4ra=#0e .9 m-).2#ur#ra0  N(A"e .99m-).2#ur#ra0

 Am0#$i4ine +-.;2#ur#ra0

Para"eam#0 +99m-,2#ur#ra0 Rim/ar ; FD1 'a60e.;2#ur#ra0

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RESUMERESUME

A 4aien8 !#men8 .+ year #0$ "ame # 2e RSS!i2 60a"5 4a"2 #n 2er ri-2(0e3 6u#"5 an$ 6a"5

#3 2i-2 "#m40ain% S2e 2a$ e74erien"e$ i /in"e

a6#u !# !ee5/ a-#% Iniia00y8 i a44eare$ #n 2e

ri-2 6u#"5% T2en /4rea$ # 2e 0e3 6u#"5 an$

 6a"5 #3 2e 2i-2% Paien’/ "2ie3 "#m40ain i/ 2e

a44earan"e #3 60a"5 4a"2 a""#m4anie$ 6y

"#m40ain/ #3 i"2in-8 n# 4ain an$ n# num6ne//%

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   Binea ruris is a der(atoyte infetion of teinguinal region in artiular te inner asets ofte uer tigs and rural folds wit ossibleetension onto te abdo(en and butto:s in(ore se9ere ase

  Wile tinea ruris ours worldwide li:e (ostoter de(atoyte infetions it is (oreo((on in troial en9iron(ents

   Be tree (ost o((on ausati9e agents are

<ider(oyton Loosu( B rubru( and B(entagroytes

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   Be disease our in (en and wo(enbut it is (u (ore often seen in (en forse9eral reason/ te srotu( enourages a

war( and (oist en9iron(ent and tineaedis and onyo(yosis are bot (oreo((on in (an

  Gter redisosing fators inlude

obesity and eessi9e ersiration Binearuris is fre+uently assoiated wit Bineaedis beause loting tat is brougto9er te feet is onta(inated and ten

o(es in ontat wit s:in in te groinregion

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   Binea ruris is alled (yosis suer.sialor eze(a (arginatu( double it

 ?o:ey it ring wor( of te groin wilassify under aute = roni

der(ato.tosis grou  S:in lesions (ay be li(ited to te

region = area genitorural alone oretends to te area around te anus

te area under gluteus and lowerabdo(inal or oter art of body

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er(atoyte sread all o9er te worldand beo(e a roble( eseially inde9eloing ountries Binea ruris tineaedis and tinea ororis is

der(atoytosis wi (ost found InIndonesia der(atoytosis is 52 ofte entire er(ato(yosis tinea rurisand tinea ororis are (ost

der(atoytosis found

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 Be ri(ary ause of tinea ruris are Brioyton rubru( *0 and<ider(oyton Luosu( Brioyton (entagroytes $

 Brioyton tonsurans , In Westernountries <ider(oyton Loosu( iste (ost o((on der(atoytes

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  S:in disorder tat aears to be ade(arated lesions inLa((ation ofte edge (ore 9isible tan in te(iddle area If tis beo(es a roni

disease an be a bla: sot wit littlesales <rosion and disarge isusually due to srating

  @rediletion lae in te groinerineu( and around te anus

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 Binea ruris on its ru(  Bere are sarlyde(arated eryte(atousla+ues in te groin and

ubi area

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KG- Culture

istoatology

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i'erential iagnosis

)% Kan$i$#/i/.% P/#ria/i/

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   Boial anti4fungal Bolylat 1 4 lotion

rea(

-alorogin

I(inazole grous

(i:onazoleloti(azole 1:eto:onazole

Allia(in grous terbina.ne

butena.ne

  Syste(i anti4fungiDriseoful9in/ 104

15(g=:gHW=day

adults 200 O 1000single dose

Keto:onazole 1 200(g = 3 wee:s

Itra:onazole / 1 100(g = 2 wee:s

 Berbina.n/ 1 1 = 2wee:s

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  @re9ent ot Binea Cruris re4infetion Breat all ati9e areas of tinea ruris

infetion si(ultaneously

eduation

  ietWeigtloss for atient wo obese and

a9e Binea Cruris

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  @rognosis is good if roer diagnosisand regular treat(ent

  )eurrene an our wen te area ofrediletion u(idity is not

(aintained

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